We prescribe Doxy-PEP (gonorrhea, syphilis, chlamydia prevention) through online consultations.
Consultations are available daily from 9:00 AM to 10:00 PM, with same-day shipping possible. You can also keep it on hand in advance.
What is Doxy-PEP?
Doxy-PEP is a method of preventing bacterial sexually transmitted infections (STIs) such as chlamydia, syphilis, and gonorrhea by taking doxycycline (generic name) after sexual intercourse. It is recommended to take it as soon as possible, ideally within 72 hours of sexual intercourse. At Mona Aoyama Clinic, doctors prescribe it through online consultations and deliver it to your home (private medical care).
About its preventive effect
Studies have reported the following approximate preventive effects when taken correctly. Individual results may vary, and it does not prevent all infections.
| Infection | Approximate Preventive Effect Reported in Studies |
|---|---|
| Chlamydia | About 88% |
| Syphilis | About 87% |
| Gonorrhea | About 55% (highly susceptible to resistance) |
It is important to note whose data these figures represent.
The above figures were obtained from clinical trials targeting men who have sex with men and transgender women. Results have been shown to differ among various groups.
| Target Group | Current Understanding |
|---|---|
| Men who have sex with men, transgender women | Preventive effects have been confirmed in multiple studies. Recommended by US CDC guidelines. |
| Cisgender women | A study of 449 individuals did not confirm a preventive effect. However, it has been suggested that low adherence may have been a factor, and conclusions are not yet definitive. |
| Heterosexual men, transgender men, others | Insufficient data, effect is not clear. |
For groups with insufficient data, use can still be considered after consulting with a doctor, taking into account infection risks and past experiences with STIs. Please discuss whether it is suitable for you during your consultation.
Note that it is not effective against HIV, Hepatitis B, Herpes (HSV), or HPV (the virus that causes genital warts). For prevention of these, please consider other methods such as PrEP, vaccines, or condoms.
This prevention can be prepared in advance.
How to Take
Must be taken within 72 hours
Doxy-PEP needs to be taken as soon as possible after sexual intercourse, within a maximum of 72 hours (3 days). Ideally, it should be taken within 24 hours, as the preventive effect decreases over time.
Dosing Schedule
| Timing | Dosage |
|---|---|
| As soon as possible after sexual intercourse (ideally within 24 hours, maximum 72 hours) | 200mg (two 100mg tablets) |
Take once per sexual encounter. Do not exceed 200mg per 24 hours. If you have multiple sexual encounters within 24 hours, you cannot take additional doses.
Important Notes on Taking
- Take with at least one glass of water and do not lie down for 30 minutes after taking. If the tablet remains in the esophagus, it can cause ulcers. Avoid taking it immediately before bedtime.
- Taking it after a meal can reduce nausea and stomach discomfort.
- Avoid taking it with milk/dairy products, antacids (stomach medicines), iron supplements, and calcium/magnesium-containing supplements for at least 2 hours. Taking them together can reduce absorption and efficacy.
- You may be more sensitive to sunlight for some time after taking it. Protect yourself from UV rays with sunscreen or clothing.
Side Effects / Who Cannot Use
Main Side Effects
- Nausea/stomach discomfort (can be reduced by taking with plenty of water after a meal)
- Photosensitivity (skin may redden when exposed to sunlight)
- Diarrhea
- Rarely, esophageal inflammation/ulcers (please follow the above instructions for taking)
Who Cannot Use / Precautions
- Cannot be used by pregnant or breastfeeding individuals, or those who may be pregnant.
- Cannot be used by children under 8 years of age (may cause tooth discoloration).
- Cannot be used by individuals who have had an allergic reaction to tetracycline-based drugs.
- If you have pre-existing conditions or are taking other medications (especially anticoagulants like warfarin, or medications that require careful consideration for interactions), please inform your doctor beforehand.
- This treatment is private medical care (self-pay). Health insurance does not apply. The manifestation of effects and side effects varies among individuals.
Understanding Antibiotic Resistance
Repeated use of antibiotics can lead to the emergence of bacteria that are less susceptible to the drug (resistant strains). The lower preventive effect against gonorrhea (around 55%) is due to already widespread resistance.
Additionally, because it affects bacteria in the body other than the target pathogen, there are concerns about increased resistance with regular use. Doxy-PEP is not intended as a "daily maintenance medication" but rather as a targeted intervention for high-risk situations, combined with regular testing, vaccines, and condom use. Please consult your doctor about the frequency of use.
