{"id":70064,"date":"2026-05-01T06:08:26","date_gmt":"2026-05-01T06:08:26","guid":{"rendered":"https:\/\/medsbase.com\/prep-starter-pack\/"},"modified":"2026-05-21T05:27:39","modified_gmt":"2026-05-21T05:27:39","slug":"prep-starter-pack","status":"publish","type":"product","link":"https:\/\/medsbase.com\/prep-starter-pack\/","title":{"rendered":"PrEP Starter Pack \u2014 Tenvir-EM + Doxycycline (Doxy-PEP)"},"content":{"rendered":"<p><!-- medsbase-tldr-answer --><\/p>\n<div style=\"background:#fffbea;border-left:4px solid #f5a623;padding:18px 22px;margin:0 0 22px 0;border-radius:4px;\">\n<h3 style=\"margin:0 0 10px 0;font-size:20px;\">Quick Answer \u2014 What is the PrEP Starter Pack?<\/h3>\n<p style=\"margin:0;\">The MedsBase PrEP Starter Pack pairs first-line HIV pre-exposure prophylaxis \u2014 <strong>tenofovir disoproxil + emtricitabine<\/strong> (Tenvir-EM by Cipla) \u2014 with <strong>doxycycline 100&nbsp;mg<\/strong> for doxy-PEP, the CDC-endorsed bacterial STI prevention strategy added in 2024. Together they provide layered protection against HIV, chlamydia, syphilis, and gonorrhoea (the latter with reduced effect due to resistance). Supply tiers: 1, 3, or 6 months. Specialist-supervised use only \u2014 baseline HIV-negative status confirmation, kidney function and HBV serology required before starting.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f4f8fb;border:1px solid #d8e3eb;padding:12px 16px;margin:16px 0;border-radius:4px;font-size:14px;\">\n<strong>What you get with MedsBase:<\/strong> WHO-GMP certified manufacturer \u00b7 Discreet packaging \u00b7 Worldwide shipping \u00b7 1,400+ verified <a href=\"https:\/\/medsbase.com\/reviews\/\">customer reviews<\/a>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"font-size:14px;color:#444;margin:8px 0 18px;\">\ud83d\udce6 Every order is covered by our <a href=\"https:\/\/medsbase.com\/medsbase-re-shipment-assurance-policy\/\"><strong>Reshipment Assurance Policy<\/strong><\/a> \u2014 if your parcel does not arrive within 20 business days, we reship it.<\/p>\n<h3>Why order from MedsBase<\/h3>\n<p>Our generic medications are sourced from WHO-GMP certified manufacturers and shipped worldwide in discreet, plain packaging \u2014 no medication name on the parcel exterior. Card payments are routed through a regulated processor (statement descriptors include a regulated card-payment processor \u2014 never &ldquo;MedsBase&rdquo; or any medication name). Crypto and SEPA bank transfer are also accepted. Every order is backed by our Reshipment Assurance Policy.<\/p>\n<h2 class=\"wp-block-heading\">What&#8217;s in the PrEP Starter Pack<\/h2>\n<p>Each tier ships matched 30\/90\/180-day quantities of both components:<\/p>\n<ul>\n<li><strong><a href=\"https:\/\/medsbase.com\/tenvir-em\/\">Tenvir-EM<\/a><\/strong> (tenofovir disoproxil 300&nbsp;mg + emtricitabine 200&nbsp;mg, Cipla). Once-daily oral tablet. Two NRTIs that block HIV reverse transcriptase before viral integration. iPrEx, Partners PrEP, IPERGAY, and PROUD trials confirm 86\u201399% relative risk reduction for HIV acquisition with consistent use. Also active against hepatitis B (HBV).<\/li>\n<li><strong><a href=\"https:\/\/medsbase.com\/doxycycline-capsules\/\">Doxycycline 100&nbsp;mg<\/a><\/strong> (Cipla). Used here for doxy-PEP: a single 200&nbsp;mg dose taken within 72 hours of condomless sex provides 60\u201380% relative risk reduction against syphilis and chlamydia, and ~55% against gonorrhoea (CDC 2024 guidelines, based on the DoxyPEP trial 2022 and ANRS DoxyVAC 2023).<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Why combine HIV PrEP with doxy-PEP?<\/h2>\n<p>HIV PrEP prevents HIV but does not prevent bacterial STIs. Studies of PrEP users consistently show high incidence of chlamydia, gonorrhoea, and syphilis \u2014 partly because consistent condom use declines once HIV anxiety is removed. Doxy-PEP closes this gap.