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Must

What are PrEP and PEP?

PrEP and PEP are medicines to prevent HIV. Each type is used in a different situation:

  • PrEP stands for pre-exposure prophylaxis. It is for people who don't already have HIV but are at risk of getting it. PrEP is medicine that can reduce this risk. You can take it as a pill every day or as an injection every two or six months. With PrEP, if you do get exposed to HIV, the medicine can stop HIV from taking hold and spreading throughout your body.
  • PEP stands for post-exposure prophylaxis. PEP is for people who have possibly been exposed to HIV. It is only for emergency situations. PEP must be started within 72 hours after a possible exposure to HIV.
PrEP (pre-exposure prophylaxis)Who should consider taking PrEP?

PrEP can help protect you if you don't have HIV and any of these applies to you:

  • You have had anal or vaginal sex in the past 6 months and:
    • Have a sexual partner with HIV,
    • Have not consistently used a condom, OR
    • Have been diagnosed with a sexually transmitted infection (STI) in the past 6 months
  • You inject drugs and:
    • Share needles or other equipment to inject drugs OR
    • Have an injection partner with HIV
  • You have been prescribed PEP and:
    • Continue engaging in high-risk behaviors OR
    • Have used multiple courses of PEP

If you have a partner who is HIV-positive and are considering getting pregnant, talk to your health care provider about PrEP. Taking it may help protect you and your fetus or baby from getting an HIV infection while you try to get pregnant, during pregnancy, or while breastfeeding.

How well does PrEP work?

PrEP is very effective when you take it consistently. It reduces the risk of getting HIV from sex by about 99%. In people who inject drugs, it reduces the risk of HIV by at least 74%. PrEP is much less effective if you do not take it consistently.

PrEP does not protect against other STIs, so you should still use latex condoms every time you have sex. If your or your partner is allergic to latex, you can use polyurethane condoms.

You must have an HIV test every 3 months while taking PrEP, so you'll have regular follow-up visits with your provider. If you are having trouble taking PrEP every day or if you want to stop taking PrEP, talk to your provider.

Does PrEP cause side effects?

Some people taking PrEP may have side effects, like nausea. The side effects are usually not serious and often get better over time. If you are taking PrEP, tell your provider if you have a side effect that bothers you or that does not go away.

PEP (post-exposure prophylaxis)Who should consider taking PEP?

If you are HIV-negative and you think you may have been recently exposed to HIV, contact your health care provider immediately or go to an emergency room right away.

You may be prescribed PEP if you are HIV negative or don't know your HIV status, and in the last 72 hours you may have been exposed to HIV:

  • During sex, for example if a condom broke during sex with someone who could have HIV,
  • Through the sharing of needles or drug preparation equipment
  • Through sexual assault

Your provider or emergency room doctor will help to decide whether PEP is right for you.

PEP may also be given to a health care worker after a possible exposure to HIV at work, for example, from a needlestick injury.

When should I start PEP and how long do I need to take it?

PEP must be started within 72 hours (3 days) after a possible exposure to HIV. The sooner you start it, the better; every hour counts.

You need to take the PEP medicines every day for 28 days. You will have to see your provider at certain times during and after taking the PEP, so you can have an HIV screening test and other testing.

Does PEP cause side effects?

Some people taking PEP may have side effects, like nausea. The side effects are usually not serious and often get better over time. If you are taking PEP, tell your provider if you have a side effect that bothers you or that does not go away.

PEP medicines may also interact with other medicines that a person is taking (called a drug interaction). So it's important to tell your provider about any other medicines that you take.

Can I take PEP every time I have unprotected sex?

PEP is only for emergency situations. It is not the right choice for people who may be exposed to HIV frequently - for example, if you often have sex without a condom with a partner who is HIV-positive. In that case, you should talk to your health care provider about whether PrEP (pre-exposure prophylaxis) would be right for you.

