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Short term and long term side effects of PrEP

PrEP, or pre-exposure prophylaxis, is used to prevent HIV infections. It includes the use of antiretroviral medications. If you are HIV-negative but at a high risk of getting HIV infections, then PrEP can help you in reducing the risk of getting HIV. Truvada and Descovy are two FDA-approved medications for PrEP treatment. A combination of two drugs in a single oral tablet is used to formulate these medications. If taken correctly, PrEP medications are quite safe and effective to prevent HIV infections.     

You can take control of your health and protect yourself from getting HIV infections by using PrEP. Like other medications, you may be a little doubtful about using PrEP medication. Questions like Is PrEP safe? Or does PrEP have side effects? might bother you.

But don’t worry and continue reading to understand more about the safety of PrEP, including the possible side effects. 

Is there any side effect of PrEP?

Almost all medications have some possible side effects. It is all about balancing the side effects and benefits. Every human body can react to a drug differently. Nevertheless, side effects of PrEP aren’t experienced by most individuals. Even if they do, these side effects are quite tolerable. As per studies, PrEP side effects are reversible and don’t lead to any severe disease. 

The FDA prescribing information has noted three common PrEP side effects. In a survey of over 10,000 people, only 2% experienced headaches, abdominal pain, and weight loss. Nausea, vomiting, and gastrointestinal problems happened to only 3.8% of people who took PrEP. The other cases of side effects include 2.4% for kidney problems and 1.7% for bone problems. In clinical trials, very few people experienced these side effects.

It is important to note that all problems reported during clinical trials aren’t associated with PrEP side effects. Various other factors like pre-existing diseases and medicine interactions can also lead to certain side effects. There may be a misunderstanding in the public that side effects lead to severe cases of Kidney or bone toxicity. However, there is a possibility that most people who experience these side effects might already have issues related to Kidney or bone density before taking PrEP. 

Most young and healthy individuals never experience any side effects of PrEP. As happens with most prescription medicines, people with age 50 or above are more prone to side effects. Still, the FDA and CDC have prescribed certain limits for patients who can take PrEP. You must tell your doctor about any pre-existing disease or other medications being taken before starting PrEP. You should also report any side effects if experienced.

What are the most common side effects of PrEP?

Generally notice side effects of PrEP are as follows:

  • Nausea
  • Vomiting
  • Headache
  • Stomach or abdominal pain
  • Diarrhea
  • Tiredness or fatigue
  • Depression and anxiety
  • Loss of appetite 
  • Weight changes (weight gain or weight loss)
  • Trouble sleeping 

The most known side effects are headache, abdominal pain, and weight loss. Gastrointestinal issues like bloating, gas, and constipation, may also be experienced with PrEP. Some side effects like dizziness, depression, and rash may be more often seen in people who use Truvada for HIV treatment instead of PrEP. 

Short-term side effects of PrEP

The chances of experiencing short terms side effects are more when you first start taking PrEP medication. This is known as the start-up period and usually occurs in the first few weeks. Short-term side effects are easy to tolerate and go away in a few weeks.

Short-term side effects of PrEP can include nausea, abdominal pain, vomiting, headache, and fatigue. These side effects are generally gone without stopping PrEP treatment. However, you must consult a doctor if the severity of PrEP side effects increases. It might be advised to take the PrEP tablet with meals or get another over-the-counter drug to reduce the side effects. 

Long-term side effects of PrEP

It is very uncommon to experience any long-term side effects of PrEP. As you continue taking PrEP medication, your body gets auto-adjusted and consequently, you don’t experience any side effects. In some cases, side effects may arise over a period of time. Still, only a few people tend to experience any long-term side effects. Risk factors leading to side effects are age, duration of PrEP intake, kidney function, and potential drug interactions. 

In special cases, liver health can be affected by PrEP. The liver may tend to become large, tender, and fatty (steatosis). Another known long-term side effect is kidney problems. PrEP medicines may tend to decrease the kidneys’ filtering capacity because they stay in the bloodstream for a long period of time. Therefore, your doctor can decrease the dosage of your tablet. Another long-term side effect can be a loss of bone density. In some individuals, there may be a risk of developing bone fractures. However, studies suggest that bone density loss is reversible and mild.  

