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PEP, 2 or better 3 drugs?
Nov 23, 2013

Hello Dr. Young,

I had a risk contact and started a PEP approx. 46h after. The doctor gave me Combid 300mg lamivudine zidovudine for 2 times a day (4 weeks).

After checking internet a little further I noticed other people take a third drug in addition + Stocrin 600mg.

Does it make a big difference taking only combid300? Should I better get Stocrin too or is it too late 6 days after start?

Thank you very much in advance!

Response from Dr. Young

Hello and thanks for posting.

There is difference in opinion about whether 2 or 3 drugs is optimal for post exposure prophylaxis, and here in the US, efavirenz (Stocrin/Sustiva) isn't generally recommended for this purpose. This is because of two major reasons: first, efavirenz side effects can be particularly bothersome for people taking PEP, and secondly, efavirenz resistance appears in about 5-10% of transmitted viruses-- limiting the potential benefit.

Either way, it's probably past the time when adding efavirenz would make a substantial difference, so I'd just continue onward with the AZT+3TC that you're taking.

Be well, BY



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