Stribild: Basics, Side Effects & Reviews
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Stribild

Stribild (elvitegravir / cobicistat / emtricitabine / tenofovir disoproxil fumarate)

Basics, Side Effects, Reviews & More

Stribild is a single-tablet-regimen containing 3 HIV antiretrovirals (ARVs), elvitegravir (Vitekta), emtricitabine (Emtriva), and tenofovir DF (Viread), and one booster medication, cobicistat (Tybost).

COMMON BRANDS

Stribild

DRUG CLASS

HIV ARV Combo

CONTROLLED SUBSTANCE CLASSIFICATION

Not a controlled medication

GENERIC STATUS

No lower-cost generic available

AVAILABILITY

Prescription only

Reviewed by:

Hope Chang, PharmD, AAHIVP

Michelle Nguyen, PharmD

Last reviewed on:

December 13, 2020

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What is Stribild?

How Stribild works

Stribild contains an integrase inhibitor (elvitegravir) and two nucleoside reverse transcriptase inhibitors (NRTIs) (emtricitabine, tenofovir). These 3 medications work together to prevent the virus from making copies of itself in your body. The booster medication (cobicistat) slows the metabolism of elvitegravir (Vitekta) and raises the level in the body.

What is Stribild used for?

  • HIV treatment

Stribild dosage forms

Typical dosing for Stribild

The recommended dose for adults and children age 12 years and older who weigh more than 35 kg is 1 tablet once a day with food.

Frequently asked questions about Stribild





Pros and cons of Stribild

Pros

Thumbs Up1 tablet once a day is a full HIV regimen

Thumbs UpContains tenofovir, which is also a first-choice treatment option for hepatitis B

Thumbs UpOne of the few single-tablet-regimens that contains an integrase inhibitor (a preferred HIV ARV subclass)

Thumbs UpIn clinical trials, caused less abnormal dreams than Atripla

Thumbs UpGilead copay card available for people with commercial health plans (not for use with Medicaid and Medicare plans)

Cons

Thumbs DownMust be taken with food

Thumbs DownDose can't be adjusted, so it's not recommended for people with kidney or liver problems

Thumbs DownCan cause kidney and bone problems

Thumbs DownInteracts with a lot of medications

Thumbs DownNot a good option for people who are pregnant, or plan to become pregnant

Pharmacist tips for Stribild

Capsule IconTake the medication around the same time each day, always with food.

Capsule IconMake sure your healthcare providers have a full list of the medications you are taking. Stribild interacts with a lot of commonly used medications like blood pressure and cholesterol medications. Your provider may have to make changes to your doses.

Capsule IconIf you take antacids like Tums or Milk of Magnesia, or any supplements that have calcium, iron, zinc, aluminum, or magnesium, make sure you take them 2 hours before or after Stribild. Taking the medications too close together can lower the amount of Stribild that's absorbed by your body.

Capsule IconTaking calcium and vitamin D supplements can help protect your bone health. Just remember to separate the calcium supplements by 2 hours from Stribild.

Capsule IconStribild is not a preferred HIV ARV in pregnancy. Talk to your provider if you become pregnant or have plans to. If you do not wish to become pregnant, talk to your provider about your options for birth control. Estrogen-based contraceptives might not be a good option when you are taking Stribild due to medication interactions.

Prices for Stribild start at just $3562.99 with a GoodRx coupon. They’re fast, easy-to-use and free!

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What are the side effects of Stribild?

With any medication, there are risks and benefits. Even if the medication is working, you may experience some unwanted side effects.

Caution Small The following side effects may get better over time as your body gets used to the medication. Let your doctor know immediately if you continue to experience these symptoms or if they worsen over time.

