Comparing PrEP Options
Everything you need to know about the differences between types of PrEP.
Did you know that there are different kinds of PrEP available?
In Canada, there are two different brand name options for use as PrEP – Truvada and Descovy.
Brand name medications are the drugs originally manufactured and sold by the company who researched and created it. However, after several years other companies can make equivalent versions with the same medication. This is known as generic medications and most people in Ontario are taking the generic version of Truvada, the original PrEP (emtricitabine-tenofovir disoproxol fumarate).
Generic medication must undergo a rigorous process to show they have equivalence to the brand drug before being approved in Ontario.
Currently there are six manufacturers of generic PrEP and our pharmacy carries these as well as the brand name options.
The main benefit of generic medication is that the cost is significantly less than the equivalent brand drug while maintaining the same level of effectiveness. Many drug plans will also only cover the generic version.
A bi-monthly injection PrEP option is now availabe in the USA, but does not yet have Canadian approval.
There is more to PrEP than
just getting a prescription.
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Brand name PrEP differences?
The newer brand version of PrEP (Descovy) is made by the same manufacturer as the original. It does not yet have a generic version available.
Both versions are quite similar in a lot of ways. The original version is made of the two drugs: emtricitabine and tenofovir disoproxil fumarate, while the newer version is made of emtricitabine and tenofovir alafenamide. Where they differ is in how the tenofovir ingredient is made. Both medications have the same level of effectiveness, but tenofovir alafenamide leads to less medication going to our kidney and bones which are rare risks on standard PrEP.
Some private insurance plans do not cover the cost fully, but we can connect you with programs to further help improve the affordability. Descovy is not covered through government programs including OHIP+ and Trillium.
Both the original and newer PrEP versions are equally effective at HIV prevention and side effects on either are quite rare. Our clinic ensures you get proper monitoring and follow-up. The newer version has very rare risks related to cholesterol/lipid levels in the body and minor weight gain is possible if switching from the original. Descovy can only be taken as once daily and not the On-Demand method (event-based dosing).
Despite heavy marketing out there for the newer option, both are safe and effective options.
The clinical team we work with has experience prescribing all types of PrEP.
Myths About PrEP
There’s a lot of misinformation out there. We’re a fact and evidence-based zone.
Myth 1: PrEP encourages everyone to higher risk behavior and increases STIs.
FALSE. Earlier studies that looked at PrEP use had found that PrEP did not significantly change sexual behavior. People who were already at risk just got protection. They also were tested more frequently due to regular monitoring being on PrEP. Some newer studies have suggested a potential increase for some.
Myth 3: People who are more sexually active go on PrEP.
FALSE. Besides the fact we should not be disparaging people who have more sex, HIV does not discriminate whether someone has sex once or multiple times. Each sexual interaction is its own independent risk.
Myth 2: PrEP is effective so condoms are not needed anymore.
Condom use should still be considered as PrEP does not protect against other STIs besides HIV. PrEP plus condom use does further reduce the risk but is something for each person to determine what is right for themselves.
Myth 4: Nothing can interact with PrEP so there is no need to worry.
It’s always important to check with a pharmacist to see if there are any drug interactions or protentional interactions. An example, is anti-inflammatory medications like Advil (ibuprofen). Regular use of these medications while on PrEP may further increase the risk of the rare side effect affecting the kidneys. Hormone medications that may be taken by some transgender individuals can be combined safely with PrEP.