<\/p>\n<p>The 2024 CDC clinical guidelines explicitly endorse doxy-PEP for: men who have sex with men (MSM) and transgender women with one or more bacterial STI in the past 12 months. The 2022 DoxyPEP randomised trial (Luetkemeyer et al., <em>NEJM<\/em>) showed a 65% reduction in any bacterial STI per quarter; the ANRS DoxyVAC trial (2023, France) replicated the chlamydia\/syphilis effect. The combination pack delivers both layers of protection in one shipment.<\/p>\n<h2 class=\"wp-block-heading\">Who this pack is for<\/h2>\n<p><strong>Best candidates:<\/strong><\/p>\n<ul>\n<li>Cisgender MSM and transgender women at substantial HIV risk who also report condomless anal\/oral sex with a history of bacterial STI<\/li>\n<li>Cisgender men in serodiscordant relationships<\/li>\n<li>Anyone who wants tested HIV PrEP who would also benefit from layered STI prevention<\/li>\n<\/ul>\n<p><strong>NOT appropriate for:<\/strong><\/p>\n<ul>\n<li>Anyone with current or untreated HIV \u2014 Tenvir-EM is dual-NRTI prophylaxis, not full ART; using it during HIV infection rapidly selects M184V resistance and compromises future treatment<\/li>\n<li>Anyone with eGFR &lt; 60 mL\/min \u2014 tenofovir disoproxil is renally cleared and nephrotoxic at the population level<\/li>\n<li>Cisgender women \u2014 TDF\/FTC has demonstrated efficacy in cisgender women only with very high adherence (\u22657 doses\/week); TAF\/FTC (Descovy) is not approved for cisgender women per CDC 2023<\/li>\n<li>Children &lt; 35 kg or younger than 12 years<\/li>\n<li>Pregnant women in the first trimester (doxycycline contraindicated; TDF\/FTC is acceptable in pregnancy if HIV risk justifies)<\/li>\n<li>Anyone with hepatitis B who would discontinue tenofovir without an HBV-active replacement (HBV reactivation risk)<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">How to use the pack correctly<\/h2>\n<p><strong>Tenvir-EM (HIV PrEP)<\/strong><\/p>\n<ul>\n<li><strong>Daily PrEP:<\/strong> One tablet at the same time every day. Takes 7 days for protective levels in rectal tissue, 21 days in cervicovaginal\/penile tissue.<\/li>\n<li><strong>2-1-1 on-demand PrEP (MSM only):<\/strong> 2 tablets 2\u201324 hours before anticipated sex, 1 tablet 24 hours after the first dose, 1 tablet 48 hours after the first dose. Effective only in MSM with anticipated, planned sex.<\/li>\n<li>Take with food to reduce nausea in the first 1\u20132 weeks.<\/li>\n<li>Do not stop abruptly without specialist guidance if you have HBV co-infection.<\/li>\n<\/ul>\n<p><strong>Doxycycline 100&nbsp;mg (doxy-PEP)<\/strong><\/p>\n<ul>\n<li>200&nbsp;mg single dose (2 capsules) within 24 hours of condomless sex; up to 72 hours if delayed.<\/li>\n<li>Maximum 200&nbsp;mg per 24-hour period.<\/li>\n<li>Take with a full glass of water; remain upright for 30 minutes (oesophagitis risk).<\/li>\n<li>Avoid taking within 2 hours of dairy, antacids, iron supplements, or calcium-fortified products (chelation).<\/li>\n<li>Use sun protection \u2014 doxycycline is photosensitising.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Mandatory testing schedule<\/h2>\n<table style=\"border-collapse:collapse;width:100%;margin:16px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Test<\/th>\n<th style=\"padding:10px;border:1px solid #ddd;text-align:left;\">Frequency<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">HIV antibody\/antigen (4th generation)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Baseline; every 3 months while on PrEP<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;background:#f9f9f9;\">Hepatitis B surface antigen + surface antibody<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;background:#f9f9f9;\">Baseline; vaccinate if susceptible<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Renal function (creatinine, eGFR)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Baseline; every 6 months while on PrEP<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;background:#f9f9f9;\">Syphilis serology + chlamydia\/gonorrhoea