DoxyPEP: doxycycline after sex

Preventing STDs

Some people take doxycycline after sex. This is called doxyPEP. It reduces the risk of syphilis and chlamydia. You take two doxycycline pills after sex. In the Netherlands, the use of doxyPEP is not recommended.

What is doxyPEP

What is it?

DoxyPEP can be used to reduce the risk of certain STIs. It consists of 200 mg of doxycycline, a commonly used antibiotic. It reduces the risk of syphilis and chlamydia by about 70%. It does not prevent other STIs such as LGV and HIV. DoxyPEP hardly reduces the risk of gonorrhea, but it does contribute to the gonorrhea bacteria becoming resistant to other antibiotics.

Best not to use

Best not to use

It is better not to use doxyPEP. And if you do, use as little as possible. Reasons not to use doxyPEP are:

  • Bacteria in your body can become accustomed to doxycycline. This is called resistance. If you become ill later, doxycycline will no longer work effectively. Unnecessary use of doxycycline can also make other bacteria, such as gonorrhea, resistant to other antibiotics.
  • There may be side effects, such as nausea, diarrhea, vomiting, and sensitivity to light. These side effects are rare. If you use doxycycline for a long time, you may experience intestinal problems or skin complaints.
  • Syphilis, chlamydia, and gonorrhea can be treated effectively with medication
  • If you use doxyPEP, a syphilis test may be less reliable. Sometimes you will need to be retested after a few weeks.
  • DoxyPEP is not effective against the gonorrhea that is active in Europe, chlamydia is not harmful, and syphilis is relatively rare in the Netherlands. Therefore, the positive effect of doxyPEP on your own health is small.

Restricted use

Still want to use doxyPEP?

Use doxyPEP as little as possible. Only use it when you are at high risk of syphilis, namely:

  • After group sex or a sex party where condoms are not used
  • After sex with multiple (anonymous) partners in quick succession. For example, in one weekend

How to use doxyPEP

How to use it

Want to use doxyPEP? Here's how to take it:

  • Take 200 milligrams of doxycycline in pill form. This is usually 2 pills
  • Take the pills within 24 hours after sex
  • Make sure you take the pills no later than 72 hours after sex
  • Are you having sex several days in a row? Take doxyPEP as little as possible. For example, if you have sex on Friday, Saturday, and Sunday, take doxyPEP on Sunday after the last sexual encounter
  • Are you having sex more than three days in a row? Then take the pills every 72 hours

Where to get doxyPEP?

Where can you get doxyPEP?

You need a prescription to buy doxyPEP. Dutch doctors do not usually prescribe doxyPEP. However, some will do so if you really want it and are at high risk of contracting syphilis.

You can order doxyPEP online without a prescription. This is not legal, and customs will confiscate the pills if they are inspected. Furthermore, you cannot be sure that the pills will work properly. Do not buy doxycycline from a dealer. You will not know for sure what you are taking.

DoxyPEP and your doctor

DoxyPEP and your doctor

If you are using doxyPEP, it is important to tell your doctor. This is especially important if you are taking antibiotics or being tested for bacterial infections (such as an STI or bacterial pneumonia).

  • Continue to be tested for STIs and HIV every 6 months
  • Also get tested if you have symptoms or if a sexual partner has informed you that they have an STI. Please note: if you are using doxyPEP, it may take longer for syphilis to be detected by a test.

F.A.Q.

Frequently Asked Questions about doxyPEP

  • Not all countries deal with antibiotic resistance in the same way. In the Netherlands, doctors are careful about (unnecessarily) prescribing antibiotics. That is also why there is less antibiotic resistance in the Netherlands than in many other countries. 

  • In the Netherlands and the rest of Europe, doxyPEP does not help prevent gonorrhea. In the US, it does work. How is that possible?

    Gonorrhea in the Netherlands is often already resistant to doxycycline. Therefore, doxyPEP does not work to prevent gonorrhea. The gonorrhea that is most common in the US is not yet resistant to doxycycline. That's why you do see less gonorrhea found in U.S. studies of doxyPEP. Although even there it works mainly against syphilis and chlamydia. Unfortunately, the use of doxycycline also causes gonorrhea to develop greater resistance to the medication used to treat this bacterium.

     

  • No, that is not necessary. Chlamydia is an STI that usually does not cause any symptoms and goes away on its own. That is why it is no longer tested for at the GGDs. Do you have symptoms of chlamydia? Then report this to your doctor, because then testing and treatment does make sense. Read more about chlamydia.

  • It is not known whether doxyPEP is effective against LGV.

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