Prep And Erection Pills

[subbitch33]

I am on PrEP... and just purchased some Spedra (avanafil) online.

 

In the instructions it says not to take with any type of HIV medications, although I can't find the reason why anywhere online.

 

Does anyone here who is on PrEP take any erection pills (Viagra, Spedra, Cialis?)

 

Does anyone know why they cannot be taken with PrEP meds?
 

[MedicalMetsFan]

I use Viagra and Truvada. No issues, and they're prescribed by the same physician and filled at the same pharmacy.

[HereInLondon]

I've used Kamagra a couple of times since going on PrEP, never had any issues.

I've mentioned using it when they're taking down details as part of my 'sexual health screens/ PrEP check-ups' and none of the clinicians have ever warned against it.

[subbitch33]

How odd, its definitely on the instructions for use with Avanafil (Spedra).

 

Maybe it is just unique to Avanafil - the active ingredient in Viagra/Kamagra and Cialis are different.

[bearbandit]

Checking through Avanafil's site the caution is against protease inhibitors, which are always (in the UK at least) prescribed with ritonavir. Ritonavir is also a protease inhibitor and used to be used by itself in much larger doses than now (I used to take 800mg a day, as opposed to the 100mg per day commonly used today). When it was prescribed at the larger dose we saw a number of deaths as a result of using E's. It was discovered that ritonavir pre-empts the enzyme in the liver that processes a number of drugs, including ED drugs of the same family as avanafil. Its use now is to act as a booster so that lower doses of other protease inhibitors can be used as the ritonavir delays their being processed through the liver.

Neither tenofovir nor embitricitabine (the components of truvada) are on the caution list on the website. I suspect they've just been lazy in the preparation of the patient information leaflet... so there's no problem with truvada and avanafil causing problems.

I have a problem with ED because of my diabetes, and gratefully take up the offer of four cialis a month (the Welsh health service is very pro-active in this area). With viagra, though, they only prescribe the 25mg version for people on ritonavir (as I am). When 25mg wasn't enough I started taking one and a half tablets (37.5mg). The last time I tried that I got the full blow of the side-effects, except for blue vision, which is why I'm giving cialis a go. Not that I've had a chance yet (that's a hint guys!)

Thanks for the prompting to do some research: there are more options out there than I was aware of.

[Poz1956]

I'm going to confirm what Bear said.  The caution is about how some medications change how other drugs are metabolized.  The Ritonavir effect slows metabolization, and would lead to much higher doses of the ED drug in the blood.

I think you'll also find Grapefruit Juice on the list of No-No's with ED drugs.  Grapefruit Juice plays with liver enzymes.  I think it's the same one as Ritonavir.  There is a specially designed drug called Cobicistat in the one pill once a day ARV Stribild that ties up the same liver enzyme, without the side effects fo Ritonavir.

 

On the other end of the scale, the NNRTI etravirine (Intelence) increases the rate at which ED drugs are metabolized. (ie It takes the drug out of the system faster.)

[bearbandit]

I'm sorry Poz1956, but when I heard that there was a possibility of cobicistat being made as a stand-alone pill, I checked it out, and about the only side effect it doesn't share with ritonavir is the coppery aftertaste some people get for the first few weeks.

[FJLinNYC]

I use Viagra and Truvada. No issues, and they're prescribed by the same physician and filled at the same pharmacy.

I use both Cialas and Truvada and the same as above.