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Truvada vs. Sustiva

Head-to-head comparisons of medication uses, side effects, warnings, and more.

Key takeaways

Truvada (emtricitabine/tenofovir disoproxil fumarate) and Sustiva (efavirenz) are both used to treat HIV, but they have some key differences. Truvada is a combination of two nucleoside reverse transcriptase inhibitors (NRTIs) and is also used for HIV prevention (PrEP). Sustiva, on the other hand, is a non-nucleoside reverse transcriptase inhibitor (NNRTI) and is not used for PrEP. Truvada is taken once daily with or without food, while Sustiva is taken once daily at bedtime on an empty stomach to reduce side effects. Sustiva can cause serious side effects like nerve issues and mood changes, and it is not recommended during pregnancy. Truvada can cause kidney and bone problems and requires regular blood tests to monitor these risks. Both medications are available in generic forms, making them more affordable options.

Truvada

 

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Efavirenz

(Sustiva)

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Summary for Truvada

Prescription only

Truvada, also known as TDF/FTC, is a combination medication that contains the antiretrovirals emtricitabine and tenofovir disoproxil fumarate. Truvada is used as part of an antiretroviral (ARV) regimen to treat HIV (human immunodeficiency virus) infections in adults and children. It's also preferred for HIV PrEP (pre-exposure prophylaxis or prevention). This medication works against HIV by stopping the virus from making copies of itself and spreading. Truvada tablets are taken by mouth once daily. Side effects when it's used for treating HIV include nausea, diarrhea, and dizziness. And Truvada side effects when used for PrEP include headache and belly pain.

Indications for Truvada

Pros and Cons for Truvada

Pros

  • Only taken once a day
  • Available as a lower-cost generic medication
  • Is a complete regimen for HIV PrEP
  • 99% effective for preventing HIV infection from sex when used as prescribed for PrEP

Cons

  • Requires regular blood work and lab tests to make sure your liver and kidneys are healthy
  • Not a complete treatment for HIV (must take one other medication with it)
  • Can worsen hepatitis B if you stop taking the medication all of a sudden
  • More likely to cause bone problems than similar medications

Common Side Effects for Truvada

HIV treatment Note: Side effects for HIV treatment were reported by people taking Truvada with efavirenz (Sustiva).

  • Higher cholesterol levels (22%)
  • Higher creatine kinase levels (9%)
  • Feeling tired (9%)
  • Depression (9%)
  • Nausea (9%)
  • Diarrhea (9%)
  • Dizziness (8%)
  • Upper respiratory infections (8%)
  • Sinus infection (congestion; 8%)
  • Rash (7%)
  • Headache (6%)

HIV PrEP (prevention)

  • Headache (7%)
  • Belly pain (4%)
  • Lower weight (3%)

Warnings for Truvada

  • Worsening of hepatitis B infection
  • PrEP only for people who test negative for HIV
  • Kidney problems
  • Overactive immune system
  • Bone problems
  • Liver problems and lactic acidosis
  • Interaction with other medications

Summary for Sustiva

Prescription only

Efavirenz (Sustiva) is a medication that's used in combination with other antiretroviral (ARV) therapy to treat human immunodeficiency virus (HIV) infections. It comes as oral tablets and capsules that are swallowed whole. The capsules can also be opened up and sprinkled in liquid for people who have trouble swallowing. Some side effects of this medication are rash, diarrhea, and nausea. Efavirenz (Sustiva) is available as both a brand-name and generic medication.

Indications for Sustiva

  • Treatment of HIV infection in people ages 3 months and older

Pros and Cons for Sustiva

Pros

  • Only taken once a day
  • Capsule form can be opened and sprinkled on soft food or liquid, such as applesauce or milk, so convenient for people with difficulty swallowing pills
  • Available as a lower-cost generic medication
  • Can be used in young children 3 months and older who weigh over 7.7 lbs

Cons

  • Has many potentially serious side effects and risks (e.g., nerve issues, irregular heartbeat)
  • Needs to be taken on an empty stomach
  • Not recommended during pregnancy
  • Interacts with a lot of medications

Common Side Effects for Sustiva

The following side effects were reported in adults taking this medication with other HIV ARVs. Side effects might differ in children.

  • Rash (5-16%)
  • Diarrhea (3-14%)
  • Pain (1-13%)
  • Higher triglyceride (fat) levels (6-11%)
  • Low white blood cell count (2-10%)
  • Nausea (2-10%)
  • Dizziness (2-9%)
  • Feeling tired (2-8%)
  • Higher liver enzymes (5-8%)
  • Headache (2-8%)
  • Difficulty sleeping (7%)
  • Vomiting (3-6%)
  • Trouble concentrating (3-5%)

Warnings for Sustiva

  • Heart rhythm problems (QT prolongation)
  • Effects on the brain, nerves, and mental health
  • Harm to unborn baby
  • Severe skin and allergic reactions
  • Liver problems
  • Higher cholesterol levels
  • Changes in body fat
  • Overactive immune system
  • Interactions with other medications

Prices with our coupons for Truvada vs. Sustiva

Price Card Drug Icon
Emtricitabine/Tenofovir30 tablets / 200mg/300mg
$27.79$1,843.69
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Efavirenz30 tablets / 600mg
$46.13$1,326.48
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