DoxyPEP review 2 years in: Amazing

[BootmanLA]

Note: DoxyPEP is a health-related concern (naturally) and there's a robust discussion about it in the Health Forum here. I've suggested to the mods that this topic be moved/merged there, but you may want to check out the extensive discussion already on file there.

[BlackDude]

11 minutes ago, Ieatcumholes said:

My prescription has these "qualifiers" on yellow stickers on it:

• It is best to avoid taking this drug at the same time as milk, dairy, or other products with calcium.
• If medication upsets your stomach, take with a modest meal, crackers, or bread.
• Prolonged or excessive exposure to direct and or artificial sunlight SHOULD BE AVOIDED when taking this medication

Hope this helps.

(I didn't include quote marks because everything is in ALL CAPS...)

Thanks I was basically told eat it in an empty stomach, sit up for 30 minutes and dint eat for 1-2 hours. Wicked first two times. Last time was a nightmare 

[PozBearWI]

Indeed @BlackDude not everyone tolerates every antibiotic.  

[norefusal]

first few times was ok. but i think i was taking it after sex just before bed. 

this last time i didn't think to take it till the next am after i woke up. took it on an empty stomach, got nauseous and almost threw up. ate some crackers and it eventually subsided. 

[viking8x6]

If it causes stomach upset, definitely take with food, BUT NOT (as per warning labels quoted by @Ieatcumholes - thanks!) with milk products, antacids, or calcium or magnesium supplements (all of which can interfere with absorption).

Also, take any kind of drugs taken by mouth, medical or otherwise, with plenty of water! Dilute! Dilute! All One God Faith! and all that yada yada... 😉 

[tallslenderguy]

On 5/20/2024 at 1:58 PM, Naruto said:

Does doing this cause any digestive issues?

 

Doxyprep is a trade off.  Discriminate use can prevent getting infected with the result of having to take an even stronger dose of antibiotics to resolve the infection. Indiscriminate and/or long term use of antibiotics has a lengthy list of side effects. 

Doxycycline is a broad spectrum antibiotic. One of the side effects of broad spectrum antibiotics is they also kill beneficial microbes that live in our gut. We have 10x more bacteria cells living in our gut than we have cells that make up our whole body and we live in symbiosis with them.  At this point, science is in the process of working to map the gut microbiome, but the process is just past the infancy stage. What we do know is the gut microbiome  plays a huge part in our overall health. 

The excerpt below is sort of specific to the question asked and from a lengthy article citing a boat load of studies. This is just one tiny out take,  the effects are numerous, i'll link the whole article for those who wanna nerd out and read the whole thing. 

"Broad‐spectrum antibiotics reduce gut microbiota diversity (Dubourg et al., 2014), and as well as killing the pathogen of concern can eradicate beneficial microbes (Blaser, 2011), with deleterious consequences for the host. 

The gut microbiota is responsible for the production of many essential metabolites including SCFAs and amino acids (Mills et al., 2019). Studies have reported that commensal‐produced butyrate and propionate have anti‐inflammatory roles, promoting the generation and differentiation of regulatory T cells (Arpaia et al., 2013; Furusawa et al., 2013), with roles in energy metabolism (den Besten et al., 2013; De Vadder et al., 2014). By impacting the composition of the microbial community, antibiotics also alter microbiota functionality and thus the metabolites produced (Ferrer et al., 2017)."

[think before following links] [think before following links] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8756738/

Edited August 21 by tallslenderguy

[BootmanLA]

I'll do my standard reminder here: it's not DoxyPrEP. It's DoxyPEP.

PrEP means PRE-exposure - something you take on an ongoing basis BEFORE you're exposed to an infectious agent.

PEP means POST-exposure - something you take AFTER being exposed to an infectious agent, to prevent the infection from taking hold.

The concern about gut health, as well as concerns about developing antibiotic resistance, are the reasons why Doxycycline is used for POST exposure medication - it's taken after the fact, to stop the infection from getting a foothold. 

