MDMA and PrEP (tenofovir/emtricitabine)
Standard PrEP does not carry the dangerous MDMA interaction that boosted HIV regimens do.
Why this happens
Standard PrEP (tenofovir with emtricitabine, such as Truvada or Descovy) does not strongly block CYP2D6, the enzyme that clears MDMA, so it does not cause the large rise in MDMA levels seen with ritonavir- or cobicistat-boosted regimens. The serious interaction is with those boosters, not PrEP itself.
What this means in practice
PrEP itself is not the concern - a ritonavir- or cobicistat-boosted regimen is. If you are unsure which you take, ask an HIV pharmacist.
Information, not medical advice. Threshold does not promote or encourage MDMA use. This exists so that people who make their own choices can make safer, better-informed ones. It is not a substitute for professional care.
Sources
- HIV drug interactions with recreational drugs (MDMA) - University of Liverpool HIV Drug Interactions