Recommended PEP regimens
Tenofovir disoproxil fumarate 300mg with lamivudine 300mg (Daily)*
Tenofovir disoproxil fumarate/emtricitabine 300mg/200mg (Daily)
Your preferred 2-drug regimen PLUS
dolutegravir 50mg (Daily)
raltegravir 400mg (BD)
rilpivirine 25mg (Daily)
^ Zidovudine, in combination with lamivudine, can be used in two-drug PEP combinations. The benefits of cheaper zidovudine cost are offset by the need for a twice-daily treatment regimen, higher incidences of gastrointestinal side effects, myalgia and headaches in comparison to the recommended regimens.
* TGA-approved generic lamivudine may be used to reduce cost.
Dolutegravir, raltegravir or rilpivirine as the 3rd drug:
The current guidelines recommend dolutegravir or raltegravir or rilpivirine as the 3rd drug in PEP. Using three drugs for PEP increases the likelihood of an adverse event e.g. drug-drug interactions and the potential for rhabdomyolysis with raltegravir. See Table 7 for further details.