Key takeaways:
Descovy (emtricitabine / tenofovir alafenamide) is a prescription-only medication that’s commonly used for HIV prevention — better known as pre-exposure prophylaxis (PrEP). It can also treat HIV when taken in combination with other medications.
Descovy can interact with several medications, including certain antibiotics, antivirals, and anti-seizure medications. It can also interact with nonsteroidal anti-inflammatory drugs (NSAIDs) and St. John’s wort.
Most Descovy interactions result in lower medication concentrations in the body. These interactions can make Descovy less effective. Other interactions can increase medication concentrations, which raise the risk of side effects. Your HIV specialist can help you manage and prevent these interactions.
Save on related medications
Descovy is a combination medication that contains two antiretroviral medications — emtricitabine and tenofovir alafenamide — in a single pill. It’s used for HIV prevention, also known as pre-exposure prophylaxis (PrEP), in adults and adolescents. It can also treat HIV when combined with other antiretroviral medications. Descovy keeps HIV at bay by preventing the virus from copying itself and spreading.
While Descovy is an effective treatment, it can interact with certain medications and supplements. Many interactions make Descovy less effective, which can make it harder to manage HIV. Other interactions can raise the risk of kidney problems or other side effects.
Descovy interactions at a glance
Notable Descovy drug interactions include:
Protease inhibitors, such as Paxlovid (nirmatrelvir / ritonavir)
Other antivirals, such as valacyclovir (Valtrex)
Several antibiotics, such as rifampin (Rifadin) or vancomycin
Anti-seizure medications, such as carbamazepine (Tegretol)
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin)
Orlistat (Alli, Xenical)
Certain immunosuppressants, such as tacrolimus (Prograf)
Certain cancer medications, such as apalutamide (Erleada)
Certain gene therapy medications, such as Zynteglo (betibeglogene autotemcel)
Aside from medications, Descovy can also interact with certain supplements and drinks, namely St. John’s wort and excessive amounts of alcohol.
Here, we’ll dive deeper into seven Descovy interactions and how to manage them.
Keep in mind: This list doesn’t include all of Descovy’s possible interactions. So be sure to talk with your HIV specialist about interactions that you should be aware of. They can review your updated medication list to help you manage and avoid potential interactions.
1. Protease inhibitors
Protease inhibitors are a commonly prescribed group of medications for treating HIV and other viral health conditions. But they have a variety of potential interactions with Descovy.
Some protease inhibitors, such as tipranavir (Aptivus), can lower the concentration of Descovy in your body. This can make it less effective at preventing and treating HIV.
However, some medications that contain ritonavir — such as Paxlovid (nirmatrelvir / ritonavir) — can actually increase Descovy concentrations in your body. This may lead to new or worsening Descovy side effects.
Handling interactions between Descovy and protease inhibitors is complex. Make sure your HIV specialist is aware of all medications (and supplements) that you’re taking. They can tell you if you should avoid an interaction altogether or if a dosage adjustment is sufficient.
2. Other antivirals
In addition to protease inhibitors, several other antivirals can interact with Descovy, including acyclovir (Zovirax), valacyclovir (Valtrex), and valganciclovir (Valcyte). These medications are used to treat herpes, shingles, and other viral infections.
Like Descovy, these antivirals leave your body through your kidneys. Taking the medications together can make it harder for your kidneys to remove them from your body, which may raise your risk of side effects, including kidney damage.
If you need to take Descovy with any of these antivirals, it's important to stay well hydrated to help your kidneys remove the medications properly. Possible signs and symptoms of kidney problems include swelling in your legs or ankles, chest pain, and less frequent urination. Let your HIV specialist know right away if you experience any of these issues. You should also let them know if you have a history of kidney problems before starting Descovy.
New to Descovy (emtricitabine / tenofovir alafenamide)? Read on for a rundown of recommended Descovy dosages for HIV treatment and prevention.
Risk management: Descovy is typically tolerated well, but it can still cause side effects such as nausea and diarrhea.
Real-life experiences: Read three firsthand accounts of what it’s like to take Descovy for HIV prevention.
3. Several antibiotics
Several antibiotics can interact with Descovy. The top ones to keep in mind are rifampin (Rifadin), rifabutin (Mycobutin), and rifapentine (Priftin), which are typically used to treat tuberculosis.
These antibiotics can lower the amount of Descovy in the body, which can interfere with its ability to prevent and treat HIV effectively. It’s recommended to avoid these antibiotics while taking Descovy.
Other antibiotics that can interact with Descovy include gentamicin, amikacin, and vancomycin. These antibiotics are given intravenously (into a vein). Like Descovy, they’re removed from the body through the kidneys. If these medications are administered with Descovy, the combination could lead to kidney problems.
If you have an infection that requires taking antibiotics, the healthcare professional who’s treating your infection will likely recommend an alternative to the above antibiotics (if possible).
