Descovy
Descovy (emtricitabine / tenofovir alafenamide), also known as FTC/TAF, is a combination antiretroviral. It's used as part of an antiretroviral therapy (ART) to treat human immunodeficiency virus (HIV) infections in adults and children. It's also preferred for HIV pre-exposure prophylaxis (PrEP). Descovy (emtricitabine / tenofovir alafenamide) works against HIV by stopping the virus from making copies of itself and spreading. Typically, this medication is taken by mouth once daily. Some common side effects of Descovy (emtricitabine / tenofovir alafenamide) include nausea and diarrhea.
What is Descovy (emtricitabine / tenofovir alafenamide)?
What is Descovy (emtricitabine / tenofovir alafenamide) used for?
Treatment of HIV infection
Prevention of HIV infection (PrEP) through sexual intercourse, except for receptive vaginal sex
How Descovy (emtricitabine / tenofovir alafenamide) works
Descovy (emtricitabine / tenofovir alafenamide) is a combination of two HIV antiretroviral medications: emtricitabine and tenofovir alafenamide. Both medications are nucleoside reverse transcriptase inhibitors (NRTIs). They insert themselves into the genetic material of the virus. As a result, Descovy (emtricitabine / tenofovir alafenamide) prevents HIV from making copies of itself and spreading.
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What are the side effects of Descovy (emtricitabine / tenofovir alafenamide)?
Common Side Effects
- Diarrhea (5%)
- Nausea (4%)
Other Side Effects
- Headache
- Feeling tired
- Belly pain
Serious Side Effects
- Buildup of lactic acid in the blood (lactic acidosis): feeling more tired and weak, belly pain, muscle pain, breathing problems
- Kidney problems: tiredness, confusion, nausea, urinating less than usual, swelling in your legs, joint or bone pain
- Liver problems: nausea, vomiting, not feeling hungry, pain in the right side of the stomach, yellowing of the whites of the eyes or skin, dark-colored urine, light-colored stool
Source: DailyMed
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The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- High lactic acid level—muscle pain or cramps, stomach pain, trouble breathing, general discomfort and fatigue
- Infection—fever, chills, cough, or sore throat
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Pros and cons of Descovy (emtricitabine / tenofovir alafenamide)
Pros
Only taken once a day
Is a complete regimen for HIV PrEP
Safer for the kidneys and bones compared to Truvada, another PrEP medication
Cons
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
Requires regular blood work and lab tests to make sure your kidneys are healthy
Pharmacist tips for Descovy (emtricitabine / tenofovir alafenamide)
Take Descovy (emtricitabine / tenofovir alafenamide) every day to help the medication treat or prevent HIV the best it can. You can use an app on your phone to help you remember.
You can take Descovy (emtricitabine / tenofovir alafenamide) with or without food.
Make sure to get your routine blood tests done on time before and while you’re taking Descovy (emtricitabine / tenofovir alafenamide). This helps your provider make sure the medication is working for you and not causing side effects.
Taking Descovy (emtricitabine / tenofovir alafenamide) can sometimes put you at risk for kidney problems. It's best to avoid other medications that can raise your risk of kidney damage, such as ibuprofen (Advil) and naproxen (Aleve), while you're taking Descovy (emtricitabine / tenofovir alafenamide). Let your provider or pharmacist know what medications you're taking or planning to take, including over-the-counter products and supplements.
Speak with your provider before stopping Descovy (emtricitabine / tenofovir alafenamide) or any of your HIV medications. Stopping your HIV medications too soon can cause the virus to spread and become harder to treat. And if you also have hepatitis B, stopping Descovy (emtricitabine / tenofovir alafenamide) suddenly can cause your hepatitis B infection to come back or worsen.
If your child is taking Descovy (emtricitabine / tenofovir alafenamide) and you notice major weight changes in your child, make sure to tell the healthcare team. Your child's Descovy (emtricitabine / tenofovir alafenamide) dose might need to be changed with changes in weight (for those weighing less than 77 pounds).