The medicines that are used for PrEP have a difference in composition and subsequent effects. Truvada may cause side effects like kidney issues or bone density. Since Descovy has very little impact on kidney and bone health, these side effects may be less if you take Descovy. However, Descovy can be more likely to increase cholesterol levels. In comparison, Truvada may lead to a decrease in cholesterol levels. 

The risk of kidney and bone issues is higher if you get positive for HIV. HIV-positive individuals may experience more health issues and a higher risk of side effects from the use of multiple antiretroviral medications.

Is PrEP treatment 100% safe?

PrEP is quite a safe and well-tolerated treatment for preventing HIV infections. Some people might feel afraid of taking PrEP because of the stigma related to its side effects. Nevertheless, PrEP is globally recognized for its effectiveness and benefits.

Your health care provider will evaluate if you are eligible to take PrEP or not.  However, PrEP demands a commitment to the schedule of taking regular pills for the best benefits. If we consider the benefit-risk ratio of PrEP, it seems to be quite favorable.

An active HIV infection may become resistant to the drug if taken alone, hence it is important to get tested before taking PrEP. However, PrEP does prevent HIV but not other sexually transmitted diseases. It is strongly advised to practice safe sex by using condoms along with PrEP medication to ensure full protection from any sexually transmitted diseases.

Being a method of pre-exposure prophylaxis, only HIV-negative people are supposed to take PrEP.  PrEP stops HIV from attacking your body’s immune system. If taken daily, the amount of drugs in the bloodstream is sufficient enough to stop the virus from reproducing and hence block pathways that cause infection. 

However, you can also take PrEP through other methods like on-demand PrEP or event-based PrEP. It may be safe and effective to take the periodic PrEP dosage. Some people may choose to take event-based PrEP if they are afraid of the side effects of daily dosing. 

Some individuals may also decide to stop taking PrEP due to various specific reasons. You can stop taking PrEP temporarily or permanently if:

  • You are at low risk of getting HIV due to a change in your lifestyle.
  • You often tend to forget to take the pill.
  • You have a concern about the PrEP cost and its availability.
  • It is difficult for you to manage or tolerate the side effects.
  • The medication causes some sort of allergy or you are sensitive to it.

You should get another HIV test before starting PrEP again. You are not fit to take PrEP again if you become HIV positive in the last 72 hours after stopping PrEP.

If in case you miss a dose, you should take the tablet immediately when you recall. However, if it’s time for the next dose, you should skip the missed dose of PrEP. Never take a double dose to make up for the missed dose of PrEP. A single missed dose of PrEP will not significantly impact the effectiveness of PrEP. But if you frequently forget to take your tablet then the risk of HIV infection may increase.

You get maximum protection during anal sex after taking PrEP contineously for 7 days. In the case of vaginal sex and injection drug use, you get maximum protection after taking PrEP tablets regularly for about 21 days.

Bottom line
For people at high risk of HIV infection, the benefits of PrEP treatment overweigh its side effects. The effectiveness of PrEP medication if taken as prescribed, is about 90%. PrEP side effects are tolerable and they tend to go away with consistent dosing. More data keeps coming out regarding the safety and effectiveness of taking PrEP, particularly with different dosing schedules.

PrEP medication is effective in preventing HIV and provides full control of sexual health to an individual. PrEP is beyond the traditional barrier methods and provides freedom to individuals so that they can enjoy a life free from the risk of HIV infection. You feel a sense of security that you are protected from HIV. The best side effect of PrEP is the freedom of choice and your peace of mind.

Get affordable PrEP medication

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For how long do PrEP side effects last?

Short-term side effects may occur in the very first week of use and will eventually go away after a few weeks or a month of taking the medication. Usually, there is no need to stop taking PrEP tablets to get rid of the side effects. 

Nausea usually goes away after the first few weeks, and infrequent diarrhea may tend to stop after three to four weeks. Some people experience that taking a PrEP tablet with meals eases gastrointestinal side effects. Other side effects may tend to disappear within a few weeks to a month. Your doctor can also advise over-the-counter medicines to help in reducing the side effects. 

You should inform your healthcare provider before stopping the PrEP medication. Certain risks are involved with stopping the medication abruptly. Your doctor will understand your conditions and complaints to evaluate if there is a need to stop the PrEP mediation. Your doctor will also conduct a test for hepatitis B infection (HBV) before stopping PrEP. Stopping PrEP can worsen an active hepatitis B infection (HBV).

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