The same terms apply for HIV, by the way. We're very familiar with PrEP for HIV - taken either daily, or in specially timed doses around the time you have sex. But there is also a PEP for HIV - basically, emergency treatment after potential exposure that prevents HIV from establishing a foothold in your system.

Because PrEP for HIV doesn't involve antibiotics, the concerns about resistance isn't there, and it doesn't affect gut health (though it can, as we've discussed extensively elsewhere, affect other organs in some cases). So daily PrEP isn't a problem the way daily DoxyPrEP would be.

Keeping the two (PEP vs PrEP) separate is important.

[tallslenderguy]

1 hour ago, BootmanLA said:

I'll do my standard reminder here: it's not DoxyPrEP. It's DoxyPEP.

PrEP means PRE-exposure - something you take on an ongoing basis BEFORE you're exposed to an infectious agent.

PEP means POST-exposure - something you take AFTER being exposed to an infectious agent, to prevent the infection from taking hold.

The concern about gut health, as well as concerns about developing antibiotic resistance, are the reasons why Doxycycline is used for POST exposure medication - it's taken after the fact, to stop the infection from getting a foothold. 

Thanks for keeping us on the straight and narrow 🙂

Re gut health.. post or pre is not a factor. Antibiotics do not discriminate between whether one takes them before or after sex, either way, broad spectrum antibiotics can have a deleterious effect on gut health because they kill beneficial bacteria as well as killing potential pathogens before they multiply. 

In terms of resistance. Overuse of antibiotics can result in bacterial/pathogen resistance to an antibiotic. Doxypep is presumptive treatment, and there are going to be guys who don't follow the guidelines and will take it indiscriminately. But even if taken according to instruction, it has the potential of facilitating resistance.   It's a numbers game, there's a broad range of pathogens doxycycline is used to treat, if one unknowingly is infected with say a respiratory, or urinary or dental issue that has a bacteria that can currently be treated with doxycycline, that bacteria can develop resistance if the person taking the med is just taking a dose after a night of sex, a dose inadequate to resolve one of the other issues.  

i think the advantages of Doxypep outweigh the disadvantages though. There are other broad spectrum antibiotics that can treat those other issues, and if we could take a big bite out of STI's it would be a huge win. But it's not without a down side.

[BootmanLA]

22 hours ago, tallslenderguy said:

Thanks for keeping us on the straight and narrow 🙂

Re gut health.. post or pre is not a factor. Antibiotics do not discriminate between whether one takes them before or after sex, either way, broad spectrum antibiotics can have a deleterious effect on gut health because they kill beneficial bacteria as well as killing potential pathogens before they multiply. 

In terms of resistance. Overuse of antibiotics can result in bacterial/pathogen resistance to an antibiotic. Doxypep is presumptive treatment, and there are going to be guys who don't follow the guidelines and will take it indiscriminately. But even if taken according to instruction, it has the potential of facilitating resistance.   It's a numbers game, there's a broad range of pathogens doxycycline is used to treat, if one unknowingly is infected with say a respiratory, or urinary or dental issue that has a bacteria that can currently be treated with doxycycline, that bacteria can develop resistance if the person taking the med is just taking a dose after a night of sex, a dose inadequate to resolve one of the other issues.  

i think the advantages of Doxypep outweigh the disadvantages though. There are other broad spectrum antibiotics that can treat those other issues, and if we could take a big bite out of STI's it would be a huge win. But it's not without a down side.

Oh, absolutely true that taking antibiotics before or after doesn't change the effect on gut health. But the point I was (perhaps clumsily) trying to make is that despite "on demand" dosing, PrEP still, for most people, involves taking medication daily even when you're not having sex, and if you do that with antibiotics, you run a much higher risk of messing up your gut fauna because you're taking it on a regular, ongoing basis.

At least taking as PEP, after the fact, means you only take when you potentially need it.