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# The First New Oral Gonorrhoea Pills in Decades (Nuzolvence & Blujepa) and 30-Minute At-Home PCR STI Tests: Dosing, Throat-Infection Limits, and Rules by Country
- URL: https://dotsexual.com/new-oral-gonorrhoea-pills-zoliflodacin-gepotidacin-at-home-sti-tests-2026/
- Published: 2026-10-28T11:30:00.000Z
- Updated: 2026-10-28T11:30:00.000Z
- Description: Two first-in-class oral gonorrhoea antibiotics—Nuzolvence (zoliflodacin) and Blujepa (gepotidacin)—and the 30-minute Visby Medical at-home PCR test offer new options amid record STI surges. Here is how they compare to ceftriaxone injections and why throat infections differ.
- Author: Dot Research Desk
- Tags: Research, Country Guides, Fit & Safety

Quick Answer (Checked 28 October 2026)

**Three clinical updates are reshaping how bacterial STIs are tested and treated in late 2026:**

1. **First New Oral Gonorrhoea Antibiotics in Decades:** The [U.S. FDA approved two first-in-class oral treatments](https://www.fda.gov/news-events/press-announcements/fda-approves-two-oral-therapies-treat-gonorrhea?ref=dotsexual.com) for **uncomplicated urogenital gonorrhoea**: **Nuzolvence (zoliflodacin)**—a single `3 g` oral dose of granules dissolved in water (\`91%\` cure rate in a 930-patient Phase 3 trial)—and **Blujepa (gepotidacin)**—two `3,000 mg` oral tablet doses taken 10–12 hours apart with food (\`93%\` cure rate in the 628-patient EAGLE-1 trial).
2. **The Throat-Infection Catch:** Both new oral medicines are approved **only for uncomplicated urogenital gonorrhoea** (urethra/cervix). Intramuscular **ceftriaxone injection (\`500 mg\` to \`1 g\` IM)** remains the global first-line standard—and is critical whenever throat (pharyngeal) gonorrhoea is possible, because oral antibiotics clear throat infections far less reliably.
3. **30-Minute Prescription-Free At-Home PCR STI Testing:** Alongside new oral therapies and [record gonorrhoea and syphilis notifications across Europe (ECDC)](https://www.bbc.com/news/articles/cm2pj07dr7lo?ref=dotsexual.com) and [Australia (Kirby Institute)](https://www.theguardian.com/australia-news/2026/sep/15/gonorrhoea-and-syphilis-rise-by-more-than-50-in-australia?ref=dotsexual.com), the FDA authorized the **Visby Medical Women’s Sexual Health Test**—a palm-sized, non-prescription true PCR device that screens a self-collected vaginal swab at home for **chlamydia, gonorrhoea, and trichomoniasis in \~30 minutes** with \`>97%\` accuracy.

For more than a decade, getting treated for gonorrhoea in a clinic meant one thing: an intramuscular injection of **ceftriaxone** into the buttock or thigh. One by one, \*Neisseria gonorrhoeae\* evolved resistance to older oral pills—first sulfonamides and penicillins, then tetracyclines, then fluoroquinolones like ciprofloxacin, and increasingly macrolides like azithromycin.

At the same time, public-health agencies in 2026 reported historic bacterial STI surges: [European Centre for Disease Prevention and Control (ECDC) surveillance](https://www.bbc.com/news/articles/cm2pj07dr7lo?ref=dotsexual.com) showed European gonorrhoea cases up **303%** over a decade (\`106,331\` annual notifications) and syphilis more than doubled (\`45,577\` cases), while [Australia’s UNSW Kirby Institute](https://www.theguardian.com/australia-news/2026/sep/15/gonorrhoea-and-syphilis-rise-by-more-than-50-in-australia?ref=dotsexual.com) reported 10-year rises of **57% in gonorrhoea** (\`42,393\` notifications) and **56% in infectious syphilis**. Against that backdrop, two breakthroughs highlighted in [October 2026 clinical reviews](https://www.contemporaryobgyn.net/clinical/sexual-health?ref=dotsexual.com)—the first new oral gonorrhoea drug classes in 30 years and the first 30-minute over-the-counter home PCR test—change what patients can ask for, provided you know their anatomical limits.

