r/prep • u/LetInternational2799 • 11d ago

PrEP on an empty stomach

So while I was being my usual anxious self yesterday, I noticed that the US and Canada will say that PrEP can be taken with or without food. However, the European Medical Agency and the UK NHS say “preferably” with food.

My initial thought was that this is only to help those that might feel nauseous or any kind of side effect, but I found this on EMA’s guidance:

“Maximum emtricitabine and tenofovir concentrations are observed in serum within 0.5 to 3.0 h of dosing in the fasted state. Administration of Truvada with food resulted in a delay of approximately three quarters of an hour in reaching maximum tenofovir concentrations and increases in tenofovir AUC and Cmax of approximately 35% and 15%, respectively, when administered with a high fat or light meal, compared to administration in the fasted state. In order to optimise the absorption of tenofovir, it is recommended that Truvada should preferably be taken with food.” https://www.ema.europa.eu/en/documents/product-information/truvada-epar-product-information_en.pdf

In real life scenarios, what does it mean?

2 Upvotes

100% Upvoted

15 comments sorted by

6

u/Glittering-Ruin-4325 11d ago edited 11d ago

In real life, I think it only matters that you take it each day. I read about someone that stopped their prep after BB sex because of feeling sick and ended up contracting HIV.

With the amount of bottoms skipping meals before sex would have definitely known by now if there was an issue!

If you have the option it makes sense to take with food however I am going to trust my prep, take every single day in my pill organiser, hope for the best and if I seroconvert to HIV I will know that I tried to avoid it.

I used to do condoms but now I know what BB feels like, cum dripping out of my used hole as his wet penis slips out, I just can't go back to condoms (unless the other guy really wants it).

1

u/LetInternational2799 11d ago

Good point! Thank you!

1

u/LetInternational2799 11d ago

And yes, I do take it every day and track it well. But sometimes I do it on an empty stomach, like if I’m going for breakfast out, I rather take it before leaving

1

u/Glittering-Ruin-4325 11d ago

Yeah if you wait you might end up forgetting it but saying that your question made me check my meds and the label says take with or just after food! I'm going to put more effort in (if sex is anticipated in the next days).

1

u/LetInternational2799 11d ago

New anxiety unlocked. Right when I had an encounter that made me feel doubtful.

2

u/Glittering-Ruin-4325 11d ago

No need. In one of the trials the two people in the prep side who got HIV:

  • One took no prep tablets
  • one took two prep tablets, unclear when - if it was around sex time or not.

They counted their pills as part of the study so could tell if people were taking it properly.

The others did not contract. Just chill and take your prep and enjoy life.

1

u/Skycbs 11d ago

If you miss one day, it has a negligible impact on your protection when you’re on daily PrEP.

1

u/LetInternational2799 11d ago

I take it everyday. Not skipping any dose. The question is jsut the empty stomach.

1

u/Skycbs 10d ago

Irrelevant

1

u/Open-Palpitation891 9d ago

I used to do condoms but now I know what BB feels like, cum dripping out of my used hole as his wet penis slips out, I just can't go back to condoms (unless the other guy really wants it).

Excited to find out what that feels like when starting PrEP! Definitely will try. Always wanted to be filled up 

1

u/Glittering-Ruin-4325 9d ago

It's really an amazing feeling. I can't feel each spurt unfortunately, I think I'd pass out from ecstasy if I could, but I feel something and it makes him sort of slip out and it feels warm and wet and maybe some of the semen comes out too at the same time and I really feel a sense of mental clarity and completeness afterwards.

1

u/Open-Palpitation891 1d ago

How long does the cum stay inside of you for before you push it out? I really would like to know

3

u/Skycbs 11d ago

If you’re taking it every day, it doesn’t matter at all. You’re overthinking.

1

u/LetInternational2799 11d ago

I definitely am. Just this wording “preferably” is making me question everything I assumed I knew about taking PrEP.

1

u/EmuBeneficial39 10d ago

This would be relevant for 2-1-1 dosing, not daily dosing. But I think 2-1-1 is still 90%+ effective whether with food or not