TABLE 5
HIV PEP REGIMEN FOLLOWING NON-OCCUPATIONAL EXPOSURE*†
Zidovudine‡ 300 mg po bid + Lamivudine 150 mg po bid
(or Combivir 1 bid)§
Plus
Tenofovir 300 mg po qd
Notes:
* When the source is known to be HIV-infected, past and current ARV therapy experience, viral load data, and genotypic
or phenotypic resistance data (if available) may indicate the use of an alternative PEP regimen. Consult an HIV
Specialist.
† NNRTIs should be considered only when 1) the patient cannot tolerate either tenofovir or a protease
inhibitor alternative, or 2) the patient has been exposed to a source with known drug-resistant HIV that is
sensitive to NNRTIs. Use of efavirenz should only be considered in men and in women not capable of bearing children
because of associated teratogenicity. If efavirenz is used in women of childbearing age, a pregnancy test
should be obtained before initiation. Initial central nervous system toxicity, often seen with efavirenz, may affect
one's ability to work. Nevirapine is not recommended for women with CD4 counts >250 cells/mm3 or men with CD4
counts >400 cells/mm3 and should only be used when NRTIs or PIs are not an option and no other hepatic risk
(e.g., hepatitis) is present. If nevirapine is used, it is essential that the 14-day lead-in period be strictly followed.
Serum liver enzymes should be obtained at baseline, at dose escalation, and 2 weeks after dose escalation.
‡ If the patient is intolerant to zidovudine, stavudine 40 mg po bid may be substituted (if patient is <60 kg, 30 mg po
bid should be given). Dosing interval of zidovudine should be adjusted in patients with baseline creatinine clearance
<15 mL/min (see Appendix A for dosing recommendations).
§ The dosing interval of lamivudine should be adjusted in patients with baseline creatinine clearance <50 mL/min (see
Appendix A for dosing recommendations). Because Combivir is a fixed-dose combination that cannot be adjusted,
zidovudine 300 mg twice daily should be combined with lamivudine (dose adjusted for creatinine clearance).
The dosing interval of tenofovir should be adjusted in patients with baseline creatinine clearance <50 mL/min (see
Appendix A for dosing recommendations).

Source: NPEP.pdf de