## 1\. Nuzolvence (zoliflodacin) vs Blujepa (gepotidacin) vs Ceftriaxone injection: how the regimens compare

Both [**Nuzolvence (zoliflodacin)** and **Blujepa (gepotidacin)**](https://www.fda.gov/news-events/press-announcements/fda-approves-two-oral-therapies-treat-gonorrhea?ref=dotsexual.com) attack bacterial DNA replication through brand-new chemical mechanisms, allowing them to kill \*Neisseria gonorrhoeae\* strains that resist older antibiotics:

- **Nuzolvence (zoliflodacin):** A first-in-class *spiropyrimidinetrione* developed through a global public–private partnership between Innoviva/Entasis Therapeutics and the non-profit Global Antibiotic Research & Development Partnership (GARDP). It blocks bacterial DNA gyrase at the **GyrB** subunit—a different binding pocket from ciprofloxacin—and is taken as a **single 3-gram packet of granules stirred into water**.
- **Blujepa (gepotidacin):** A first-in-class *triazaacenaphthylene* antibiotic developed by GSK that inhibits two bacterial type II topoisomerase enzymes simultaneously (**GyrA and ParC**). Originally cleared for uncomplicated urinary tract infections (\`1,500 mg\` twice daily for 5 days), its gonorrhoea regimen uses a higher two-dose burst: **3,000 mg (four 750 mg tablets) taken orally with food, followed by a second 3,000 mg dose 10 to 12 hours later** (\`6,000 mg\` total).

| Feature / Clinical Rule                     | Standard Ceftriaxone Injection*(Global First-Line Standard)*                                                            | Nuzolvence (Zoliflodacin)*(Oral Granules)*                                                                                                                                                                                     | Blujepa (Gepotidacin)*(Oral Tablets)*                                                                                                                                                                                                  |
| ------------------------------------------- | ----------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------ | -------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Antibiotic Class**                        | Third-generation cephalosporin (β-lactam)                                                                               | First-in-class spiropyrimidinetrione (DNA gyrase GyrB inhibitor)                                                                                                                                                               | First-in-class triazaacenaphthylene (dual GyrA + ParC topoisomerase inhibitor)                                                                                                                                                         |
| **Exact Dosing Regimen**                    | **Single intramuscular (IM) injection:**• US CDC: 500 mg IM (\`1 g IM\` if weight ≥150 kg)• UK BASHH / EU IUSTI: 1 g IM | **Single 3-gram oral dose** of granules dissolved in water (follow mixing instructions regarding food/fasting status).                                                                                                         | **Two 3,000 mg oral doses** (four 750 mg tablets per dose) taken **10 to 12 hours apart after a meal** (\`6,000 mg\` total).                                                                                                           |
| **Age & Weight Eligibility**                | All ages (weight-adjusted in children; safe in pregnancy)                                                               | Age **≥12 years** weighing **≥35 kg (77 lb)**; non-pregnant patients.                                                                                                                                                          | Age **≥12 years** weighing **≥45 kg (99 lb)** with limited or no alternative options.                                                                                                                                                  |
| **Phase 3 Urogenital Cure Rate**            | **96%–98%+** microbiological clearance at 4–10 days                                                                     | **90.9% (\`91%\`)** in 930-patient Phase 3 trial ([*The Lancet*](https://www.hcplive.com/view/fda-approves-zoliflodacin-nuzolvence-granules-uncomplicated-urogenital-gonorrhea?ref=dotsexual.com); non-inferior to comparator) | **92.6% (\`93%\`)** in 628-patient EAGLE-1 Phase 3 trial ([*The Lancet*](https://www.contagionlive.com/view/reviewing-recently-approved-antibiotics-for-uncomplicated-urogenital-gonorrhea?ref=dotsexual.com) vs \`91.2%\` comparator) |
| **Throat (Pharyngeal) & Rectal Infections** | **Gold standard for pharyngeal, rectal, and urogenital sites**                                                          | **Approved ONLY for urogenital site.** Not reliable as standalone therapy for pharyngeal gonorrhoea; test-of-cure required if throat exposed.                                                                                  | **Approved ONLY for urogenital site.** Limited pharyngeal numbers in EAGLE-1 (with 2 pharyngeal failures); requires pharyngeal test-of-cure.                                                                                           |
| **Key Side Effects & Warnings**             | Injection-site soreness; rare cephalosporin allergy                                                                     | Headache, dizziness, nausea, diarrhoea, transient low WBC; **animal embryo-fetal & male fertility warnings** (avoid in pregnancy).                                                                                             | GI effects (diarrhoea, nausea, abdominal cramping, soft stools due to acetylcholinesterase inhibition); QTc / CYP3A4 precautions.                                                                                                      |

