What Drugs Aren't Safe To Take While On PrEP?

Before deciding to use the daily drug Truvada as PrEP, a prevention strategy that when taken routinely virtually makes it impossible to contract HIV, one of the biggest concerns is whether or not it will have an interaction with other drugs. After all, the last thing we want is for one drug to limit the effectiveness of another. 

The good news is PrEP does not interact with most other medicines, but one important exception is the combination of non-steroidal anti-inflammatory drugs (NSAIDS), especially diclofenac (sold under a number of trade names).

Other NSAIDS include ibuprofen and naproxen. The simple reason for this exception is the added pressure it puts on our kidneys and liver. 

Keep in mind, NSAIDS like ibuprofen will not make PrEP less effective, just as PrEP won’t make ibuprofen less effective, so no need to worry there. However, it should be noted that NSAIDS should be taken sparingly while on PrEP as a precaution. 

Truvada is putting our kidneys and liver through a workout, which isn’t something to be too concerned about — unless you’re taking other additional drugs. What many people don’t realize is that the medicines we take are filtered through the body by way of our kidneys and liver, so the more drugs we take, the more chemicals they have to process. That can get them exhausted. 

It’s important to speak with your PrEP doctor about all the drugs you’re taking, not just so they can monitor your kidney/liver functions every three months at your required check up, but also so they can make sure effectiveness isn’t sacrificed for each drug.

Here are some things we do know: 

Anti-Depressants: These drugs do not interact with any of drugs that are in Truvada. Mental health itself can put a damper on drug regimens for a variety of different reasons, which is why it’s important to stay balanced and not ever miss a dose of your anti-depressants. Worry free! 

“If you’re mood is good, if you’re dealing with a mental health issue — depression, anxiety, whatever it is – if you take that medicine it’s going to support a plan for you to prevent HIV, and PrEP may be a part of it,” Plus magazine’s PrEP doctor said. “Your anti-depressant won’t reduce the effectiveness of PrEP and PrEP won’t reduce the effectiveness of your anti-depressant.” 

Hormone therapy: PrEP is safe for trans and non-binary folks who are also taking hormone therapy. Neither drugs impact the other’s effectiveness. Among the good news to come out of the 22nd International AIDS Conference in Amsterdam this year were recent results that prove taking PrEP does not affect hormone levels in transgender women. 

Fitness enhancers: Workout supplements like creatine, which many take to try and build muscle and strength at the gym, might impact the tests doctors give you during visits that tell them how well your kidneys are working.

These tests, called estimated glomerular filtration rate (eGFR), calculates creatinine clearance (numbers around 90 are normal, but numbers around 60 should inspire doctors to do more tests). The problem is those who take creatine monohydrate as a workout supplement could impact these tests, so it’s best to either inform your doctor you’re taking creatine or simply limit it altogether. 

* Tip: Alcohol is fine to have while on Truvada, but to be safe, make sure you drink a glass of water with every glass of alcohol. Water helps to purify your kidneys and liver. So do beets by the way! (Who's up for beet juice?) 

For more research, visit PrEPFacts.org.