4. Anti-seizure medications
Anti-seizure medications treat a number of health conditions, such as seizures and mood disorders. Some of these medications can reduce Descovy levels in the body, limiting its effectiveness.
The most commonly prescribed anti-seizure medications that interact with Descovy are carbamazepine (Tegretol), oxcarbazepine (Trileptal), and phenytoin (Dilantin, Phenytek). Phenobarbital and primidone can interact with Descovy as well.
If you need to take an anti-seizure medication with Descovy, the healthcare professional who manages your seizures can recommend an anti-seizure medication that doesn’t interact with it. They may opt to prescribe you to a medication such as gabapentin (Neurontin), lamotrigine (Lamictal), or levetiracetam (Keppra), for example.
5. St. John’s wort
St. John’s wort is an over-the-counter (OTC) herbal supplement that’s sometimes marketed as a treatment for depression. But St. John’s wort can cause several interactions, including with Descovy. St. John’s wort can lower Descovy levels in the body, which decreases the medication’s ability to fight HIV as intended.
Let your HIV specialist know if you’re taking St. John’s wort. Since it’s not recommended to take St. John’s wort and Descovy at the same time, they’ll likely recommend an alternative antidepressant. There are also other natural ways to manage depression, including mindfulness practices, acupuncture, and journaling.
6. NSAIDs
Descovy has occasionally been linked to kidney problems. This is more common in people who have a history of kidney problems or are taking other medications that can harm the kidneys, such as nonsteroidal anti-inflammatory drugs (NSAIDs).
In general, taking NSAIDs, such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn), frequently or at high dosages isn’t recommended because of the risk of kidney problems. That risk goes up when you throw Descovy into the mix.
Before starting Descovy, tell your HIV specialist if you’re taking an NSAID. Depending on what you’re taking the NSAID for, they may recommend switching to a different pain reliever, such as acetaminophen (Tylenol), that doesn’t carry the risk of this interaction.
7. Certain cancer medications
Certain cancer medications, such as apalutamide (Erleada) and lorlatinib (Lorbrena), may also interact with Descovy. Apalutamide is a medication commonly used to treat advanced prostate cancer. Lorlatinib treats non-small cell lung cancer.
These medications may interact with Descovy because they change a protein that affects how your body absorbs it. This can lead to lower concentrations of Descovy and hinder how effectively it prevents and treats HIV.
Let your HIV specialist know if you take any cancer medications before starting Descovy. Depending on the severity of the interaction, you may need to switch to an alternative cancer or HIV medication.
Frequently asked questions
Yes, your prescriber may recommend taking Descovy after a potential HIV exposure as part of a 28-day post-exposure prophylaxis (PEP) regimen. You should take it in combination with a medication like Tivicay (dolutegravir). You should begin taking PEP within 72 hours (3 days) of the exposure for the best chance of success. Your prescriber should also guide you through the necessary testing and follow-up.
Descovy isn’t just for men, but the FDA has only approved it for men and transgender women for HIV PrEP. People at risk for HIV from receptive vaginal sex did not take part in the medication’s clinical trials. For now, experts recommend other PrEP medications, such as Truvada (emtricitabine / tenofovir disoproxil fumarate), for people at risk through vaginal sex.
Gilead, Descovy’s manufacturer, is conducting ongoing research to see if Descovy is safe and effective for cisgender women. Until those results are available, Descovy for PrEP is limited to men and transgender women.
Yes, your prescriber may recommend taking Descovy after a potential HIV exposure as part of a 28-day post-exposure prophylaxis (PEP) regimen. You should take it in combination with a medication like Tivicay (dolutegravir). You should begin taking PEP within 72 hours (3 days) of the exposure for the best chance of success. Your prescriber should also guide you through the necessary testing and follow-up.
Descovy isn’t just for men, but the FDA has only approved it for men and transgender women for HIV PrEP. People at risk for HIV from receptive vaginal sex did not take part in the medication’s clinical trials. For now, experts recommend other PrEP medications, such as Truvada (emtricitabine / tenofovir disoproxil fumarate), for people at risk through vaginal sex.
Gilead, Descovy’s manufacturer, is conducting ongoing research to see if Descovy is safe and effective for cisgender women. Until those results are available, Descovy for PrEP is limited to men and transgender women.
The bottom line
Descovy (emtricitabine / tenofovir alafenamide) can interact with certain antibiotics, antivirals, and anti-seizure medications. It can also interact with St. John’s wort and nonsteroidal anti-inflammatory drugs (NSAIDs). Some interactions can result in less effective treatment with Descovy, while others may contribute to side effects. Before starting treatment with Descovy, share your medication list with your HIV specialist, so they can check for potential interactions.
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References
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HIV.info. (2025). HIV prevention. National Institutes of Health.
Janssen Products. (2024). Erleada - apalutamide tablet, film coated [package insert].
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Pfizer Laboratories Div Pfizer. (2023). Lorbrena - lorlatinib tablet, film coated [package insert].
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