Substantial + Moderate Risk

Perform Baseline Laboratory Testing

Tenofovir fumarate/emtricitabine (TDF/FTC) 300/200mg once daily (Grade 1C)

NRTI backbone

AND ONE OF

Darunavir (800mg) + ritonavir (100mg) once daily (Grade 1A)

Drug interactions common: ritonavir inhibits P450 enzyme system, and darunavir inhibits the CYP 3A4 enzyme system

OR

Dolutegravir 50mg once daily (Grade 1C)

Caution in women of childbearing age: may increase neural tube defects in pregnancies conceived while taking medication

OR

Raltegravir 400mg twice daily (Grade 1A)

Myopathy, elevated CK, and rhabdomyolysis rarely reported

Alternative nPEP regimens may be considered. Please consult Appendix 1 CMAJ 2017; 189(4): E1448-1458 for details.