Pep (Postexposure Prophylaxis)
Medically reviewed by Drugs.com. Last updated on Apr 6, 2025.
Postexposure prophylaxis (PEP) is medical care given to prevent HIV infection, hepatitis B, and other diseases. PEP may include first aid, testing, and medicines. Exposure happens when you have contact with another person's blood, semen, or vaginal fluid. You are exposed if these fluids touch an open area of your skin, such as a cut, or touch a mucus membrane. You can also be exposed by a stick from an infected needle.
DISCHARGE INSTRUCTIONS:
Return to the emergency department if:
- You have a fever.
- You have a rash.
- You have new muscle pain or pain in your back or abdomen.
- You urinate more often than usual, have blood in your urine, or have pain while urinating.
- You are more thirsty than usual.
- You have trouble swallowing or breathing.
Call your doctor if:
- You have nausea or diarrhea.
- You are more tired than usual.
- You have new headaches, or you feel dizzy.
- You have trouble sleeping.
- Your eyes or skin turn yellow.
- You are not eating because of appetite loss.
- You are or may be pregnant.
- You have questions or concerns about your condition or care.
Medicines:
You may need any of the following:
- Antiretrovirals help prevent HIV infection. PEP is a combination of antiviral medicines that help prevent HIV from reproducing. This helps keep the viral load undetectable. You must start PEP within 72 hours of possible exposure and continue for 28 days.
- The hepatitis B vaccine helps prevent hepatitis B. You will need 3 doses (shots) of the vaccine. The second dose should be taken 1 to 2 months after the first dose. The third dose should be taken 4 to 6 months after the first dose.
- Antibiotics help treat or prevent a bacterial infection.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell your provider if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
Precautions:
In case you are HIV-positive, you will need to take steps to prevent spreading HIV to others:
- Have safe sex. Use a latex condom each time you have sex. Ask your healthcare provider what to use if you or your partner has a latex allergy.
- Do not share needles with anyone. Always use needles that are sterile (germ-free). Talk to your provider about how to get clean needles.
- Follow all safety rules at your workplace if you are at risk of exposure. Be sure to use safety equipment as needed.
- Get the hepatitis B vaccine, if needed. Your healthcare provider can tell you if you need this vaccine.
- Ask about breastfeeding. Do not breastfeed unless you know you are not infected. Talk to your provider if you have any questions or concerns about breastfeeding.
In case of future exposure:
If you think you have been exposed, get first aid right away. If you are at work, follow work policy to report the exposure. The type of first aid you need depends on the part of your body that was exposed:
- Wash the area on and around open skin right away with soap and water. Use a gel hand cleaner if you do not have soap or running water. Do not use anything harsh, such as bleach. Do not squeeze or rub the skin.
- Rinse your eyes with water or saline (a salt solution) right away. Be sure to clean well by moving your eyelids with your fingers as you rinse. Keep contact lenses in while rinsing your eyes, then remove and clean them as usual. Avoid soap or other cleaners.
- Spit out the blood or body fluid right away. Rinse your mouth with water or saline several times. Do not put soap or other cleaners in your mouth.
Follow up with your doctor as directed:
If you did not receive any treatment after the exposure, you will need to follow up within 1 week. If you were given antiretrovirals, you will need a follow-up visit in about 2 weeks. More HIV testing will be needed 6 weeks, 3 months, and 6 months after the exposure. Write down your questions so you remember to ask them during your visits.
For support and more information:
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC
Web Address: www.cdc.gov/nchhstp/
- The National Clinicians' Post-Exposure Prophylaxis Hotline
Web Address: www.nccc.ucsf.edu/about_nccc/pepline/
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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