Common side effects

  • Nausea (16%)
  • Diarrhea (12%)
  • Abnormal, strange dreams (9%)
  • Headache (7%)

Other side effects

  • Tiredness, fatigue
  • Rash
  • Trouble sleeping, insomnia
  • Dizziness
  • Gas

Source: FDA

The following side effects have also been reported:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur:

More common

Cloudy urine

Incidence not known

Abdominal or stomach discomfort or pain

bloody urine

bone fractures

bone pain

change in urination

convulsions

cough

dark-colored urine

decreased appetite

difficulty with swallowing

dizziness

dry mouth

fast or irregular heartbeat

fast, shallow breathing

fever

general feeling of discomfort

increased thirst

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs

light-colored stools

lower back or side pain

mood changes

muscle pain, cramps, or stiffness

nausea, vomiting or diarrhea

numbness or tingling in the hands, feet, or lips

puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

skin rash, hives, or itching

sleepiness

swelling of the face, fingers, or lower legs

tightness in the chest

trouble breathing

unusual tiredness or weakness

weight gain

yellow eyes and skin

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Abnormal dreams

headache

Less common

Bloated

full feeling

passing gas

trouble sleeping

unusual drowsiness

Incidence not known

Chills

constipation

indigestion

lack or loss of strength

pains in the stomach, side, or abdomen, possibly radiating to the back

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

What are the risks and warnings for Stribild?

Stribild 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

  • Risk factors: Hepatitis B virus (HBV) | Stopping Stribild

Black Box Warning People who have stopped taking Stribild have had severe worsening of their hepatitis B. Don't stop taking Stribild unless instructed by your healthcare provider. If you are instructed to stop the medication, or switch to a different antiviral medication, make sure you get your labs drawn regularly. This is how your provider will monitor your liver and HBV.

CHANGES IN KIDNEY FUNCTION

  • Risk factors: History of kidney damage | Taking Viread (tenofovir)

Stribild can cause kidney damage or changes to your kidney function blood tests. This is more common in people with a history of kidney damage. Make sure to have routine labs drawn so your provider can monitor your kidney function.

LIVER PROBLEMS

  • Risk factors: Obesity | Women | History of liver problems

Although rare, NRTIs including those in Stribild can cause a life-threatening liver problem called lactic acidosis with hepatic steatosis. Most of the cases have been in women. Symptoms can include appetite loss, stomach pain, muscle pain, fast and shallow breathing, extreme tiredness, and sudden weakness. Stop taking Stribild and go to the emergency room right away if this happens.

DRUG INTERACTIONS

  • Risk factors: Taking other medications or supplements

Stribild interacts with a lot of medications. The interaction usually makes the level of the other medication too high, and can lead to serious or fatal side effects. There are also medications that can lower the amount of Stribild in your body. Talk to your healthcare provider or pharmacist before starting or stopping any medications.

BONE PROBLEMS

  • Risk factors: History of bone fractures | Osteoporosis

Stribild can lower your bone mineral density and weaken your bones. This can lead to osteoporosis and raise your risk of fractures. Many people take calcium and vitamin D supplements to help prevent this. Your provider may order additional tests to check your bone density if you have a fracture or other risk factors for bone problems.

IMMUNE RECONSTITUTION SYNDROME

  • Risk factors: Weakened immune system | Current untreated infection

HIV attacks your immune system. Over time, if the virus isn't treated your body may become defenseless against bacterial and fungal infection. Your HIV medications are very good at killing the virus, and when the number of viruses goes down, your immune system gets started making more cells. Once your immune system gets better, it will start to fight off any infections you might have, which can lead to a lot of inflammation. Even though it's a good thing that your immune system is getting better, too much inflammation can be bad. Your healthcare provider might check for underlying infections (sometimes called opportunistic infections) before starting Stribild especially if it is your first time taking HIV medications. Call your provider if you experience fever, difficulty breathing, or sudden changes to your health after starting Stribild.

Interactions between Stribild and other medications

Stribild may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Stribild. Please note that only the generic name of each medication is listed below.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

How much does Stribild cost?

There is currently no generic for Stribild, so it can be expensive, even with insurance. GoodRx coupons, copay cards and patient assistance programs may help lower the cost.

Lowest GoodRx Price
Stribild (brand)

$3562.99

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Pricing based on most commonly-filled versions: 30 tablets of Stribild 150mg/150mg/200mg/300mg

What are alternatives to Stribild?

There are a number of medications that your doctor can prescribe in place of Stribild. Compare a few possible alternatives below.

Stribild
Drug Class:HIV ARV Combo

$3562.99

lowest GoodRx price

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Atripla
Drug Class:HIV ARV Combo

$249.13

lowest GoodRx price

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Genvoya
Drug Class:HIV ARV Combo

$3396.86

lowest GoodRx price

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