Tips for taking Descovy (emtricitabine / tenofovir alafenamide) for HIV PrEP (prevention):
Let your provider know if you have flu-like symptoms within the past month before you start Descovy (emtricitabine / tenofovir alafenamide) for PrEP. Symptoms of a new HIV infection, such as tiredness, vomiting, diarrhea, fever, joint or muscle aches, sore throat, or night sweats, are similar to flu symptoms.
Make sure to get tested for HIV before starting PrEP and at least every 3 months during PrEP. If you become infected with HIV, you'll need different treatment. Taking Descovy (emtricitabine / tenofovir alafenamide) when you test positive for HIV can make the infection harder to treat.
While you're taking Descovy (emtricitabine / tenofovir alafenamide), continue to practice safe sex and use condoms to lower your risk of HIV and other sexually transmitted infections (STIs).
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What are the risks and warnings for Descovy (emtricitabine / tenofovir alafenamide)?
Descovy (emtricitabine / tenofovir alafenamide) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Worsening of hepatitis B infection
Risk factors: Have hepatitis B and HIV | Stopping Descovy (emtricitabine / tenofovir alafenamide) | Severe liver problems
Before you start Descovy (emtricitabine / tenofovir alafenamide), your provider will test you for hepatitis B virus (HBV). If you have HBV, suddenly stopping Descovy (emtricitabine / tenofovir alafenamide) might make your liver condition worse (also called an HBV flare-up). Don't stop taking Descovy (emtricitabine / tenofovir alafenamide) without talking with your provider first. Make sure to get your refills on time so that your treatment isn't interrupted. If you need to stop taking Descovy (emtricitabine / tenofovir alafenamide), your provider might follow up with you for several months after you stop treatment. Your provider will order blood work to check your liver for an HBV flare-up.
PrEP only for people who test negative for HIV
Risk factors: Undetected HIV infection while taking Descovy (emtricitabine / tenofovir alafenamide) for PrEP
Descovy (emtricitabine / tenofovir alafenamide) can be used as PrEP. PrEP is for people who don't have HIV to help prevent infection before they're potentially exposed to the virus through sex. You'll need to test for HIV to make sure that you don't have HIV before you start PrEP and at least every 3 months while you're taking Descovy (emtricitabine / tenofovir alafenamide). If you test positive for HIV, your provider will need to change your medications. Taking Descovy (emtricitabine / tenofovir alafenamide) alone isn't enough to treat HIV and can make your infection more difficult to treat.
Kidney problems
Risk factors: History of kidney problems | Taking other medications known to harm kidneys
Some people taking Descovy (emtricitabine / tenofovir alafenamide) have had kidney problems. To prevent kidney injury, it's recommended that you avoid taking other medications that can also harm the kidneys, like high doses of nonsteroidal anti-inflammatory drugs (NSAIDs). Before starting and during treatment with Descovy (emtricitabine / tenofovir alafenamide), your provider will order blood work or urine tests to check on your kidneys. Let your provider know right away if you experience bone or muscle pain, pain in your arms or legs, and general weakness that doesn't go away. These might be signs of kidney problems.
Overactive immune system
Taking Descovy (emtricitabine / tenofovir alafenamide) can cause changes to your immune system called immune reconstitution syndrome. This medical condition happens when your immune system becomes more active after you start Descovy (emtricitabine / tenofovir alafenamide). Your immune system begins to fight off different infections that it was too weak to fight off before you started treatment. In rare cases, your immune system might improve so much with treatment that it starts to attack normal cells in your body (autoimmune). You can develop immune reconstitution syndrome as early as during the first few weeks of taking Descovy (emtricitabine / tenofovir alafenamide) or many months later. Tell your healthcare provider right away if you start having any new symptoms, such as fever, pain, hair loss, bulging eyes, or sweating, after you start Descovy (emtricitabine / tenofovir alafenamide).
