On-demand HIV PrEP

On-demand HIV PrEP is recommended only for cis-gender men who have sex with men who express a preference for this regimen, have at-risk sex less than twice a week, and can plan ahead for at-risk sex at least 2 hours in advance. On-demand PrEP is contraindicated in patients with hepatitis B infection.

If on-demand PrEP is indicated, useAustralasian Society for HIV Viral Hepatitis and Sexual Health Medicine (ASHM), 2021Brady, 2019:

1tenofovir disoproxil fumarate+emtricitabine 300+200 mg, 2 tablets orally at least 2 hours, but no more than 24 hours, before sex; followed by (after sex) 1 tablet 24 hours after the first dose, and 1 tablet 48 hours after the first dose. For dosage adjustment in adults with kidney impairment, see tenofovir disoproxil fumarate+emtricitabine dosage adjustment tenofovir disoproxil fumarate + emtricitabine tenofovir disoproxil fumarate+emtricitabine tenofovir disoproxil fumarate+emtricitabine

OR

1tenofovir disoproxil maleate+emtricitabine 300+200 mg, 2 tablets orally at least 2 hours, but no more than 24 hours, before sex; followed by (after sex) 1 tablet 24 hours after the first dose, and 1 tablet 48 hours after the first dose. For dosage adjustment in adults with kidney impairment, see tenofovir disoproxil maleate+emtricitabine dosage adjustment tenofovir disoproxil maleate+emtricitabine (Tenofovir Disoproxil Emtricitabine Mylan 300/200) tenofovir disoproxil maleate+emtricitabine tenofovir disoproxil maleate+emtricitabine

OR

1tenofovir disoproxil phosphate+emtricitabine 291+200 mg 2 tablets orally at least 2 hours, but no more than 24 hours, before sex; followed by (after sex) 1 tablet 24 hours after the first dose, and 1 tablet 48 hours after the first dose. For dosage adjustment in adults with kidney impairment, see tenofovir disoproxil phosphate+emtricitabine dosage adjustment tenofovir disoproxil phosphate+emtricitabine (Tenofovir EMT GH) tenofovir disoproxil phosphate+emtricitabine tenofovir disoproxil phosphate+emtricitabine

OR

1tenofovir disoproxil succinate+emtricitabine 301+200 mg, 2 tablets orally at least 2 hours, but no more than 24 hours, before sex; followed by (after sex) 1 tablet 24 hours after the first dose, and 1 tablet 48 hours after the first dose. For dosage adjustment in adults with kidney impairment, see tenofovir disoproxil succinate+emtricitabine dosage adjustment. tenofovir disoproxil succinate+emtricitabine tenofovir disoproxil succinate+emtricitabine tenofovir disoproxil succinate+emtricitabine

If sexual activity continues beyond one day, advise patients to take one tablet orally, daily until 48 hours after the last sexual contact.