Must FDA Approved Drugs

BENDAMUSTINE HYDROCHLORIDE [Bendamustine HydrochlorideC16H21Cl2N3O2ClH]
RX
-
100mg/vial (iv (infusion) powder)
25mg/vial (iv (infusion) powder)
Accord HlthcareMay 19, 2016
Breckenridge PharmDec 29, 2016
Glenmark Pharms LtdMar 24, 2016
Hospira IncMay 20, 2016
Innopharma LicensingMar 24, 2016
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

BENDEKA [Bendamustine HydrochlorideC16H21Cl2N3O2ClH]
RX
-
100mg/4ml (25mg/ml) (iv (infusion) solution)
Eagle PharmsDec 7, 2015
  • For the treatment of patients with chronic lymphocytic leukemia.
  • For the treatment of patients with indolent b-cell non-hodgkin lymphoma.
  • For use in the treatment of patients with chronic lymphocytic leukemia and/or non-hodgkins lymphoma.
  • For use in treatment of patients with chronic lymphocytic leukemia (cll) and/or non-hodgkin's lymphoma.
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

BICNU [CarmustineC5H9Cl2N3O2]
RX
-
100mg/vial (injection injectable)
Emcure Pharms LtdApproved Prior To Jan 1, 1982
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

EMCYT [Estramustine Phosphate SodiumC23H30Cl2NO6P2NaH2O]
RX
-
eq 140mg phosphate (oral capsule)
Pharmacia And UpjohnApproved Prior To Jan 1, 1982
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

GLEOSTINE [LomustineC9H16ClN3O2]
RX
-
100mg (oral capsule)
10mg (oral capsule)
40mg (oral capsule)
5mg (oral capsule)
Corden PharmaApproved Prior To Jan 1, 1982
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

GLIADEL [CarmustineC5H9Cl2N3O2]
RX
-
7.7mg (intracranial implant)
Arbor Pharms LlcSep 23, 1996
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

MUSTARGEN [Mechlorethamine HydrochlorideC5H11Cl2NClH]
RX
-
10mg/vial (injection injectable)
Recordati RareApproved Prior To Jan 1, 1982
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

TREANDA [Bendamustine HydrochlorideC16H21Cl2N3O2ClH]
RX
-
100mg/vial (iv (infusion) powder)
180mg/2ml (90mg/ml) (iv (infusion) solution)
25mg/vial (iv (infusion) powder)
45mg/0.5ml (90mg/ml) (iv (infusion) solution)
CephalonMar 20, 2008
  • For use in the treatment of patients with chronic lymphocytic leukemia (cll) and/or indolent b-cell non-hodgkin lymphoma (nhl).
  • For use in the treatment of patients with chronic lymphocytic leukemia (cll).
  • For use in the treatment of patients with chronic lymphocytic leukemia and/or non-hodgkins lymphoma.
  • For use in the treatment of patients with indolent b-cell non-hodgkin lymphoma.
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

VALCHLOR [Mechlorethamine HydrochlorideC5H11Cl2NClH]
RX
-
eq 0.016% base (topical gel)
Actelion Pharms LtdAug 23, 2013
  • Alkylating drug indicated for the topical treatment of stage ia and ib mycosis fungoides-type cutaneous t-cell lymphoma in patients who have received prior skin directed therapy.
efficacy
0.0  (0)
side effects
0.0  (0)
danger
0.0  (0)

UNK

WARNING: Consult a licensed physician in the appropriate field for medical treatment and drug prescription. Do not self medicate.


WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Felter's Materia Medica on Must

ACONITUM NEPALLUS
   The dried tuberous root of Aconitum Napellus, Linné (Nat. Ord. Ranunculaceae). Mountains of Europe and Asia, and northwestern North America.... / ...er will produce the characteristic tingling and benumbing sensation of aconite. The alkaloid itself must never be tasted, and the solution only when extremely diluted, and then with the greatest of ca... / ...approaching from the extremities to the body. Excessive sweating comes on, rapidly lowering the body temperature, dimness of vision, 1

AMYGDALUS PERSICA
   The leaves and bark of the twigs of Amygdalus Persica, Linné (Nat. Ord. Rosaceae). Native to Persia. Cultivated everywhere. Common Name: Peach... / ...d by saturating the freshly scraped inner bark of the twigs (1 ounce) in cold water (16 ounces). It must not be boiled. Dose, 1 fluidrachm to I fluidounce. 2. Specific Medicine Amygdalus. (Made from t... / ...It is of less value for cough than wild cherry or hydrocyanic acid. For the latter the infusion or the specific medicine may be used. 1

ANISUM (Pimpinella anisum)PIAN3
   The dried ripe fruit of Pimpinella Anisum, Linné (Nat. Ord. Umbelliferae). Egypt and Western Asia; cultivated in Southern Europe. Dose, 5 to 40... / ... (above) or from Star Anise (Illicium verum, Hooker, Nat. Ord. Magnoliaceae.). The botanical origin must be stated on the label. Oil of Anise is a highly refractive, colorless or lightyellow liquid, h... / ...hot water is more agreeable and effective for older children and adults. The oil (1 to 5 drops) on sugar may be used by the latter, if desired. 1

APOCYNUM CANNABINUM
   ... Goss, for the removal of ascarides. To use apocynum intelligently and successfully, the prescriber must recognize, first, that debility is the condition in which it exerts its specific and beneficial......ne can not expect apocynum to reconstruct wornout tissues or to restore damaged vascular valves. We must not hope to work miracles with it where there are such structural lesions as incurable or malig...1

ASPIDIUM
   The rhizome of Dryopteris Filix-mas and of Dryopteris marginalis, Asa Gray (Nat. Ord. Filices). World-wide ferns of the Northern Hemispheres.... / ... a full meal without fats, and in the evening give a brisk saline cathartic. Under no circumstances must oils, especially castor oil, be given with it during the treatment. They favor absorption of th...1

BALSAMUM PERUVIANUM
   A balsam obtained from Toluifera Pereirae (Royle) Baillon. San Salvador in Central America; called Balsam of Peru because first exported to Europe... / ...thod is one of the best forms of treatment for old tibial ulcers, due to varicosis, but the patient must be compelled to rest the leg in a horizontal position for some weeks in order to insure results... / ...balsam should not be used in inflammatory or febrile conditions; and its use should be discontinued if it produces gastro-intestinal irritation.1

CANTHARIS
   ... produce abortion. There is no known chemical or physiologic antidote to cantharis. Poisoning by it must be treated on general principles, with opiates to control pain. When non-toxic doses have produ....... In very small doses it is a decided stimulating diuretic and special sedative to the bladder. One must be very careful, however, to avoid irritant doses. It is the remedy for vesical irritation, to ...1

CAPSICUM
   ...at satisfaction for pain coursing along the spermatic cord in the lower quadrant of the abdomen. It must not, however, be allowed to come in contact with the tender skin of the scrotum. The tincture h......s apparently aborts tonsillitis. Capsicum may be used for many of the revulsant effects required of mustard. It does not blister nor cause strangury when so applied. Either the tincture painted upon t...1

CARBO LIGNI
   Charcoal prepared by burning soft wood. It must be kept in tightly-closed vessels. Common Names: Charcoal, Wood Charcoal; Synonym: Carbo Vegetabilis. (Activated... / Charcoal prepared by burning soft wood. It must be kept in tightly-closed vessels. Common Names: Charcoal, Wood Charcoal; Synonym: Carbo Vegeta... / ...tract. The pulse is feeble, the belly-wall tumid and doughy, the tongue expressionless and pale with little coating and lenticular spots, or the coating may lift in patches.1

