Doxycycline Post-Exposure Prophylaxis (DoxyPEP) Prescription
Take doxycycline 200 mg by mouth as a single dose within 72 hours after condomless oral, vaginal, or anal sex, with a maximum of 200 mg per 24-hour period. 1, 2
Dosing Instructions
The prescription should provide enough doses based on anticipated sexual activity until the next follow-up visit (typically 3-6 months). 1, 2
- Take 200 mg (two 100 mg tablets or one 200 mg tablet) as soon as possible after sexual exposure, but no later than 72 hours 1, 2
- Do not exceed 200 mg in any 24-hour period 1
- Take on a full stomach with a full glass of water 1, 2
- Remain upright (do not lie down) for at least 1 hour after taking to prevent esophagitis 1, 2
Drug Interactions and Timing
- Separate doxycycline by at least 2 hours from dairy products, antacids, and supplements containing calcium, iron, magnesium, or sodium bicarbonate 1, 2
- No clinically significant interactions with gender-affirming hormonal therapy 1
- Review all medications including over-the-counter products for potential interactions 1
Important Counseling Points
Photosensitivity is a common side effect—avoid direct sunlight and UV radiation during treatment. 2
- Other common side effects include gastrointestinal intolerance (nausea, vomiting, diarrhea) and esophageal discomfort 1
- Chronic alcohol consumption may reduce doxycycline serum levels and decrease efficacy 2
- This medication is specifically for STI prevention after sexual exposure—do not use for other purposes 1
Follow-Up Schedule
- Screen for gonorrhea, chlamydia, and syphilis at baseline and every 3-6 months 1
- Reassess continued need for doxyPEP every 3-6 months 1, 2
- Monitor for side effects at each follow-up visit 1
Sample Prescription Sig
"Take 200 mg by mouth within 72 hours after condomless sex. Maximum one dose per 24 hours. Take with full glass of water on full stomach. Stay upright for 1 hour after taking. Avoid sun exposure." 1, 2