NAAT (3-site if applicable)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;background:#f9f9f9;\">Baseline; every 3 months<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px;border:1px solid #ddd;\">Pregnancy test (cisgender women \/ transmasculine on TDF)<\/td>\n<td style=\"padding:10px;border:1px solid #ddd;\">Every 3 months<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<h2 class=\"wp-block-heading\">Combined-use safety<\/h2>\n<p>Tenvir-EM and doxycycline have no clinically significant pharmacokinetic interaction. Both are well-tolerated together. The main combined-use considerations are:<\/p>\n<ul>\n<li><strong>Photosensitivity<\/strong> from doxycycline can be amplified in users who also take SSRIs or thiazide diuretics.<\/li>\n<li><strong>Antacids and iron<\/strong> reduce doxycycline absorption \u2014 separate by \u22652 hours.<\/li>\n<li><strong>Nausea<\/strong> in the first week is more common when both drugs are taken together on an empty stomach. Take Tenvir-EM with breakfast and doxy-PEP with a small meal.<\/li>\n<li><strong>Vaginal\/anal microbiome<\/strong> may shift on chronic doxycycline \u2014 monitor for new candidiasis or bacterial vaginosis symptoms.<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Side effects<\/h2>\n<p><strong>Tenvir-EM<\/strong> (typical &lt; 10% incidence): nausea, headache, fatigue in the first 2 weeks (&ldquo;start syndrome&rdquo;, usually resolves). Rare: small reductions in bone mineral density (BMD reverses on stopping); slow renal function decline (~1 mL\/min\/year on average \u2014 relevant in long-term use).<\/p>\n<p><strong>Doxycycline<\/strong> (typical incidence): photosensitivity, GI upset, oesophagitis if taken without water\/upright, rare hypersensitivity. Long-term use raises tetracycline-resistance concerns at the population level \u2014 a key reason doxy-PEP is restricted to higher-risk populations rather than universal recommendation.<\/p>\n<p><strong>Stop and seek care<\/strong> for: any sign of acute HIV seroconversion (fever, rash, lymphadenopathy, sore throat 2\u20134 weeks after suspected exposure \u2014 get an HIV test immediately and continue PrEP until result); severe rash (Stevens-Johnson Syndrome); severe abdominal pain; jaundice; persistent vomiting or diarrhoea.<\/p>\n<h2 id=\"faqs\">Frequently Asked Questions<\/h2>\n<h3 class=\"wp-block-heading\">Does this protect against all STIs?<\/h3>\n<p>HIV: yes (86\u201399% with adherence). Syphilis: yes (~73% reduction per DoxyPEP trial). Chlamydia: yes (~74% reduction). Gonorrhoea: partial (~55% reduction with rising resistance). Mycoplasma genitalium: probably not (resistance rates &gt; 50% to doxycycline). HSV \/ HPV \/ hepatitis A \/ hepatitis C: not protected \u2014 get vaccinated and use condoms for ongoing protection.<\/p>\n<h3 class=\"wp-block-heading\">Can I take both pills the same day?<\/h3>\n<p>Yes. Take Tenvir-EM at your usual daily time. Take the doxy-PEP 200&nbsp;mg dose any time within 72 hours of condomless sex. They do not interact significantly.<\/p>\n<h3 class=\"wp-block-heading\">How quickly does PrEP start working?<\/h3>\n<p>Rectal mucosa: 7 days of daily dosing. Cervicovaginal\/penile mucosa: 21 days. The 2-1-1 on-demand regimen achieves protection 2 hours after the first 2-tablet dose (MSM only).<\/p>\n<h3 class=\"wp-block-heading\">What if I miss a dose of Tenvir-EM?<\/h3>\n<p>Take it as soon as you remember unless your next scheduled dose is within 4 hours. Daily adherence above 4 doses\/week confers high protection in MSM; below 4 doses\/week, protection drops quickly. Cisgender women need \u22657 doses\/week for similar protection.<\/p>\n<h3 class=\"wp-block-heading\">Can I drink alcohol?<\/h3>\n<p>Yes \u2014 neither Tenvir-EM nor doxycycline interacts meaningfully with alcohol at moderate intake. Heavy alcohol use is associated with PrEP non-adherence and increased risky-sex frequency, so manage that pathway separately.