CINCHONACINCH
   I. Cinchona.-The dried bark of Cinchona Ledgeriana, Moens; Cinchona Calisaya, Weddell, and hybrids of these with other species of Cinchona... / ...ntiperiodic, slightly astringent, and mildly antiseptic. In small doses it is a good stomachic, but must not be long continued. Large doses irritate and cause an unpleasant excitement of the stomach a... / ...chronic suppuration; and to arrest profuse and debilitating night sweats in one suffering from general debility with poor recuperative powers.1

COCCULUS
   The seeds of Anamirta panniculata, Colebrooke (Nat. Ord. Menispermaceae.) East India. Common Names: Fishberries, Indian Berries. Synonym: Cocculus... / ...erries, in ointment or whisky tincture, are often used by the laity for the destruction of lice. It must not be used on abraded surfaces, nor in any considerable quantity. Internal. Homeopaths use an ... / ...to stupefy fish, so as to readily catch them, and it is asserted to be in use among brewers to add bitterness to beer and other malt beverages.1

CROCUSCROCU
   The stigmas of Crocus sativa, Linné (Nat. Ord. Irideae). Asia Minor; much cultivated in Europe. Common Name: Saffron. Principal... / ...luidounces), in doses of 1 to 3 fluidounces to hasten the appearance of the eruption in measles. It must not be confounded with “Dyer's Saffron” (Carthamus tinctorius), which see under Carthamus. It...1

CUBEBA
   The unripe, full-grown fruits of Piper Cubeba, Linné, fil. (Nat. Ord. Piperaceae.) Java, Borneo, Sumatra, Prince of Wales Island, and other isles... / ...for nasal catarrh. Smoking cubebs is a popular method of treating nasal catarrh and hay fever. Care must be had not to blister the roof of the mouth, an untoward effect that is produced by the oil in ...1

EUPATORIUM PERFOLIATUM
   The flowering tops and leaves of Eupatorium perfoliatum, Linné (Nat. Ord. Compositae). Swamps and low meadows throughout the United States. Dose,... / ...umid asthma. It is one of the best of medicines to relieve the irritable cough of measles, but care must be taken not to push its effects to nausea and vomiting. For children it is best administered i... / ...tonic and stomachic, when given in small doses it improves the appetite and digestion and thus favors a more rapid and perfect convalescence.1

GAULTHERIA
   ...ntergreen. This is prepared synthetically and sold under the name of Oil of Wintergreen. Its source must be stated on the label. It ranges from colorless to yellowish or reddish and has the odor and t......orders with putrescent urine. Too long continued, however, it may induce renal irritation, and this must be carefully guarded against. Urine that was ammoniacal and putrescent a few hours after passag...1


WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Physician's Materia Medica on Must

AMYL NITRITE
   Antispasmodic, reducing arterial tension and so causing momen tary acceleration of the heart beat. Used chiefly by inhalation to relax spasm, notably in asthma, in whooping cough. in spasmodic croup, in epileptic seizures, in tetanus and strychnine poisoning and in spasmodic dysmenorrhea. It is a valuable agent also in angina pec toris and in sudden heart failure, but must be used always intelli gently and with due caution remembering that it is a depressant, not a stimulant. Dose. usually 0.13 2

CAFFEINE
   Alkaloid found in Coffee, Tea, Guarana. Kola and some other plants. Cerebral and cardiac stimulant, acting indirectly as a diure tic. Prescribed often for headache. especially in combination with acetanilid. Useful in adynamic conditions and in all forms of heart failure; a standard remedy in poisoning by opium and other narcotics. Dose of Caffeine or Caffeine Hydrobromide, 0.03 to 0.3 Grm. (96 to 5 grs.- or more. [Caffeine Citrated must be given in double the dose to produce the same effect].2

HEROINE
   Synthetic alkaloid, a derivative of MORPHINE. A sedative resembling codeine rathor than morphine, but more active than the former. Unlike morphine it stimulates rather than depresses the respiratory center, hence is particularly valuable as a remedy for cough. Does not stupify or constipate like morphine, but must be used with caution where there is a weak heart. Dose, 1-20 to 1-16 gr. three times a day.2

