Side Effects and Risks of PrEP

Of those who take PrEP pills, about 10% deal with a queasy stomach and throwing up, making nausea one of the most common side effects. Typically, it's worse when you start PrEP for the first time, and it improves after a month or so as you adjust to it. Taking your medication with food may help prevent nausea. Tell your doctor if you vomit more than a few days or can't keep fluids down — they may suggest taking anti-nausea meds.

Runny, watery, loose stools are among common side effects when you start taking PrEP. Be sure you drink plenty of water if you have diarrhea so you don't dehydrate. Eating bland foods can help your poop be more solid. Always tell your doctor if a side effect is severe or lasts for more than a few days.

If you're dealing with nausea or diarrhea, you may also have other digestive issues such as gas, bloating, and indigestion. Steer clear of gaseous foods like beans, eat small meals more frequently, and chew and swallow slowly to help prevent gas. Ask your doctor if an over-the-counter antacid or anti-gas medicine would help. These side effects should be temporary as you adjust to the medication, and they should get better with time.

It's uncommon to gain weight while you're on PrEP, but for some people taking the oral medication Descovy or the injectable medication cabotegravir, it can happen. The amount of weight is usually small. Many things besides PrEP — including age, diet, exercise, and other medications — can affect your weight. If you notice ongoing weight changes, talk to your doctor. Regular physical activity and a balanced diet can help you manage your weight while you're on PrEP medication.

You may temporarily have a mild headache after you start PrEP. Hydration and rest can help. Check with your doctor before using over-the-counter pain relievers like ibuprofen, since they can tax your kidneys more than usual when you're on a PrEP medication. Report any severe head pain or headache that doesn't go away after a few days to your doctor.

For some people, PrEP medications may make it harder to fall asleep or stay asleep, or may cause unusual or vivid dreams. These aren't common side effects, but if they happen to you, it can affect your mood, energy, and concentration. Practice good sleep hygiene: Limit caffeine and heavy meals before bed, keep a consistent sleep and wake schedule, and make your bedroom cool, dark, and distraction-free.

A few people on PrEP deal with constant tiredness and a woozy or lightheaded feeling. To offset this until your body adjusts, make sure you stay hydrated, don't skip meals, and avoid standing up too quickly. If you're falling, or your dizziness and fatigue are getting in the way of your daily activities or lasting longer than a few weeks, call your doctor.

When you start to feel sick with aches, pains, or a fever, it's important to pay attention — it could be a sign of an active HIV infection. But if you're taking the injectable PrEP cabotegravir, it's possible you're having an uncommon side effect related to the shot. A rash alongside flu-like symptoms is also cause for concern, so call your doctor right away. For less serious reactions, your doctor may just recommend rest, fluids, and pain relievers to help you feel better.

When you take an injectable PrEP option, redness, swelling, tenderness, or bruising where you give yourself the shot is common. These reactions are usually mild and temporary. Try putting a cool compress on the area and avoid further irritating it. Check with your doctor before taking any over-the-counter pain relievers to find out what is safest for you. Any severe swelling with warmth or drainage needs to be checked by your doctor right away.

The risk is low, but if you have kidney disease, your doctor may recommend you take injectable options. Truvada, an oral PrEP with tenofovir disoproxil fumarate (TDF), may not be right for you because of the slight increased load on your kidneys. If you do take it, you may need regular lab tests with your doctor. Contact your doctor right away if you get swelling in your legs, unusual fatigue, you're peeing less, or you have nausea you can't explain.

Truvada may decrease your bone density, especially during the first months of treatment. But the changes are small and usually get better after the medication is stopped. Weight-bearing exercise, and proper calcium and vitamin D intake, help boost your bones if you're at risk of osteoporosis.

Serious side effects are very uncommon, but it's good to know what to look for. It's rare, but PrEP can cause severe allergic reactions or liver problems,. It's also possible that, if you have chronic hepatitis B and stop PrEP, you'll have a flare-up of hepatitis. Warning signs include severe weakness, yellow skin or eyes, dark urine, severe pain in your belly area, trouble breathing, or constant nausea and vomiting. See your doctor regularly so that you catch any serious issues early.

Overall, PrEP is a very safe, very effective prevention medicine for HIV. Most side effects are uncommon, and those that happen usually go away within the first month. If you have side effects that last, your doctor can recommend ways to manage them, or switch you to a different PrEP option. Don't stop PrEP on your own. PrEP reduces your risk of getting HIV from sex by about 99% when you take it the way your doctor tells you.