<\/p>\n<h3 class=\"wp-block-heading\">Can I take this in pregnancy?<\/h3>\n<p>Tenvir-EM has good pregnancy data and is acceptable when HIV risk justifies use. <strong>Doxycycline is contraindicated in pregnancy after 18 weeks<\/strong> (tooth and bone effects in the foetus). Stop the doxy-PEP component if you become pregnant; continue Tenvir-EM if HIV risk continues, under specialist supervision.<\/p>\n<h3 class=\"wp-block-heading\">What if I get exposed to HIV before PrEP is fully active?<\/h3>\n<p>If you have a known high-risk exposure within the first 7 days of starting daily PrEP, contact a clinician about HIV PEP (a 28-day 3-drug regimen started within 72 hours). Do not rely on partial-protection PrEP for an acute high-risk exposure.<\/p>\n<h3 class=\"wp-block-heading\">How is the pack shipped?<\/h3>\n<p>Discreet plain packaging with no drug names on the outside. Worldwide delivery. The <a href=\"https:\/\/medsbase.com\/medsbase-re-shipment-assurance-policy\/\">Reshipment Assurance Policy<\/a> covers a free reship if your parcel does not arrive within 20 business days.<\/p>\n<h3 class=\"wp-block-heading\">Can I pay with cryptocurrency?<\/h3>\n<p>Yes \u2014 Bitcoin, Ethereum, USDT and other major cryptocurrencies via Plisio with an automatic 10% discount at checkout. See the <a href=\"https:\/\/medsbase.com\/crypto-payment-guide\/\">Crypto Payment Guide<\/a>.<\/p>\n<h3 class=\"wp-block-heading\">Where can I get the testing done?<\/h3>\n<p>Most sexual-health clinics, GP surgeries, and many free community testing programmes (e.g. Terrence Higgins Trust in the UK, Planned Parenthood in the US, regional services elsewhere) offer the full quarterly STI panel and HIV testing required to safely use PrEP.<\/p>\n<p><!-- mb-bundle-quantities-v1 --><\/p>\n<h2 class=\"wp-block-heading\" id=\"whats-in-each-tier\">What you get in each tier<\/h2>\n<p>Tenvir-EM is taken once daily for HIV PrEP. Doxycycline 100&nbsp;mg is included for Doxy-PEP \u2014 two tablets (200&nbsp;mg) within 72&nbsp;hours of condomless sex, per CDC 2024 guidance. The doxy supply assumes roughly 5 events per month; heavier users should top up with a separate Cendox or Doxypal pack.<\/p>\n<table style=\"border-collapse:collapse;width:100%;margin:12px 0 18px 0;\">\n<thead>\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:10px 12px;border:1px solid #ddd;text-align:left;\">Tier<\/th>\n<th style=\"padding:10px 12px;border:1px solid #ddd;text-align:left;\">Contents<\/th>\n<\/tr>\n<\/thead>\n<tbody>\n<tr>\n<td style=\"padding:10px 12px;border:1px solid #ddd;vertical-align:top;white-space:nowrap;font-weight:600;\">1 Month<\/td>\n<td style=\"padding:10px 12px;border:1px solid #ddd;\">\n<ul style=\"margin:6px 0 0 18px;padding:0;\">\n<li>Tenvir-EM (TDF 300 mg + FTC 200 mg) \u2014 30 tablets<\/li>\n<li>Doxycycline 100 mg \u2014 10 tablets (\u22485 doxy-PEP events)<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px 12px;border:1px solid #ddd;vertical-align:top;white-space:nowrap;font-weight:600;\">3 Months<\/td>\n<td style=\"padding:10px 12px;border:1px solid #ddd;\">\n<ul style=\"margin:6px 0 0 18px;padding:0;\">\n<li>Tenvir-EM (TDF 300 mg + FTC 200 mg) \u2014 90 tablets<\/li>\n<li>Doxycycline 100 mg \u2014 30 tablets (\u224815 doxy-PEP events)<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:10px 12px;border:1px solid #ddd;vertical-align:top;white-space:nowrap;font-weight:600;\">6 Months<\/td>\n<td style=\"padding:10px 12px;border:1px solid #ddd;\">\n<ul style=\"margin:6px 0 0 18px;padding:0;\">\n<li>Tenvir-EM (TDF 300 mg + FTC 200 mg) \u2014 180 tablets<\/li>\n<li>Doxycycline 100 mg \u2014 60 tablets (\u224830 doxy-PEP events)<\/li>\n<\/ul>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n<p><!-- \/mb-bundle-quantities-v1 --><\/p>\n<p class=\"medsbase-link-boost-2026-05-21\" data-marker=\"mb-link-boost-tavin-em\">The <a href=\"https:\/\/medsbase.com\/prep-starter-pack\/\">PrEP Starter Pack<\/a> bundles Tenvir-EM with doxycycline for Doxy-PEP; users who prefer Emcure-manufactured TDF\/FTC can substitute <a href=\"https:\/\/medsbase.com\/tavin-em\/\">Tavin EM (tenofovir 300 mg + emtricitabine 200 mg)<\/a> as the daily PrEP tablet while keeping the doxycycline component for STI prophylaxis.