It’s important to have a review of people’s medications before they start PrEP. Any medicines that could affect renal function are worthwhile making sure that everything is okay. Examples include people who are on ACE-inhibitors, people who are on metformin, or who regularly use [inaudible 00:00:20], all of these drugs can affect kidney function so it’s important that you review these medicines as well as making sure that their kidney function is okay. These are not contraindications to starting PrEP. However, it is good to know where you are starting from and if you are going to be adding any of these medications whilst the person is being treated on PrEP. It’s worthwhile to carefully monitor renal status during this process.
For this reason, I like to make sure that I have all of the information for my patients. Sometimes patients may only come to you for PrEP but they may have another GP. It’s important to be able to talk with your patients about the importance of continuity of care and all doctors having access to this information, not just for yourself, but also for the other practitioner as well. I understand that there are some patients who are worried about confidentiality in situations like this. However, their health is vital so it’s important that you reinforce to these patients that somebody or both doctors have to be in complete communication to make sure that everybody is aware of all medicines that are being taken.