8 Genvoya Side Effects and How to Manage Them

Genvoya (elvitegravir / cobicistat / emtricitabine / tenofovir alafenamide) is a combination antiretroviral (ARV) medication used to treat human immunodeficiency virus (HIV) in adults and kids. Genvoya is dispensed as an oral tablet in its original container.

Taken once daily as a single tablet with food, Genvoya helps make HIV treatment simple. Genvoya is effective, but it occasionally comes with a few side effects. Understanding potential Genvoya side effects and how to manage them will help make your experience with the medication as smooth as possible.

Genvoya side effects at a glance

Genvoya is a well-tolerated medication. Many people take it without issue. But a number of side effects can still appear. Some can be serious and require medical attention.

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Common Genvoya side effects include:

• Headache

• Nausea

• Fatigue

• Diarrhea

• Rash

Less common, but potentially serious, Genvoya side effects include:

• New or worsening kidney problems

• Severe liver problems

• Buildup of lactic acid in the blood (lactic acidosis)

Let’s look at eight notable Genvoya side effects and how to manage them.

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1. Nausea

Nausea is the most commonly reported side effect of Genvoya. If Genvoya upsets your stomach, try taking your doses with food (it’s recommended to take Genvoya with food anyway). You can also try eating smaller, more frequent meals throughout the day instead of a few larger ones. Avoiding spicy or greasy foods also helps lessen stomach upset.

Contact your healthcare professional if your nausea becomes too bothersome to self-manage. They may recommend that you change what time you take your dose. Over-the-counter (OTC) nausea medications may be helpful. But be sure to check with your healthcare professional before adding any medications or supplements to your routine. They can tell you if they’re safe for you to take.

2. Diarrhea

Diarrhea is another common Genvoya side effect. It’s typically manageable at home.

If you’re having diarrhea while taking Genvoya, be sure to drink plenty of fluids. You’ll want to avoid dehydration by replenishing the fluids that are lost with diarrhea. Water, electrolyte drinks, and broth are all good replacement options.

You can also consider taking an OTC antidiarrheal medication, such as loperamide (Imodium A-D). Keep in mind that it’s recommended to use loperamide for only a few days at a time. Longer-lasting diarrhea symptoms should be addressed by a healthcare professional.

3. Feeling tired or sleepy

Some people report feeling more tired than usual while taking Genvoya. But Genvoya may not be the culprit. Many medications can make you feel more tired.

If this happens to you, make sure you’re getting enough rest, and try to stick to a regular sleep schedule. Light exercise and staying active during the day can also help boost your energy levels.

In most cases, this side effect goes away as your body adjusts to taking Genvoya. But if Genvoya makes you overly tired for an extended period of time, talk to your healthcare professional for personalized advice.

4. Headache

Headaches are another possible Genvoya side effect. There are several ways to manage headaches at home, with or without medication.

For starters, do your best to make sure you’re getting enough rest. Also, try to stay hydrated and keep your stress levels low to lessen headaches. Research also suggests that exercise can help reduce headache frequency and severity.

OTC headache medications, such as acetaminophen (Tylenol) or naproxen (Aleve, Naprosyn), can provide relief. But if headaches don’t get better after a few days, tell your healthcare professional. These OTC treatments are meant for short-term relief only.

Also, make sure to listen to any warning signs that your body is giving you. Severe headache that comes with confusion or a loss of consciousness is a very rare Genvoya side effect. If you experience this, go to the emergency room.

5. Kidney problems

Genvoya rarely causes kidney problems, including kidney failure. But preexisting kidney problems could get worse while taking Genvoya.

Before you start taking Genvoya, your healthcare professional will likely test your blood or urine to analyze your kidney function. They’ll do this by looking at your lab work. If you already have severe kidney problems, Genvoya may not be right for you.

Your healthcare professional will likely check your kidney function regularly while you’re taking Genvoya. But it’s important to do your part to protect your kidney health. Be sure to stay hydrated, and avoid medications that can be harmful to your kidneys if possible. Tell your prescriber right away if you notice any changes in urination — such as dark urine or less frequent bathroom trips — or swelling in your legs or feet.

6. Lactic acidosis

Lactic acidosis is another rare but potentially serious side effect of Genvoya. Lactic acidosis is a buildup of lactic acid in your blood. If left untreated, lactic acidosis can lead to organ damage.

Lactic acidosis symptoms can include:

• Trouble breathing

• Confusion

• Nausea and vomiting

• Fever

• Excessive fatigue 

If you experience severe forms of any of these symptoms, seek immediate medical attention. Lactic acidosis can be life-threatening, especially if you have underlying liver or kidney problems.

7. Hepatitis B exacerbation

For people living with hepatitis B, stopping Genvoya can cause a sudden worsening of hepatitis symptoms. The medication has a boxed warning for this risk, the FDA’s most serious medication warning.

Symptoms that may suggest a hepatitis B flare include:

• Stomach pain

• Nausea and vomiting

• Jaundice (yellowing of your skin or the whites of your eyes)

• Loss of appetite

• Flu-like symptoms

If you have concerns about hepatitis B at any time, it’s important to talk with your healthcare professional. You should be tested for hepatitis B before starting Genvoya or another ARV treatment. Your prescriber should also proactively check your liver function while you’re taking Genvoya and for a few months after stopping it.

8. Drug resistance

We all make mistakes. Sometimes that means forgetting to take your medicine. Drug resistance can develop if Genvoya isn’t taken consistently. Skipping doses can lead to the virus becoming resistant to treatment. As a result, treatment failure is possible. This can limit future treatment options.

To help prevent drug resistance, do your best to take Genvoya exactly as prescribed. Try not to miss a dose. If you have trouble taking your medication consistently, ask your healthcare professional about your options. They might recommend a long-acting injectable such as Cabenuva (cabotegravir / rilpivirine). This HIV treatment is administered once every 1 to 2 months. Sunlenca (lenacapavir) is another long-acting option.

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Written by:

Taylor K. Clarke, PharmD

Taylor K. Clarke, PharmD, has 8 years of pharmacy experience working in community practice, hospital pharmacy, and ambulatory care pharmacy. Taylor's commitment to patient education motivated her to pursue health communications as a pharmacist.

Edited by:

Joshua Murdock, PharmD, BCBBS

Joshua Murdock, PharmD, BCBBS, is a licensed pharmacist in Arizona, Colorado, and Rhode Island. He has worked in the pharmacy industry for more than 10 years and currently serves as a pharmacy editor for GoodRx.

Reviewed by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

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