Everything You Need to
Know About DoxyPEP
for STD Prevention

Written by Kathleen Morrison
Medically Reviewed by Dr. Shannon Chatham, DO, a healthcare provider affiliated with Wisp

We don’t love everything about the times we live in. But modern advancements in STD and STI treatment? That’s something we can’t imagine living without. Gone are the days of silently suffering through itching, burning, and overall discomfort—something we are all grateful for!

But, besides treating infections once they happen, did you know there’s also a pill that can help prevent certain STDs and STIs? Meet DoxyPEP, a prescription antibiotic that can reduce your risk of chlamydia, gonorrhea, and syphilis if taken 24 to 72 hours after an unprotected sexual encounter (think of it as the morning-after pill but for STIs!). Here’s what you need to know.

What is DoxyPEP?

DoxyPEP is short for doxycycline post-exposure prophylaxis. That medical jargon might sound intimidating, so let’s dive into the details! Doxycycline is a long-standing antibiotic used to treat bacterial infections in different parts of the body—think: chest, dental, and skin infections, and STIs, too. This antibiotic treats infections by killing bacteria or stopping them from growing, spreading, and messing up your day.

The “post-exposure” part of doxycycline PEP is a little more self-explanatory! It refers to when you’re taking the medication, in this case after potential exposure to an STD. We can do our best to come prepared with an overnight bag—filled with condoms, lube, cleanup wipes, and the works – but unprotected sex still happens, and that’s okay! DoxyPEP has your back if you think you’ve been exposed to an STD.

The last technical bit here, “prophylaxis” refers to taking action to prevent a disease. Fun fact: prophylaxis comes from the Greek word phalax, meaning “guard.” So we like to imagine DoxyPEP in action as a cute little pill wearing a helmet and a shield, working hard to keep you safe.

Put it all back together, and doxycycline post-exposure prophylaxis is your prescription antibiotic best friend for guarding against pesky bacterial STIs. Not so intimidating at all!

What is DoxyPEP used for?

Alright, now that our vocabulary lesson is finished, we can focus on the good stuff—like what does DoxyPEP do, anyway? We’re oh-so-glad you asked!

DoxyPEP is used to help prevent bacterial STDs and STIs after having unprotected sex.

(And by unprotected sex, we mean oral, anal, and vaginal or front-hole sex where condoms or dental dams weren’t used during the entire event, so skin-to-skin contact was made and fluids were exchanged.)

So, we’ve covered that DoxyPEP is an antibiotic for some STDs. That means it can reduce your risk of chlamydia, gonorrhea, and syphilis.

What DoxyPEP doesn’t do is reduce the risk of viral infections—think herpes, HIV, or hepatitis B. But don’t panic if you think you may have been exposed to a viral infection! Schedule a quick and easy STD consult with one of our licensed medical providers. (No embarrassment, no hassle—just treatment.)

Who should take DoxyPEP?

It’s easy to get excited after hearing about the potential benefits of DoxyPEP, especially if you think you might have recently been exposed to an STI. But before you run (or click!) to the pharmacy, it’s important to know who doxycycline PEP is for, according to the research.

Clinical trials focused on gay, bisexual, and transgender populations and other men who have sex with men have shown DoxyPEP to be an effective STD prevention pill. There have been clinical trials focused on the medication’s effectiveness for cisgender women, but the results were mixed. With all that in mind, here’s who can benefit most from DoxyPEP.

DoxyPEP can be most useful for:

• Transgender women
• Gay and bisexual cisgender men
• Other men who have sex with men
• People in the above groups who can’t or don’t use condoms regularly
• People in the above groups who have had a bacterial STI in the last 12 months

Here at Wisp, we’re committed to increasing access to sexual health services for every person and every body. And, doxycycline has long been prescribed as a low-risk antibiotic for various bacterial infections. For these reasons combined, our providers have made the decision to offer DoxyPEP to all our patients, including cisgender women.

And while we wait for more data around patients assigned female at birth, we’ll continue advocating for increased research around women’s health and we’ll keep you updated if our protocol changes.

