Management

What is Doxy-PEP?

Is an oral dose of doxycycline within 72 hours (3 days) of having sex (oral, anal, or vaginal) to protect against syphilis and chlamydia. 

Who can benefit most from Doxy-PEP?

Doxy-PEP is most likely to benefit people at higher risk of syphilis, such as gay, bisexual, and other men who have sex with men, and transgender women, especially with recent syphilis or multiple recent STIs in the last 12 months.
Doxy-PEP reduces the risk of syphilis (by 70-80%) and chlamydia (by 70-90%). Due to antibiotic resistance, it is unlikely to be effective against gonorrhoea.

Safety information about doxycycline

  • Do not prescribe doxycycline if there is a known tetracycline allergy 
  • Do not prescribe doxycycline after the 18th week of pregnancy
  • Discuss the risks and benefits of taking doxycycline while breastfeeding 
  • •Potential drug interactions:
    • Vitamin A preparations and isotretinoin, etretinate
    • Warfarin
    • Penicillins
    • Epilepsy medicines (e.g., phenytoin, carbamazepine, phenobarbitone)
    • Birth control pills, as doxycycline may decrease their effectiveness, requiring additional contraception.

Prescriber information

Doxy-PEP is primarily recommended for people at increased risk of syphilis but can be prescribed to anyone (without a specific contraindication) who wishes to reduce their risk of syphilis and chlamydia and understands the risks and benefits.
The need for ongoing Doxy-PEP should be reviewed at least every 6-months.
Prescribe doxycycline 200mg orally as a single dose up to 72 hours after sex but most effective if taken in the first 24 hrs after sex.
Most people should be provided with a private prescription for 28 tablets to last up to 6-months.
 

Disclaimer

We recognise that gender identity is fluid. In our treatment guidelines, the words and language we use to describe genitals and gender are based on the sex assigned at birth.

The content of these treatment guidelines is for information purposes only. The treatment guidelines are generic in character and should be applied to individuals only as deemed appropriate by the treating practitioner on a case by case basis. Alfred Health, through MSHC, does not accept liability to any person for the information or advice (or the use of such information or advice) which is provided through these treatment guidelines. 

The information contained within these treatment guidelines is provided on the basis that all persons accessing the treatment guidelines undertake responsibility for assessing the relevance and accuracy of the content and its suitability for a particular patient. Responsible use of these guidelines requires that the prescriber is familiar with contraindications and precautions relevant to the various pharmaceutical agents recommended herein.