Genvoya
Genvoya (elvitegravir / cobicistat / emtricitabine / tenofovir alafenamide) is a combination antiretroviral therapy (ART) that treats human immunodeficiency virus (HIV) infections in adults and children. It's made up of two nucleoside reverse transcriptase inhibitors (NRTIs), emtricitabine and tenofovir alafenamide; an integrase strand transfer inhibitor (INSTI) called elvitegravir; and a "booster" medication known as cobicistat. Genvoya is taken by mouth, typically once daily. Some common side effects of this medication include nausea and diarrhea. It's not available as a generic medication.
What is Genvoya?
What is Genvoya used for?
- Treatment of HIV infection
How Genvoya works
Genvoya is a combination of four medications:
- Emtricitabine and tenofovir alafenamide are both nucleoside reverse transcriptase inhibitors (NRTIs). They insert themselves into the genetic material of the virus. This helps to prevent HIV from making copies of itself and spreading.
- Elvitegravir is an integrase strand transfer inhibitor (INSTI). Integrase is an enzyme (protein) that HIV uses to insert its genetic information into your cells. Once inserted, HIV uses your cells to make more copies of itself. Elvitegravir works by blocking integrase, which then helps prevent HIV from spreading.
- Cobicistat is a "booster" medication. It slows down your body from breaking down other HIV ARVs in Genvoya. This "boosts" the levels of Genvoya in the body. Cobicistat also makes the other HIV ARVs last longer in the body so they can work better to fight the infection.
Drug facts
Side effects of Genvoya
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Nausea (11%)
- Diarrhea (7%)
- Headache (6%)
- Feeling tired (5%)
Less Common Side Effects
- Rash
- Itching
- Angioedema (swelling)
Genvoya serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- 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
More on Genvoya side effects
The following Genvoya 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
- 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):
Get your GoodRx coupon
Pros and cons of Genvoya
Pros
- Is a complete regimen for HIV treatment
- Only taken once a day
- Taken by mouth
Cons
- Needs to be taken with food
- Can’t take while pregnant
- Can worsen hepatitis B if you stop taking the medication all of a sudden
Pharmacist tips for Genvoya
- Take Genvoya every day so that it can treat HIV as best as it can. You can use an app on your phone to help you remember.
- Take Genvoya with food to help your body absorb the medication better.
- Make sure to get your routine blood tests done on time while you’re taking Genvoya. This helps your provider make sure the medication is working for you and not causing side effects.
- Taking Genvoya 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 Genvoya.
- If you take antacids that contains aluminum, magnesium, or calcium, make sure to take them 2 hours before or after Genvoya. Taking these medications too close together can lower the amount of Genvoya that's absorbed by your body.
- Let your provider or pharmacist know what medications you're taking or planning to take, including over-the-counter products and supplements, so they can make sure these medications don't interact with Genvoya.
- Speak with your provider before stopping Genvoya 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 Genvoya suddenly can cause your hepatitis B infection to come back or worsen.
- If your child is taking Genvoya and you notice major weight loss in your child, make sure to tell the healthcare team. Your child might not be able to continue taking Genvoya if they weigh below 55 pounds.
Common questions about Genvoya
You should take Genvoya as a whole tablet; swallow each tablet whole. Don't crush, split, or chew the tablet since it's known how it'll affect how the medication gets absorbed into the body. Talk to your provider if you're having trouble swallowing pills, especially if it prevents you from taking your HIV medication(s) every day. Your provider can work with you to determine the best treatment option for you.
No, Genvoya isn't FDA-approved for post-exposure prophylaxis (PEP). In PEP, a provider prescribes medications to prevent an HIV infection after someone has been exposed to a person who is infected. If you have questions about PEP, ask your provider about possible options.
No, Genvoya isn't FDA-approved for pre-exposure prophylaxis (prevention), also known as PrEP. A provider prescribes PrEP for a person who is at risk for exposure to HIV, before they've been exposed. If you're interested in taking medications for PrEP, talk to your provider about the best option for you.
