How does PrEP work?
PrEP contains the two antiretroviral drugs, emtricitabine and tenofovir, which are also used to treat those that already have HIV. However, in PrEP, the dosages are different.
The two medicines work together in the body to fight off HIV before it has chance to establish in your cells and multiply. This essentially kills the virus and allows you to stay HIV-negative.
Someone that may have contracted HIV without PrEP will stay HIV-negative whilst taking PrEP over 90% of the time, making it an extremely successful method of prevention, especially if you have a lot of unprotected sex with people of an unknown HIV status.
PrEP medication can’t treat HIV – it can only prevent it. If you think you may already have HIV, please visit your nearest sexual health clinic for testing, as effective treatments are available.
What’s the difference between PrEP and Truvada?
PrEP is the name of the treatment in general, whilst Truvada is a brand of PrEP medication. Generic versions of Truvada are available, and are usually just referred to as PrEP.
There’s no real difference between generic PrEP and the branded version, Truvada. Both types contain the same amounts of the same drugs, and will work in an identical way in your body. Whilst other ingredients might vary, such as colourings for example, the mechanism and effectiveness of the medicines are exactly the same
The main difference between Truvada and generic PrEP medication is the price. Generic PrEP can be bought from £49.99 for 30 pills, whilst the same amount of branded Truvada costs much, much more.
What does PrEP cost?
Doctor4U is passionate about making PrEP accessible for those that need it, especially when places on the impact trial are so limited. At the moment, the cost of PrEP from us is as follows:
• 30 tablets - £49.99 • 60 tablets - £89.99 • 90 tablets - £139.99 • 180 tablets - £259.99
We’re currently the only UK-based and MHRA-regulated online prescribing service that can offer these prices.
PrEP is unfortunately fairly difficult to access through the NHS in England, as many of those in need are being turned away from the nation’s impact trial on the basis that there aren’t any spaces left. This isn’t as much of an issue in Scotland, Wales, and Northern Ireland who are offering PrEP medication in uncapped trials to anyone that needs it.
Unfortunately, if you haven’t managed to secure a place on the impact trial in England, your only other option is to source a private prescription. Whilst we’ve done what we can to make the drug accessible, we understand that there will still be people that aren’t in the position to fund their own prescriptions each month. Luckily, the Terrence Higgins Trust (THT) who partner with www.iwantprepnow.co.uk have the Mags Portman PrEP Access Fund, which if you’re eligible for, can provide you with up to three months’ worth of PrEP at a time. To see if you’re eligible, click here to visit the Mags Portman Access to PrEP page on the THT website.
There are actually several ways to take PrEP, it just depends on your lifestyle and how often you have sex as to which method is most suitable for you. However, the most common Truvada dosage is to take one tablet per day. This method is the most studied and is over 90% effective at preventing HIV. If you have sex regularly, either with people that have HIV, or of an unknown HIV status, this is most likely to be the best method for you. In this case, 30 tablets should last you a month, on average.
Other ways to take PrEP include:
The on-demand method.
Many people choose this method if they don’t have sex regularly. If you’re expecting to have sex on a certain day, it’s recommended for you to take 2 tablets 2-24 hours before intercourse, another tablet 24 hours after the first dose, and one more tablet 24 hours after that. We’ve marked an example on this calendar to show you:
The Ts & Ss method:
This method is usually recommended if you only have sex a couple of times a month. Rather than taking Truvada every day, the idea is that you only take 4 tablets a week. To make it easy to remember, it’s been dubbed the Ts and Ss method with the suggestion of only taking it on days beginning with T or S, so Tuesday, Thursday, Saturday and Sunday.
The Holiday Method:
The holiday method is for those that don’t usually have unprotected sex with people that have a positive or unknown HIV status, but suspect that they might do over a certain period, i.e holidays or festivals. It’s recommended that you start taking one tablet of PrEP medication per day starting 7 days before your holiday (or, time period where you expect to be having unprotected sex). You should continue taking one tablet each day during this time, and for 7 days afterwards. We’ve created an example to explain it:
How is it taken?
It’s recommended that you swallow PrEP with a glass of water, and take it with food wherever possible.
If you find it difficult to swallow pills, you can crush the tablets between two spoons, and mix the powder into 100ml of water, making sure to drink it immediately.
If you forget a dose, and its more than 12 hours until your next dose is due, you can take the missed dose. If your next tablet is due in less than 12 hours, skip the forgotten one and take the next dose as normal. Don’t take two tablets to make up for a forgotten one.
If you vomit within an hour of taking your tablet, you will need to take another one as soon as you’re able to in order to stay protected. If you vomit after an hour, you shouldn’t need to take another dose.
Does Truvada protect you straight away?
No. Clinical trials have shown that PrEP takes between 4-7 days to reach its full potential in your system, so it’s a good idea to use barrier methods until then to make sure you’re protected against HIV.
Side effects of PrEP
Most people that take PrEP for HIV prevention don’t usually notice any side effects. However, a small amount of people do.
Side effects are symptoms that are caused by taking a medicine, and some of the most common side effects of Truvada and generic PrEP include:
- Abdominal pain
- Joint pain
- Sleep disturbances
- Strange dreams
- Back pain
If you do experience some side effects, they may begin to improve after your body has gotten sued to the PrEP medication. However, if the symptoms are too much for you to cope with, you should make an appointment to see your doctor to discuss other options. Whilst there aren’t any other drugs that can prevent HIV, your GP will be able to suggest other methods of protection such as condoms and diaphragms.
If you notice signs of a severe allergic reaction (anaphylaxis) such as swelling of the throat, tongue, and face, difficulty breathing, and wheezing, you should call 999 as soon as possible.
With most people, the benefits of Truvada outweigh the side effects.
Do I need a prescription for PrEP?
Yes. Truvada and generic versions of PrEP medication are prescription-only medicines (POMs). This means that you’ll need a prescription from a GMC-registered doctor or prescriber in order to obtain it.
As PrEP isn’t routinely available on the NHS, it’s unlikely that your own GP would be able to help you with a prescription. However, there are alternative options for you to access it.
Doctor4U is able to provide you with a prescription for generic Truvada once you’ve completed a consultation for PrEP on our website. One of our GMC-registered prescribing doctors will review your answers, and if they feel that the medication is safe for you, they’ll approve your request and generate an electronic prescription. This is completely safe and legal, and the fact that we’re regulated by the MHRA and regularly inspected should hopefully put your mind at ease.
If you want to buy PrEP online through Doctor4U, it’s just like visiting a private doctor, with the difference of being able to complete a consultation 24/7 at a time that suits you.
How is my order shipped to me?
When an order is ready for shipping, it is collected and delivered by either the Royal Mail or DPD depending on your preference (or possibly your location or the item you ordered). Each order is assigned a tracking number, which will be emailed to you at the time of dispatch. Your medicine will be sent in plain and discreet packaging that’s eco-friendly. We do not include any branding on our packaging nor any labels which inform readers what type of product is contained within.
Advice on Addiction and Medication Restrictions
If you are at all worried or concerned about an addiction to any type of medication, we urge you to speak to a professional for help and advice. Below are links to organisations that can help.
Talk To Frank
NHS Help & Advice On Drug Addiction