How effective is DoxyPEP?

What do you think, does a bacterial STD prevention pill sound too good to be true? We don’t think so! We’re here to give you the quick and exciting details about the effectiveness of doxycycline post-exposure prophylaxis.

Research has shown that taking DoxyPEP as directed by the CDC—within 24-72 hours after unprotected sex—can reduce the possibility of contracting chlamydia by 88%, syphilis by 87%, and gonorrhea by 55%.

As we mentioned, research focused on gay, bisexual, transgender women, and other MSM. This population bears the brunt of STI diagnoses in the US according to the CDC. There were 2.5 million cases of chlamydia, gonorrhea, and syphilis reported in the U.S. in 2022.

Research shows that DoxyPEP can dramatically reduce rates of syphilis, gonorrhea, and chlamydia (amazing!), specifically in more at-risk populations (incredible!). This antibiotic is a powerful new advancement in sexual healthcare, but it’s still only one tool in our giant toolbox of bacterial STD prevention and treatment strategies. Regular STI testing, condoms and dental dams, and abstinence are tried and true methods of keeping you safe and sexy.

How often can you take DoxyPEP?

First things first, remember that the sooner you take DoxyPEP after unprotected sex, the better! Like the morning-after pill for pregnancy, the effectiveness of doxycycline as an antibiotic for bacterial STDs depends on timing. Let’s take a closer look at some important info about doxycycline post-exposure prophylaxis!

Things to keep in mind when taking DoxyPEP:

• The prescribed DoxyPEP dose is two 100 mg tablets within 72 hours (three days) of condomless sex
• DoxyPEP is most effective if taken within 24 hours after unprotected intercourse
• While it’s safe to take daily, don’t take more than 200 mg every 24 hours
• Taking DoxyPEP with a glass of water and food will help you avoid potential side effects like upset stomach and headache
• Don’t take DoxyPEP right before bed and wait at least 30 minutes before lying down to avoid esophagitis
• Don’t take DoxyPEP with dairy, calcium, antacids, or isotretinoin
• DoxyPEP can make you more sensitive to the sun, so make sure you wear sunscreen

One more thing! There’s a current public health concern about antibiotic and antimicrobial resistance. This resistance happens when infection-causing bacteria change their genes so the usual antibiotics no longer kill them. So far, the bacteria that cause syphilis and chlamydia have not shown any adaptations or resistance to doxycycline—meaning DoxyPEP remains a great strategy in STI prevention! However, about 25% of bacteria that cause gonorrhea in the US were already resistant to doxycycline, even before DoxyPEP was used as a bacterial STD prevention pill. This has the potential to limit DoxyPEP’s effectiveness against gonorrhea, but doxycycline is still considered a useful option in overall bacterial STI prevention.

Is DoxyPEP safe and effective?

The CDC has endorsed DoxyPEP for preventing bacterial STIs as an STD prevention strategy. Current efficacy data on DoxyPEP applies to gay, bisexual, transgender women, and other MSM. Weighing the potential benefits of DoxyPEP against the low risk associated with a single dose of doxycycline, Wisp believes it’s important for all our patients to have access to this new preventative care.

How do I get DoxyPEP?

Order DoxyPEP online for one-time treatment and your prescription will be prescribed within 24 hours*. You can also order extended treatment options for up to 30 treatments for 3 months to pick up at your local pharmacy or have shipped.

At Wisp, we’re glad to be offering new, innovative sexual healthcare so you can go on living your happiest, healthiest lives. We’ll keep you posted if the science around doxycycline changes or if there are any updates to the DoxyPEP regimen. Until then, we’re committed to providing your healthcare, on your time.

*Most prescriptions are sent to your pharmacy within 3 hours of completing your medical intake form and phone call or video chat when necessary. Pending retail pharmacy hours.

This blog post is for informational and educational purposes only and should not be taken as professional advice. Always consult with a qualified professional before making any decisions based on the information provided here.