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2 class=\"wp-block-heading\">Also in our Sexual Health range<\/h2>\n<ul>\n<li><strong>HIV PrEP TDF\/FTC alternatives:<\/strong> <a href=\"https:\/\/medsbase.com\/ricovir-em\/\">Ricovir EM<\/a>, <a href=\"https:\/\/medsbase.com\/tenof-em\/\">Tenof EM<\/a>, <a href=\"https:\/\/medsbase.com\/tavin-em\/\">Tavin EM<\/a><\/li>\n<li><strong>HIV PrEP TAF\/FTC (MSM and trans women only):<\/strong> <a href=\"https:\/\/medsbase.com\/taficita\/\">Taficita<\/a><\/li>\n<li><strong>STI bundle:<\/strong> <a href=\"https:\/\/medsbase.com\/std-protection-pack\/\">STD Protection Pack<\/a><\/li>\n<li><strong>Doxycycline alone:<\/strong> <a href=\"https:\/\/medsbase.com\/doxycycline-capsules\/\">Doxycycline Capsules<\/a>, <a href=\"https:\/\/medsbase.com\/cendox\/\">Cendox<\/a><\/li>\n<li>See the full <a href=\"https:\/\/medsbase.com\/sexual-health\/\">Sexual Health<\/a> category<\/li>\n<\/ul>\n<h2 class=\"wp-block-heading\">Important safety information<\/h2>\n<p>HIV PrEP requires confirmed HIV-negative status before starting and every 3 months while on therapy. Hepatitis B serology and renal function (eGFR) must be checked at baseline. The PrEP Starter Pack is a specialist-supervised regimen, not a substitute for clinical follow-up. Do not start if HIV-positive \u2014 TDF\/FTC alone selects M184V resistance rapidly. Do not use if eGFR &lt; 60 mL\/min. Doxycycline is contraindicated in pregnancy after 18 weeks, in children under 8 years, and in anyone with known tetracycline hypersensitivity. Stop immediately and seek care for severe rash, jaundice, signs of acute HIV seroconversion (fever\/rash\/lymphadenopathy 2\u20134 weeks post-exposure), or severe abdominal pain. This page is for educational purposes and does not replace consultation with a qualified clinician.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>PrEP Starter Pack \u2014 Tenvir-EM (TDF\/FTC) HIV PrEP + doxycycline 100 mg for CDC-endorsed doxy-PEP bundled. Layered protection against HIV (86\u201399% reduction) + bacterial STIs (60\u201380% reduction). Specialist-supervised regimen.<\/p>\n","protected":false},"featured_media":70078,"comment_status":"open","ping_status":"closed","template":"","meta":[],"product_brand":[],"product_cat":[3338,3337],"product_tag":[5833,5906,5907,3225,5815,5908,5354,5909,5910,5834,5911,5912,3340],"class_list":{"0":"post-70064","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-prep-medication-pre-exposure-prophylaxis","7":"product_cat-sexual-health","8":"product_tag-bundle","9":"product_tag-chlamydia-prevention","10":"product_tag-doxy-pep","11":"product_tag-doxycycline","12":"product_tag-hiv-prevention","13":"product_tag-medsbase-pack","14":"product_tag-prep","15":"product_tag-prep-starter-pack","16":"product_tag-sexual-health","17":"product_tag-stack","18":"product_tag-sti-prevention","19":"product_tag-syphilis-prevention","20":"product_tag-tenvir-em","22":"first","23":"instock","24":"shipping-taxable","25":"purchasable","26":"product-type-variable","27":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/wp-json\/wp\/v2\/product\/70064","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/wp-json\/wp\/v2\/comments?post=70064"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/wp-json\/wp\/v2\/media\/70078"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/wp-json\/wp\/v2\/media?parent=70064"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/wp-json\/wp\/v2\/product_brand?post=70064"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/wp-json\/wp\/v2\/product_cat?post=70064"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/wp-json\/wp\/v2\/product_tag?post=70064"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}