To get doxyPEP, you need a prescription from a healthcare provider, either through an in-person visit at a sexual health clinic or through a telehealth consultation online. DoxyPEP is a single 200 mg dose of doxycycline taken within 72 hours after condomless sex to reduce the risk of chlamydia, syphilis, and gonorrhea. It’s not available over the counter, but getting a prescription is straightforward once you know where to go.
Who Can Get a DoxyPEP Prescription
The CDC published clinical guidelines for doxyPEP in 2024, and the recommendation currently applies to gay and bisexual men and transgender women who have had a bacterial STI in the past 12 months or who are at increased risk based on sexual history. Your provider will ask about recent STI diagnoses, number of partners, and condom use to determine whether you’re a good candidate.
DoxyPEP is not recommended if you’re already taking doxycycline or another tetracycline-class antibiotic for something else, like acne, rosacea, or malaria prevention. It’s also contraindicated during pregnancy due to potential effects on fetal development. If you have a known allergy to tetracycline antibiotics, your provider will discuss alternatives or other prevention strategies.
Getting DoxyPEP Through a Telehealth Service
Telehealth is one of the fastest routes to a prescription. Several online platforms now offer doxyPEP consultations specifically. Wisp, for example, connects you with an independent physician after you complete a medical intake form. Most prescriptions through their service are sent to your pharmacy within three hours, and some platforms offer free discreet home delivery as well.
Other sexual health-focused telehealth services, including those affiliated with PrEP providers, have added doxyPEP to their offerings. The process typically involves filling out a health questionnaire, a brief phone or video consultation if needed, and then a prescription sent to the pharmacy of your choice. If you’re already seeing a provider for HIV PrEP, that same provider can often prescribe doxyPEP during the same visit or follow-up.
Getting DoxyPEP at a Clinic
Sexual health clinics, STI clinics, and LGBTQ+ health centers are the most likely in-person options. Major health systems have started integrating doxyPEP into their sexual health services. Penn Medicine, for instance, lists doxyPEP as part of its STI prevention offerings. Community health centers, Planned Parenthood locations, and city or county public health departments may also prescribe it, though availability varies by location.
If you already have a primary care provider, you can bring up doxyPEP at a regular appointment. Some providers may not yet be familiar with the 2024 CDC guidelines, so it can help to mention the recommendation by name. Any provider who can prescribe antibiotics can technically write you a doxyPEP prescription once they’ve assessed your eligibility.
What the Prescription Looks Like
DoxyPEP isn’t a daily medication. Your provider will prescribe doxycycline 200 mg to be taken as a single dose after a sexual encounter, ideally as soon as possible and no later than 72 hours afterward. You’ll keep the pills on hand and take them only when needed. The maximum dose is 200 mg in a 24-hour period, so if you have multiple encounters in a single day, one dose covers it.
Doxycycline itself is a common, inexpensive generic antibiotic. A prescription typically costs between $5 and $30 at most pharmacies, depending on the quantity and whether you have insurance. Because doxycycline has been on the market for decades, cost is rarely a barrier.
Insurance and Cost
Insurance coverage for doxyPEP varies. Doxycycline as a medication is almost always covered, but insurers may handle the “prophylaxis” use differently than a standard treatment course. Some plans cover it without issue, while others may require prior authorization or may not explicitly cover preventive use yet. If you run into coverage issues, the out-of-pocket cost for generic doxycycline is still relatively low. GoodRx-style discount programs can bring it under $15 in many cases.
If you’re accessing doxyPEP through a public health clinic or a subsidized program, it may be available at no cost. Programs that already provide free PrEP sometimes include doxyPEP as part of their sexual health services.
Side Effects to Know About
Doxycycline is generally well tolerated at this dose. The most common side effects are nausea, stomach upset, and increased sun sensitivity. In clinical trials, gastrointestinal symptoms were more common among people using doxyPEP compared to those who weren’t, though fewer than 1% of participants in one major trial stopped taking it because of side effects. No serious adverse events were attributed to the medication in the largest studies.
To minimize stomach issues, take the dose with food and a full glass of water. Avoid lying down for at least 30 minutes afterward, since doxycycline can irritate the esophagus. If you’re spending time in the sun, use sunscreen, as photosensitivity reactions are a real possibility.
The Antibiotic Resistance Question
One concern that comes up frequently is whether widespread doxyPEP use could drive antibiotic resistance. A study published in Nature Medicine found that after six months of use, people taking doxyPEP had a higher proportion of tetracycline resistance genes in their gut bacteria. However, the overall composition and diversity of their gut microbiome remained unchanged, and there was no increase in harmful pathogens like C. difficile. This is an active area of monitoring, and your provider may discuss it during your consultation, but the current consensus is that the STI prevention benefits outweigh this concern for people who meet the eligibility criteria.
Steps to Get Started
- Option 1, telehealth: Create an account on a platform that offers doxyPEP (Wisp, or a PrEP-affiliated telehealth provider), complete the intake form, and have your prescription sent to a pharmacy the same day.
- Option 2, sexual health clinic: Visit an STI clinic, LGBTQ+ health center, or public health department and ask about doxyPEP during your appointment.
- Option 3, your regular doctor: Bring up the CDC’s 2024 doxyPEP guidelines at your next visit and ask whether you’re a candidate based on your sexual health history.
In all three cases, you’ll walk away with a prescription for doxycycline that you fill at any pharmacy and keep on hand for when you need it.