## 2\. The critical clinical catch: why throat (pharyngeal) gonorrhoea still needs an injection and a Test-of-Cure

As [public-health clinical advisories (such as CDPH’s May 2026 guidance)](https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/Clinical-Recommendations-Recently-Approved-Oral-Treatment-Uncomplicated-Urogenital-Gonorrhea.pdf?ref=dotsexual.com) emphasize, the single biggest mistake patients and urgent-care clinics make with gonorrhoea is treating a urine test alone while missing the throat:

1. **90%+ of throat and rectal gonorrhoea has zero symptoms:** Performing oral sex on a partner with urethral or cervical gonorrhoea frequently transmits \*Neisseria gonorrhoeae\* to the tonsils and pharynx without causing a sore throat. As we detail in [What a “Standard” STI Panel Includes, What It Misses, and How to Ask](https://dotsexual.com/what-standard-sti-panel-includes-misses-partner-scripts/), a urine sample only checks the urethra—it never detects a throat or rectal infection unless you swab those sites.
2. **Why oral pills struggle in the throat:** Tonsillar crypts have lower antibiotic tissue penetration than the urethra or cervix, where urine concentrates drug metabolites. Even with older oral alternatives like **cefixime 800 mg**, pharyngeal cure rates lag far behind intramuscular ceftriaxone.
3. **The 7-to-14-Day Test-of-Cure + 7-Day Abstinence Rule:** Whether you are treated with an intramuscular ceftriaxone injection or an oral regimen (\*Nuzolvence\* or \*Blujepa\*), you must **abstain from all sexual contact for 7 full days after completing treatment** (and until all partners have completed treatment and symptoms have resolved). If you have pharyngeal gonorrhoea—or received any oral alternative regimen—guidelines require a **Test-of-Cure (TOC) swab 7 to 14 days after treatment**, followed by routine retesting at **3 months** because reinfection from untreated network partners is common.
4. **Remember chlamydia co-treatment:** Neither ceftriaxone nor \*Nuzolvence\* nor \*Blujepa\* reliably treats co-existing \*Chlamydia trachomatis\*. Unless chlamydia has been ruled out by a modern nucleic acid amplification test (NAAT/PCR), standard guidelines add **doxycycline 100 mg orally twice daily for 7 days**.

## 3\. 30-minute at-home PCR (\*Visby Medical\*) vs rapid fingerstick vs clinic/postal lab kits

For years, “at-home STI test” meant pricking your finger or swabbing at home, dropping a box into a postbox, and waiting 3 to 7 business days for a central laboratory to run PCR. In 2025–2026, [FDA De Novo authorizations](https://www.contemporaryobgyn.net/clinical/sexual-health?ref=dotsexual.com) created a new category: **true point-of-care molecular PCR and rapid immunoassays you run on your own bathroom counter in 15 to 30 minutes**.

| Home Testing Option                                                                                           | What It Tests & Sample Type                                                                                          | Time to Result & Accuracy                                                                                                                               | Window Period & Country Availability (2026)                                                                                                                                                       |
| ------------------------------------------------------------------------------------------------------------- | -------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------- | ------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- |
| **Visby Medical Women’s Sexual Health Test** *(Single-use powered home PCR device)*                           | **Chlamydia, Gonorrhoea & Trichomoniasis** *Sample:* Self-collected vaginal swab (symptomatic or asymptomatic women) | **\~30 minutes at home** via Visby App• Chlamydia: 98.8% sens / 97.2% spec• Gonorrhoea: 99.1% sens / 100% spec• Trichomoniasis: 98.5% sens / 97.8% spec | **Window period:** **7 to 14 days** post-exposure.**Availability:** FDA De Novo OTC cleared in the **US** (no prescription needed). Does *not* test urine, throat, or rectal swabs.               |
| **First To Know Syphilis Test** *(NOWDiagnostics lateral-flow immunoassay)*                                   | **Treponemal syphilis antibodies** *Sample:* Single drop of fingerstick blood                                        | **\~15 minutes at home** *Requires confirmatory lab testing (RPR + treponemal) if positive*                                                             | **Window period:** **3 to 12 weeks** post-exposure.*Crucial rule:* Anyone who EVER had syphilis in the past will test positive for life on treponemal rapid tests—use a clinic RPR titer instead. |
| **Multi-Site Postal Lab NAAT Kits** *(UK NHS SH:24 / Sexual Health London; US/CA/AU telehealth mail-in kits)* | **Chlamydia, Gonorrhoea (3-site: urine/vaginal + throat + rectal), HIV & Syphilis**                                  | **2 to 5 days** after mailing to accredited laboratory (\`>98%\` NAAT sensitivity across anatomical sites)                                              | **UK:** Free via NHS postal sexual health services.**US/CA/AU/EU:** Covered by public clinics, telehealth platforms, or private pharmacies.                                                       |