Combined with Regular Testing
Doxy-PEP does not prevent all infections. Furthermore, chlamydia, gonorrhea, and syphilis often progress asymptomatically, leading to unknowingly spreading the infection to partners.
For those who have regular sexual activity, we recommend testing every 3 to 6 months. Our clinic also offers online STI testing, and for those seeking HIV prevention, PrEP consultations are available.
What is Chlamydia?
Chlamydia (Chlamydia trachomatis) is one of the most common sexually transmitted infections in Japan. Many infected individuals are asymptomatic and may not realize they have it, leading to a risk of unknowingly spreading the infection to partners.
Main Symptoms
In Men
- Urethral discharge
- Discomfort/pain during urination
- Swelling and pain in the testicles (epididymitis)
- Often asymptomatic
In Women
- Increased/unusual vaginal discharge
- Abnormal bleeding
- Lower abdominal pain
- Often asymptomatic, can cause infertility
Pharyngeal Infection from Oral Sex
- Sore throat/discomfort
- Mostly asymptomatic
Transmission Routes and Precautions
Chlamydia is transmitted through contact with mucous membranes (sexual intercourse, oral sex, anal sex). Condoms can provide some protection, but they do not cover all areas where mucous membranes may come into contact. Since infection is often asymptomatic, regular testing is crucial after risky sexual activity.
What is Syphilis?
Syphilis (Treponema pallidum) is a sexually transmitted infection that has been rapidly increasing in Japan in recent years. It progresses through stages with symptoms appearing and disappearing, and if left untreated, it can cause severe damage throughout the body.
Stages of Syphilis Progression
| Stage | Timing | Main Symptoms |
|---|---|---|
| Primary | 3 to 6 weeks after infection | Painless chancre (sore) at the site of infection (genitals, lips, anus, etc.). Often overlooked as it disappears naturally. |
| Secondary | 3 months to 3 years after infection | Rash on the entire body, including palms and soles (roseola), fever, fatigue, swollen lymph nodes. |
| Latent | After secondary stage | Symptoms disappear, but bacteria continue to multiply in the body. |
| Tertiary/Quaternary | Several years after infection | Severe damage to the heart, blood vessels, nerves, brain, etc. |
Consult a doctor early if any of these apply:
- A painless lump has appeared on your genitals, lips, or anus.
- You have developed a rash on your palms or soles.
- You have had sexual intercourse with multiple partners.
- Your partner has been diagnosed with syphilis.
Can it be transmitted through kissing?
Syphilis can be transmitted through kissing. If there are lesions on the lips or in the mouth, there is a risk of infection through mucous membrane contact during kissing. It is not safe to assume "it's just a kiss," so if you have any concerning symptoms, please consult a doctor as soon as possible.
What is Gonorrhea (Gonococcal Infection)?
Gonorrhea (Neisseria gonorrhoeae) is a sexually transmitted infection caused by gonococcus, and like chlamydia, it is common in Japan. While symptoms tend to be severe, antibiotic-resistant gonorrhea, which is difficult to treat with antibiotics, has become a problem in recent years.
Main Symptoms
In Men
- Severe pain/burning sensation during urination
- Purulent discharge from the urethra
- If untreated, it can progress to epididymitis and prostatitis.
In Women
- Purulent discharge
- Pain during urination
- Often asymptomatic; if left untreated, it can lead to pelvic inflammatory disease and infertility.
Pharyngeal Infection (from oral sex)
- Sore throat/discomfort
- Mostly asymptomatic and often goes unnoticed
Consult a doctor early if any of these apply:
- You have severe pain or a burning sensation during urination.
- You have purulent discharge from your urethra or vagina.
- You have had unprotected oral sex.
- Your partner has been diagnosed with gonorrhea.
Our Prescription Process
| STEP | Content |
|---|---|
| 1. Order & Pre-consultation Questionnaire | Please select your desired plan (number of doses) and place your order. Afterwards, you will answer a questionnaire sent via LINE or email. |
| 2. Online Consultation | A doctor will conduct a consultation and prescribe medication via video call. All you need is a smartphone or PC. |
| 3. Shipping | Orders completed by video call by 3:00 PM daily are shipped the same day. Delivered in discreet packaging to protect your privacy. If you need it urgently, please notify us via our official LINE. |
It is more reliable to have Doxy-PEP on hand in advance rather than ordering it when needed, due to the 72-hour (ideally 24-hour) time constraint.
You can be prepared before you need it.