JUNIPERJUNIP
   The fruit of JUNIPERUs COMMUNIS, Lin. Stimulant diuretic. Much used in chronic affections of the genito-urinary tract; must be avoided while there is active inflammation. Active constituent the volatile oil, which is oflicial.2

LETTUCE CALMATIVE
   A non-narcotic soothing syrup for infants. Each fluidrachm rep resents; Wild Lettuce, 5 grs.; Caraway seed,... / ... grs.; Catnep, 4 grs.; Lupulin, % gr.; Fennel seed, 3 grs. The uses of such a a preparation as this must be apparent to every physician. It may be made more effective sometimes by add‘ ing to it a l...2

PHOSPHATES
   Calcium Phosphate plays an important part in the animal econ omy in supplying the principal part of the solid framework of the body. Hence phosphates constitute an essential part of our food. In some diseased conditions the system fails to assimilate from the ordi nary food suflicient of these compounds to supply the daily waste, and in these conditions the deficiency must be made up by the use of chemicalfonds consisting of combinations of the phosphates of cal. cium, sodium, potassium and iron2

SALOPHEN
   A compound of SALICYLIC ACID with modified PHENOL base, having the same range of use as Salol. It is less liable to produce unto ward effects, but must be given in large doses. In combination with phenacetin it is very useful in neuralgia. Dose, 0.3 to 1.3 Grm. (5 to 20 grs.), three times a day.2

SQUILL
   The bulb of URGINEA MARITIMA, (L.) Bak. Nauseant, expecto rant, diuretic. Used chiefly in bronchial affections andinadropsy, in the latter case often in combination with Digitalis. It must not be given when there is acute inflammation of the kidneys.2


WARNING: All medicines, drugs, plants, chemicals or medicial precedures below are for historical reference only. Many of these treatments are now known to be harmful and possibly fatal. Do not consume any plant, chemical, drug or otherwise without first consulting a licensed physician that practices medine in the appropriate field.

Physician's Therapeutics Memoranda on Must

ABORTION
   ...ent or to anemia or other form of malnutrition. Prevention of the accident in such cases depends upon recognizing and removing the cause. The patient must be given the benefit of the best hygienic conditions; avoid irri tant cathartics, regulating the bowels with compound liquorice powder or cascara......atient at rest and give an opiate (morphine hypodermatically or opium extract by injection or suppository). If these measures fail, an aseptic tampon must be introduced and fluid extract of ergot must be given, the after treatment consisting of antiseptic irrigation of the vagina and if necessary of...2

ANEURISM
   When accessible, treat by pressure and other surgical procedures. Rest in bed and freedom from... / When accessible, treat by pressure and other surgical procedures. Rest in bed and freedom from excitement are essential in any case. The diet must be simple and not stimulating. Potassium iodide is commonly useful. Use veratrum viride or possibly aconite, but not digitalis to control heart a...2

APOPLEXY, CEREBRAL
   Blood pressure must be reduced by ve-nesection, if the case ad mits it, by action of a rapid purge of croton oil or elaterium or by arterial sedatives, (veratrum vir......e-nesection, if the case ad mits it, by action of a rapid purge of croton oil or elaterium or by arterial sedatives, (veratrum viride or aconite); by mustard plasters to feet or a hot mustard foot bath, with applications of ice to the head. Keep the head high and the feet low. In the days immediate ...2

CALCULI. RENAL OR VESICAL
   Pain, (renal colic) must be treated with chlorodyne, belladonna in full doses, morphine and atropine hypodermatically, cautious in hzilations of chloroform. Remedies depend on nature of the calculus.2

CHOLERA INFANTUM
   Withheld milk, substituting the juice of raw beef. , If irritant un digested food is present, give castor oil (aromatic); if stools are wa tery and colorless, give podophy1lin(1-20 gr. repeated in 2 hours), to change character of stools, then give astringents and carminatives. If vomiting is severe the best remedy is calomel in small repeated doses. Irrigation of the bowels with water at 100° F. is often useful. Apply a mild mustard or spice poultice over the bowels.2