## 4\. Matching your test and treatment to the right timeline clock

- **Within 72 hours of condomless exposure:** Testing 24 hours after sex will miss an infection acquired the night before because bacteria and antibodies have not yet reached detectable levels (see [STI Test Window Periods: When to Test and Retest](https://dotsexual.com/sti-test-window-periods-when-to-test-and-retest/) and [Confidential Postal STI Testing Routes by Country](https://dotsexual.com/confidential-postal-sti-testing-routes-by-country/)). If you are within 72 hours of condomless sex in a high-incidence network, check our [DoxyPEP 72-Hour STI Prevention Guide](https://dotsexual.com/doxypep-after-sex-72-hour-sti-prevention-rules-by-country/) (noting that while DoxyPEP cuts syphilis and chlamydia by 70%–88%, high tetracycline resistance means it cannot be relied on to prevent gonorrhoea in the UK/EU/Australia).
- **At Day 7–14:** Run your urogenital/vaginal PCR (such as \*Visby Medical\* at home or a clinic/postal 3-site NAAT covering throat and rectum if you had oral or anal exposure).
- **If your home test turns positive:** Do not take leftover antibiotics from a cabinet. Share your digital PCR readout with a licensed clinician or sexual health clinic ([Talk to a Real Clinician](https://dotsexual.com/talk-to-a-clinician/)) so you receive either standard intramuscular ceftriaxone or—if you have needle phobia, a cephalosporin allergy, or cannot reach an injection clinic for an uncomplicated urogenital infection—a weight-verified prescription for **Nuzolvence (zoliflodacin)** or **Blujepa (gepotidacin)**.

## Sources and evidence notes

1. **U.S. Food and Drug Administration (FDA).** FDA Approves Two Oral Therapies to Treat Gonorrhea (Nuzolvence \[zoliflodacin\] and Blujepa \[gepotidacin\]). [FDA Press Announcement](https://www.fda.gov/news-events/press-announcements/fda-approves-two-oral-therapies-treat-gonorrhea?ref=dotsexual.com).
2. **California Department of Public Health (CDPH).** Clinical Recommendations for Recently Approved Oral Treatment of Uncomplicated Urogenital Gonorrhea. May 2026\. [CDPH Clinical Guidance PDF](https://www.cdph.ca.gov/Programs/CID/DCDC/CDPH%20Document%20Library/Clinical-Recommendations-Recently-Approved-Oral-Treatment-Uncomplicated-Urogenital-Gonorrhea.pdf?ref=dotsexual.com).
3. **HCPLive.** FDA Approves Zoliflodacin (Nuzolvence) Granules for Uncomplicated Urogenital Gonorrhea. September 2026\. [HCPLive](https://www.hcplive.com/view/fda-approves-zoliflodacin-nuzolvence-granules-uncomplicated-urogenital-gonorrhea?ref=dotsexual.com).
4. **Contagion Live.** Reviewing Recently Approved Antibiotics for Uncomplicated Urogenital Gonorrhea (EAGLE-1 Gepotidacin & Zoliflodacin Phase 3 Trials). August 2026\. [Contagion Live](https://www.contagionlive.com/view/reviewing-recently-approved-antibiotics-for-uncomplicated-urogenital-gonorrhea?ref=dotsexual.com).
5. **Contemporary OB/GYN.** Sexual Health Clinical & Regulatory Updates: FDA Approval of Visby Medical At-Home STI Test, Zoliflodacin, and Gepotidacin. 20 October 2026\. [Contemporary OB/GYN](https://www.contemporaryobgyn.net/clinical/sexual-health?ref=dotsexual.com).
6. **European Centre for Disease Prevention and Control (ECDC) / BBC News.** Gonorrhoea and syphilis hit record levels in Europe. May 2026\. [BBC Health / ECDC](https://www.bbc.com/news/articles/cm2pj07dr7lo?ref=dotsexual.com).
7. **UNSW Kirby Institute / The Guardian.** Gonorrhoea and syphilis rise by more than 50% in Australia. September 2026\. [The Guardian / Kirby Institute](https://www.theguardian.com/australia-news/2026/sep/15/gonorrhoea-and-syphilis-rise-by-more-than-50-in-australia?ref=dotsexual.com).

*Evidence checked: 28 October 2026\. Educational clinical and regulatory synthesis only; does not replace evaluation and prescription by a qualified clinician.*