Liver problems and lactic acidosis
Rarely, people who take medications containing NRTIs, such as Descovy (emtricitabine / tenofovir alafenamide), have reported liver problems, like fatty liver disease. Descovy (emtricitabine / tenofovir alafenamide) can also cause a buildup of lactic acid in the blood (lactic acidosis). Both conditions can be life-threatening.
Make sure to get blood tests done while you take Descovy (emtricitabine / tenofovir alafenamide) so your provider can check for these harmful side effects and make sure the medication is still safe to take. Talk with your provider right away if you experience signs and symptoms of liver damage, such as upper right stomach pain, yellowing of the skin or whites of the eyes, or dark urine. Also, let your provider know if you have symptoms of lactic acidosis, such as feeling weak, muscle pain, and trouble breathing.
Interaction with other medications
Taking certain medications for HIV (e.g., Aptivus (tipranavir), ritonavir (Norvir)), seizures (e.g., carbamazepine (Tegretol)), bacterial infections (e.g., rifampin (Rifadin)), or herbal supplements (e.g., St. John's wort) can lower the amount of Descovy (emtricitabine / tenofovir alafenamide) in your body. This can cause the HIV virus to spread and become harder to treat. Because of the potential for drug interactions with Descovy (emtricitabine / tenofovir alafenamide), tell your provider and pharmacist about all the medications you take or plan to take. They can make sure your medications are safe to take together.
Descovy (emtricitabine / tenofovir alafenamide) dosage forms
Typical dosing for Descovy (emtricitabine / tenofovir alafenamide)
Treatment of HIV
Adults and children who weigh at least 77 pounds: The typical dose is 1 tablet (200 mg/25 mg of emtricitabine/tenofovir alafenamide) by mouth once daily.
Children who weigh 30 to under 77 pounds: The typical dose is 120 mg/15 mg (emtricitabine / tenofovir alafenamide) by mouth once daily.
Prevention of HIV (PrEP)
Adults and children who weigh at least 77 pounds: The typical dose is 200 mg/25 mg (emtricitabine/tenofovir alafenamide) by mouth once daily.
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How much does Descovy (emtricitabine / tenofovir alafenamide) cost?
Descovy (emtricitabine / tenofovir alafenamide) contraindications
For HIV PrEP: People who have HIV (tested positive for HIV) or aren't sure if they're infected with HIV
What are alternatives to Descovy (emtricitabine / tenofovir alafenamide)?
Treatment of HIV infection
Prevention of HIV infection (PrEP) through sexual intercourse, except for receptive vaginal sex
Treatment of HIV infection
Prevention of HIV infection (PrEP or pre-exposure prophylaxis)
What is the latest news about Descovy (emtricitabine / tenofovir alafenamide)?
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References
Best studies we foundAnderson, P. L., et al. (2012). Emtricitabine-tenofovir concentrations and pre-exposure prophylaxis efficacy in men who have sex with men. Science Translational Medicine.
Centers for Disease Control and Prevention. (2024). What is PrEP
Clinical Info HIV.gov. (n.d.). Nucleoside reverse transcriptase inhibitor (NRTI).
Clinical Info HIV.gov. (2022). Initial combination antiretroviral regimens for people with HIV.
Gilead Sciences, Inc. (2022). Descovy- emtricitabine and tenofovir alafenamide tablet [package insert]. DailyMed.
Lake, J. E., et al. (2021). Impact of Integrase inhibitors and tenofovir alafenamide on weight gain in people with HIV. Current Opinion in HIV and AIDS.
MedlinePlus. (2017). Fatty liver disease.
National Institute of Allergy and Infectious Diseases. (2024). 10 things to know about HIV suppression.
US Public Health Service. (2021). Preexposure prophylaxis for the prevention of HIV infection in the United States.
Thapa, S., et al. (2023). Immune reconstitution inflammatory syndrome. StatPearls.
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