CHOLERA MORBUS
   Apply hot mustard poultice over abdomen. Calomel may be given in the outset or castor oil to free bowel of irritant matter. Give aromatic sulphuric acid with carminatives and intestinal antisep tics. Large rectal injections of water as hot as can be borne often give prompt relief.2

COLIC, INTESTINAL
   Internally carminatives, especially chlorodyne; ether or Holl mann’sAnodyne; for infants, Lettuce Calmative. Exter nally counter-irritants, especially mustard and oil of turpentine.2

DIABETES MELLITUS
   Exclude sugar and starch as far as possible from the diet, but do not starve the patient. The remedies most likely to... / ...ther remedies are methylene blue (2 to 5 grs. three times a day), uranium nitrate (2 grs. increased gradually to 10 or more, after each meal). Tonics must be prescribed as indicated, arsenic, iron, g1ycerophos phates and strychnine being particularly useful.2

DIPHTHERIA AND MEMBRANOUS CROUP
   Isolate the patient and watch carefully all children who may have been exposed. In every case use Diphtheria... / ...e and 10 fluidrachms absolute alcohol) is preferred by some. As tonics, tincture ferric chloride, quinine and strychnine are of service, and strength must be maintained by fluid or semifluid nourishing food such as peptonized milk (given per rectum if swallowing is im possible).2

DIPSOMANIA
   The treatment must be largely moral, but sustaining agents such as coca are important. The remedies having most effect are salts of gold (especially Solution Gold and Arsenic Bromide, N., B. & Co.); pilocarpine, tartar emetic, lupulin and capsicum.2

ECZEMA
   Improve general... / ...health of patient by hygienic measures. See that the diet is simple and substantial. Fats, salted meats, pastry and all indigestible articles of food must be interdicted. See that the excretory functions are properly performed. If anemia or de bility or any constitutional taint is present, treat on ...2

EPILEPSY
   During the seizure, amyl nitrite is the remedy most likely to be of service; chloroform must be used, if at all, with caution. To prevent the paroxysms. prescribe the bromides, particularly potassium bromide, which must be given well dilu......tassium salt. In the more chronic cases, acetanilid may be a better remedy than potassium bromide. In syphilitic cases potassium iodide in full doses must be used instead of the bromide. Other remedies of im portance are belladonna (combined with bromides), cannabis indica, digitalis, horse-nettle a...2

EPISTAXIS
   In severe cases, surgical measures must be resorted to (plugging anterior and posterior nares). Styptic solutions (alum, tannin, vegetable astringents,... / In severe cases, surgical measures must be resorted to (plugging anterior and posterior nares). Styptic solutions (alum, tannin, vegetable astringents, Monsel’s solution, vinegar) may...2

FEVER
   The remedies commonly resorted to include; 1st cardiac or ar terial sedatives, particularly aconite, 2d... / ...tute a measure almost always serviceable, 4th sedatives and anodynes, which may well be combined with diaphoretics. These several classes of remedies must be suited to the individual case, bearing in mind the fact that fever is not in and of itself necessarily an evil thing.2

GASTRIC ULCER
   Nourish patient by enemas so that stomach may have complete rest. Internally, silver nitrate and resorcin with codeine or morph ine, antacids, especially sodium bicarbonate with bismuth subcar bonate; counter-irritation by tincture iodine or mustard leaves; antiemetics as needed; for hematemesis, emulsion of oil turpentine, antipyrin, alum or other styptic; suprarenal extract. Bowels must be regulated by enemata.2


References

1) Felter, Harvey Wickes, 1922, The Eclectic Materia Medica, Pharmacology and Therapeutics, Cincinnati, Ohio.
2) Nelson, Baker & Co., 1904, Physician's Handy Book of Materia Medica and Therapeustics, Detroit, Michigan.