DoxyPEP in Portugal

What Is DoxyPEP

DoxyPEP (doxycycline post-exposure prophylaxis) is a single dose of 200 mg doxycycline taken within 72 hours after condomless sex. Clinical trials have shown it reduces the incidence of chlamydia and syphilis by around 70–80%, and gonorrhoea by roughly 50%. It does not protect against HIV.

DoxyPEP is becoming part of the prevention toolkit for gay and bisexual men on PrEP in several European countries. In Portugal, it is not yet a formally established protocol, but Doenças Infecciosas doctors at the major PrEP centres are increasingly familiar with the evidence and some will discuss it with patients.

Current Status in Portugal

DoxyPEP does not have a national Portuguese protocol as of early 2026. It is not automatically offered alongside PrEP. However:

Doxycycline is a long-established antibiotic and is inexpensive and widely available on prescription
Doctors at Curry Cabral, Santa Maria, São João, and other PrEP centres are aware of the DOXYVAC and DoxyPEP trial data
Some prescribers will discuss it with patients who raise it and prescribe it informally where they consider the clinical case appropriate
GAT and CheckpointLX staff are up to date on the evidence and can help you make the case to your prescriber

How to Access It

Step 1 — Raise it at your PrEP follow-up appointment

Your Doenças Infecciosas appointment (every 3 months for PrEP) is the right moment. Mention that you have read about DoxyPEP and want to discuss whether it is appropriate for you. Most Doenças Infecciosas doctors at PrEP centres in Lisbon and Porto will be familiar with the concept.

Step 2 — Ask GAT/CheckpointLX for support

If you are not sure how to raise it, or if your prescriber is unfamiliar, CheckpointLX staff can brief you on the evidence and help you frame the conversation. They can also sometimes liaise with prescribers directly.

Step 3 — Prescription and dispensing

If your doctor agrees to prescribe, doxycycline is available at street pharmacies (farmácias) on a standard prescription (receita médica). It is not on the SNS free list for this indication — you pay out-of-pocket. A single 200 mg dose (two 100 mg tablets) costs roughly €2–5. A small supply for occasional use costs very little.

Generic doxycycline (doxiciclina) is the same medication — ask for the generic to keep costs low.

Cost

Item	Approximate Cost
Single 200 mg dose (2 × 100 mg tablets)	€2–5
Pack of 10 × 100 mg tablets	€5–12
Prescription appointment (private)	€50–80 if via private doctor
Prescription via SNS PrEP follow-up	Free consultation; medication at pharmacy cost

What DoxyPEP Does and Does Not Do

DoxyPEP reduces the risk of bacterial STIs — specifically syphilis, chlamydia, and to a lesser extent gonorrhoea. It does not:

Protect against HIV (PrEP does this)
Replace regular STI testing — you still need three-site swab testing every 3 months
Work if taken more than 72 hours after sex
Eliminate gonorrhoea risk entirely (gonorrhoea is developing doxycycline resistance in some strains)

DoxyPEP works best as part of a broader prevention strategy alongside PrEP, regular testing, and awareness of your partners' status. It is not a reason to test less frequently.

Concerns About Antibiotic Resistance

The main clinical concern with widespread DoxyPEP use is contributing to antibiotic resistance, particularly for gonorrhoea. This is a legitimate debate in the medical community. If you are using DoxyPEP, continuing to test regularly remains important — early detection of gonorrhoea allows it to be treated with other antibiotics before resistance develops.

Discuss the resistance question with your prescriber if you want a fuller picture of the tradeoffs.