People who took Genvoya in clinical studies didn't report weight gain as a side effect. But other studies showed that people who took elvitegravir and tenofovir alafenamide (two of the medications in Genvoya) together had some weight gain in the first 6 months of treatment. Talk to your provider if you're concerned about this side effect.
Genvoya isn't known to cause weight loss as a side effect. But this medication can cause nausea and diarrhea, which can make it difficult for some people to eat or get the proper nutrients through food. It's important to have a conversation with your provider about how to eat a healthy diet before starting treatment. They can also suggest ways to manage side effects like nausea and diarrhea. If you experience unexpected weight loss after starting Genvoya, let your provider know because you might need more medical attention.
Although Genvoya doesn't cause hair loss, some people with HIV infections might lose hair due to other factors. Since HIV is a virus that attacks the body's immune system, it can cause frequent infections, nutritional deficiencies (your body not absorbing enough nutrients), or abnormal hormonal levels. All these changes can cause hair loss.
It can take 2 to 3 days for most of Genvoya to leave your body. This time frame is estimated based on the half-life of elvitegravir, one of the medications in Genvoya. But in order for Genvoya to work well to treat the HIV infection, you must take it very day. If not, the infection can come back and be more difficult to treat. Don't stop taking Genvoya without first speaking to your provider.
Genvoya doesn't contain a protease inhibitor (PI). It's made up of NRTIs (emtricitabine and tenofovir alafenamide), an INSTI (elvitegravir), and a "booster" (cobicistat).
How to save using GoodRx
Risks and warnings for Genvoya
Genvoya 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 Genvoya | Severe liver problems
Before you start Genvoya, your provider will test you for hepatitis B virus (HBV). If you have HBV, suddenly stopping Genvoya might make your liver condition worse (also called an HBV flare-up). Don't stop taking Genvoya 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 Genvoya, 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.
Kidney problems
- Risk factors: History of kidney problems | Taking other medications known to harm kidneys
Some people taking Genvoya have had kidney problems. Before starting and during treatment with Genvoya, your provider will order blood work or urine tests to check on your kidney health. If you develop kidney problems, you might not experience any noticeable symptoms. But your provider will be able to detect it through labs. Some people developed kidney problems as early as 2 weeks after starting treatment. 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). Let your provider know right away if you experience bone or muscle pain, pain in your arms or legs, and general weakness that don't go away. These might be signs of kidney problems.
Liver problems and lactic acidosis
In some rare cases, people who take medications containing NRTIs, such as Genvoya, have reported liver problems, like fatty liver disease. Genvoya 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 Genvoya 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.
Overactive immune system
Taking Genvoya 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 Genvoya. 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 Genvoya 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 Genvoya.
Interaction with other medications
Taking certain medications for seizures (e.g., carbamazepine (Tegretol)), bacterial infections (e.g., rifampin (Rifadin)), oral steroids (e.g., dexamethasone) or herbal supplements (e.g., St. John's wort) can lower the amount of Genvoya in your body. This can can cause the HIV virus to spread and become harder to treat.
In addition, Genvoya can also raise the amount of other medications in your body when taken together. This raises your risk for side effects from those other medications. For example, taking Genvoya with alfuzosin (Uroxatral) can put you at risk for dangerously low blood pressure. Taking this HIV medication with some blood thinners, like Eliquis (apixaban) or Xarelto (rivaroxaban), can raise your risk for serious bleeds.
Because of the potential for drug interactions with Genvoya, 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.
Genvoya dosage
Tablet| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 150mg/150mg/200mg/10mg | 30 tablets | $4,099.85 | $136.66 |
Typical dosage for Genvoya
Each tablet of Genvoya contains 150 mg of elvitegravir, 150 mg of cobicistat, 200 mg of emtricitabine, and 10 mg of tenofovir alafenamide.
- Adults and children who weigh at least 55 pounds: The typical dose is 1 tablet by mouth once daily with food.
More on Genvoya dosage
How much does Genvoya cost?
$4,099.85
Genvoya contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Genvoya will not be safe for you to take.
- Taking certain medication that interact with Genvoya (e.g., alfuzosin, lovastatin, carbamazepine)
What are alternatives to Genvoya?
News about Genvoya
Genvoya images
