Generic PrEP

What are generic PrEP tablets?

A generic PrEP tablet is a course of HIV drugs designed to lower your risk of getting HIV. It can protect HIV-negative people against the virus. Research shows that Generic PrEP has up to 99% chance of reducing your risk of getting HIV from sexual intercourse. ^[1] It can also reduce your risk of getting the virus from injection drug use by at least 74%. ^[1]

What are generic PrEP tablets prescribed to treat?

It’s prescribed to prevent HIV, a virus that affects the cells in your immune system, which makes it harder for your body to fight off infections and diseases. PrEP helps reduce the chance of infection for people who are at risk. But it’s important to take it correctly to get the most protection from it. Once HIV is unable to make copies of itself or replicate, it dies or it’s cleared by your immune system.

How do generic PrEP tablets work?

The active ingredients in PrEP, emtricitabine and tenofovir, don’t directly kill the virus, instead, they stop the virus from replicating. It does this by disrupting the function of the enzyme that HIV needs to multiply in the body, which ultimately weakens the virus.

Taking PrEP before exposure is key to its effectiveness in blocking HIV from reproducing and whilst it is highly effective it’s important to remember that it isn’t 100% guaranteed. So it’s still crucial to practice safe sex, such as using a condom.

PrEP can be easily confused with PEP (post-exposure prophylaxis), but they are two very different treatments. PEP is used as an emergency measure after being exposed to the virus, rather than as a preventative medication.

How to take generic PrEP tablets

You’ll usually be advised to take PrEP daily:

Take one tablet at the same time each day, preferably with food.

Some clinicians may prescribe PrEP to be taken “on demand”,^[2] but this use is off-label, meaning it’s not described in the patient information leaflet.

If you’re using PrEP on-demand, and you know you might have anal sex without a condom within the next 24 hours:

• Take two tablets 2-24 hours before you have sex.
• After having sex, take one tablet 24 hours later.
• Take one more tablet 24 hours after the second dose.

If you’re having sex for an extended amount of time (so over the course of a few days or a weekend) you should take a pill every 24 hours until you have two days where you’re sex-free.

Taking PrEP on demand is only suitable if you’re having anal sex. So if you’re having vaginal
sex, you should take it on a daily basis. You can take PrEP either daily or on demand if you’re using it for anal sex, though.

How effective are generic PrEP tablets?

If you take it correctly, it’s very effective. More than 90%.^[1] It’s far less effective when you don’t take it as instructed, though. You get maximum protection from HIV for anal sex at around seven days if you’re taking it daily. For vaginal sex and injection drug use, PrEP offers the most protection at approximately 21 days on a daily schedule.

What to do if you forget to take it

It depends on whether you’re having anal sex or vaginal sex.

Having anal sex and taking PrEP daily:
If you’re having anal sex and if you’re taking PrEP daily, missing a dose here and there shouldn’t affect your protection too much. You’ll still have a high level of it. You need to take PrEP at least four days a week for good protection.

If you miss more doses than this, you’re not going to get enough protection from HIV if you’re having sex without a condom. And if you’ve missed more than three doses of PrEP during the week and are having sex without a condom, you may need to take PEP. You should get in touch with a clinician or a healthcare professional immediately in these circumstances.

Using PrEP on demand:
If you’re using PrEP on demand, it’s very important that you don’t miss any doses. If you’ve missed any doses and had sex without a condom or if the condom has broken, you may need to use PEP. If you didn’t take a dose before sex, take twice the amount as soon as you can after sex. You’ll also need to contact a clinician within 72 hours. They can then advise you on whether you should take PEP.

For vaginal sex:
For vaginal sex, you need to take PrEP for at least six days a week to ensure that you get strong protection. If you miss more than one dose in a week, you won’t have protection from HIV if you’re not using a condom for sex, and you may need to take PEP. You should get in touch with a clinician immediately about this.