DoxyPEP every time?

[JockstrapBottom]

15 hours ago, RealCute said:

As most of my hookups are later in the evening to the early morning. I go to sleep and when I wake up, then I take them which might be 6 to 8 Hours afterwards, sometimes a little longer..   I always make sure I'm going to be vertical, not laying down after taking them seems to help with stomach issues..

 

Thank you! I've waited almost 24 hours to take a dose,  earlier this week it was 2-3 hours after a session. I just wondered if there was an ideal timing within the 24 hours (or is 2-3 hours too soon?). I have the same problem with feeling very nauseated about 45 mins after taking the dose. I try to time it so I'll be up and walking around. My provider also said I could take it with a bit of food as long as I avoid dairy, magnesium, etc.

[BootmanLA]

FWIW: I am, or will be, new to DoxyPEP as my sexual activity level (since it was introduced) hasn't justified it. But I'll be making a visit to a much more "active" climate soon, so I decided to broach the topic with my HIV doctor. I was a little hesitant as his practice is owned by AHF, which was downright negative about PrEP at first and very cautious about DoxyPEP. But to my pleasant surprise he said immediately it was a good thing, and wrote a prescription on the spot for me. I don't know whether or not I'll actually need it, but I'm very pleased it's going to be an option.

[KylerIsTrash]

I don’t take PEP after every hookup. It’s usually when I’ve been to the bathhouse (10-20 loads) or fucked with more than 3 guys in a 72 hour window. Some weekends I’ll binge fuck with a train of guys then not at all for months. It’s worked so far for me. There’s still the option for treatment if I ever catch something. 

[partying.hard]

2 minutes ago, KylerIsTrash said:

… when I’ve been to the bathhouse (10-20 loads) or fucked with more than 3 guys in a 72 hour window. Some weekends I’ll binge fuck with a train of guys …

When I grow up, I want to be just like Kyle.  😈

[PozToxVersPig]

Every four weeks I get an alert from the pharmacy saying that I have a prescription to pick up.  (All my other ones are mail order).  So I go and I pick it up and it's another DoxyPrep prescription from my doctor --- she prescribes it as often as insurance will cover it.  Cracks me up.  I have a full drawer full of it and my slut friends call me every once in a while and ask "hey...uh...do you have any more doxyprep?"

Come to think of it after this last week I should probably down some....

[fuckholedc]

Is DoxyPep available everywhere in the US now?  My Gay doctor has not mentioned it to me but he works for a very restrictive health care conglomerate.

[PozToxVersPig]

I think it is.  It's just doxycycline in a high dose I believe.  It's super cheap.  You should be able to get it prescribed by anyone and available at any pharmacy.

[BootmanLA]

5 minutes ago, fuckholedc said:

Is DoxyPep available everywhere in the US now?  My Gay doctor has not mentioned it to me but he works for a very restrictive health care conglomerate.

From a legal perspective, yes - it's a very long-established antibiotic approved by the FDA.

That said, use as post-exposure prophylaxis (PEP) for sexually transmitted infections (STI) is what's classified as an "off-label" use. For those who want the longer explanation, read on; the short version is that use as PEP may not be covered by insurance.

The longer version: the FDA approves drugs for use, and they also regulate the labels on those drugs, including a section called "indications". These are the conditions or diseases which the FDA has decided are reasonable uses for the medication in question. And indications can be rather loose and generic, or very tightly controlled. So Drug A's approved label may list, in its indications section, that it's intended for use for treating conditions B and C. 

That doesn't mean it's illegal to prescribe the medication for condition D or E - it just means that an insurance company may not approve payment for A for a patient with D or E, because treating D or E is considered "off-label". 

For example, ivermectin is a drug many of us became familiar with during the pandemic. It's a medication that has a formulation approved by the FDA for treating infections caused by certain parasitic worms, specifically Strongyloidiasis and Onchocerciasis. Treatment of those two infections with ivermectin is, thus, an "on-label" use - one that's blessed by the FDA - and that's usually, though not always, enough to trigger coverage under most insurance policies.

I say "usually" because some insurers cover what's called "step therapy", where the least expensive medication that is indicated for a condition has to be tried first. That way, doctors aren't always prescribing the newest and most expensive medications as soon as they become available when something tried-and-true may work just as well. In addition, insurers often put newer and more expensive medications on a "prior approval" list, meaning that the prescriber must request permission from the insurer to prescribe the particular medication and provide the reason it's preferred over a less expensive alternative. (Insurers do recognize that there are sometimes good reasons for this - for instance, the patient may have a documented allergy to one of the components of a less pricey drug, or the less pricey drug may have proven ineffective in a previous bout of treatment - but they want to be sure doctors aren't always shooting for the newest and flashiest thing. And sometimes insurers are just dicks who want to force people to go the cheap route as long as possible even if it's not effective.)

Anyway: COVID-19 was not an "on-label" indication for ivermectin, and there's really no reason it should work, since it's an anti-parasitical and COVID is caused by a coronavirus. And in fact, there was never any valid* medical evidence that it worked for COVID at all. (People took it, recovered from COVID, and gave credit to the drug when in fact most people who caught COVID recovered even without treatment. The few studies that showed it might work turned out to have been largely faked.) It was still perfectly legal for doctors to prescribe it for COVID, but by and large insurers wouldn't cover it, especially once the limited positive evidence turned out to be fraudulent.

Technically, DoxyPEP is in that same boat - it's not an approved indication, although there are efforts being made to get approval in place (the FDA issued clinical guidelines in June of this year, which is often a precursor step to approving the indication). But because Doxycycline is routinely prescribed anyway, especially for treatment of STIs, it's pretty easy for a cooperative doctor to prescribe it, officially for an STI, and insurance isn't going to bat at eye at it, especially since it's a pretty cheap antibiotic. 

[sindiktas]

Has anyone of you tried using Doxy PEP every day when you went away for a slutty holiday week?

[sindiktas]

I've been on sexual holiday, took Doxy PEP daily, but now I still have yellow discharge (possibly chlamydia).

[JockstrapBottom]

On 9/14/2024 at 6:49 AM, sindiktas said:

Has anyone of you tried using Doxy PEP every day when you went away for a slutty holiday week?

The instructions that came with mine are maximum DoxyPEP of 3x per week if playing daily

[BootmanLA]

Bearing in mind that DoxyPEP is an off-label usage, the CDC *has* (this summer) issued a recommendation for clinical guidelines for use of doxycycline for DoxyPEP.

Those guidelines call for taking 200 mg of Doxycycline within 72 hours of potential initial exposure, limited to 200 mg every 24 hours.

 I interpret that to mean that taking it daily, as long as it's AT LEAST 24 hours between doses - NOT doing one at 4 PM and then the next day at 9 AM - is within the clinical guidelines, if not within the specific recommendations of any particular physician.

Bear in mind that some physicians may not grasp fully the notion of having unprotected sex with different guys every day for a week on vacation - that is, they may *know* it happens, but not realize *you* are one of the people doing it. 

Bear in mind also that when used to *treat* an STI, a lower does (100 mg) is often prescribed for twice a day dosing for ten days, and that's an on-label, approved dosage. So 200 mg a day over ten days isn't necessarily a bad thing.