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DoxyPEP Treatment Guide

Instructions

You have stated that you wish to obtain treatment with Doxycycline for post-exposure prophylaxis from a recent episode of unprotected intercourse to reduce the risk of acquiring chlamydia, gonorrhea, and syphilis. This medication is Doxycycline Hyclate 100mg tablets which you are to take 2 tablets by mouth within 24 hours of your exposure but no later than 72 hours after condomless sex. You should drink at least 5 oz of water with your treatment and stay upright and not lay down for 30 minutes after administering. Current data shows that Doxycycline Post Exposure Prophylaxis can reduce chlamydia, gonorrhea, and syphilis from 62-66% in patients assigned male at birth.

DoxyPEP doesn’t protect against Monkeypox, HIV, herpes, or other viral infections. At this time, there is insufficient evidence to recommend DoxyPEP for STD prevention for individuals who report receptive vaginal sex. The CDC has endorsed DoxyPEP for preventing bacterial STIs as an STD prevention strategy. Current efficacy data on DoxyPEP applies to gay and bisexual cisgender men and transgender women. Research on DoxyPEP conducted with cisgender women is ongoing, per the CDC. The Department of Public Health in California (DPH) has recommended the use of this regimen for high-risk individuals, and many Infectious Disease Clinics have already started prescribing it.

Considering the potential impact of this treatment and the low risk associated with a single dose of Doxycycline, Wisp has made the decision to offer this treatment to all patients, regardless of sex. Wisp’s commitment to advocacy for women’s health and people with uteruses along with access to treatment drove this decision. We will continue to monitor data from ongoing studies to guide treatment and to continue providing safety.

Allergies

Do not take Doxycycline if you are pregnant or breastfeeding. This medicine, like all medications, may cause an allergic reaction if you are allergic to similar medicines or components. If you are allergic to any of the following please do not take the medicine and call or message us or see your doctor in person.

  • Tetracyclines (Minocycline, Tetracycline)

Conditions

We have evaluated your health history and the specific health information you provided us, however if anything changes and you develop one of these conditions, please stop taking this medicine and call or message us immediately.

  • Pregnancy
  • Myasthenia Gravis
  • Oesophagitis (inflammation of your esophagus)

Pregnancy and Breastfeeding

Based on available data, Doxycycline is not considered acceptable or safe for use in pregnancy.

Examination of current literature indicates there is no likely harm in short term use of Doxycycline with breastfeeding as milk levels are low and absorption by the infant is inhibited by the calcium in breastmilk. As a precautionary measure prolonged (more than 21 days) or repeat courses while breastfeeding should be avoided.

Medicines, Supplements, and Foods

We have evaluated the specific health information you provided us, however if you are taking any of the medicines, foods, or supplements listed below call or message us before you take the medicine. Some of these can cause dangerous interactions with the medicine we are prescribing you and we will help you evaluate that risk and decide on an appropriate treatment plan. Please ensure your chart is up to date with your current medications, allergies, and medical conditions so your provider can safely treat you as this list may not be all inclusive.

  • Dairy (should avoid for 2 hours after treatment)
  • Antacids (should avoid for 2 hours after treatment)
  • Multivitamins (should avoid for 2 hours after treatment)
  • Anticoagulants (Warfarin)
  • Penicillins
  • Barbiturates
  • Antiepileptic medications (Carbamazepine, Phenytoin)
  • Isotretinoin
  • Rifampin

Emergency Side Effects

This medicine can cause dangerous and potentially life-threatening side effects. If any of the emergency side effects listed in the manufacturer’s pamphlet or those below happen to you please stop taking the medicine and call 911 or seek immediate medical help in person.

  • Sudden onset of chest pain
  • Shortness of breath
  • Difficulty or painful swallowing
  • Severe skin rash and/or itching
  • Facial or throat swelling
  • Blurred vision
  • Severe bloody diarrhea

Other Side Effects

This medicine can also cause other side effects, including:

  • Sun sensitivity (be sure to wear SPF while taking this medication)
  • Skin hyperpigmentation
  • Abdominal discomfort
  • Diarrhea
  • Vaginal yeast infections
  • Nausea and vomiting

Accurate Information

We have evaluated your health history and your specific health information you provided and determined it is safe to proceed with oral Doxycycline Hycalate at this time. If your health history changes including diagnoses or medications please message or call us before you take the medicine to ensure it's safe to proceed. Some medications and conditions can cause dangerous interactions with the medicine we are prescribing and we will help you evaluate that risk and decide on an appropriate treatment plan.

Treatment Failure

This treatment is not guaranteed to be effective. It may not work or may only partially resolve the condition for which you are seeking treatment. If the treatment is not working, or if you are experiencing new or worsening symptoms, give us a call or message us anytime. If it is an emergency, call 911 or seek immediate medical help in person. You may need to seek alternative treatment such as those listed below or in the follow up plan.

Misdiagnosis or Delayed Diagnosis

Through telehealth, there is also a risk that we misdiagnose or fail to diagnose conditions that you may have which could affect our recommendation for treatment. This risk exists with a doctor in person as well but they may have additional resources to aid their evaluation. We use evidence-based practice and guidelines as well as clinical decision-making to minimize these risks.

Accepting or Declining Our Recommendation

We have based our recommendation on your specific case and medical guidelines, but there may be alternative treatments or strategies that may be helpful to you. Some may be more or less effective than what we provide. Some treatments may require an in-person exam or procedure which we can’t provide. Message us or talk to your doctor in person to discuss alternative treatments.

Share with Your In-Person Healthcare Team

You can access your records anytime. We strongly recommend that you update your in-person doctor, pharmacist, and the rest of your healthcare team to let them know about any new medicines you are taking or other changes in your health.

You can also ask us questions anytime and we are happy to help you share any information about your health with your in-person healthcare team.