Biktarvy side effects and how to avoid them

Biktarvy is a brand-name medication manufactured by Gilead Sciences, Inc. (GSI), used to treat HIV (human immunodeficiency virus). While Biktarvy is generally well tolerated, there are some potential side effects that people should be aware of. The most common side effects of Biktarvy include stomach pain and loss of appetite. Less common, but more serious side effects, can include lactic acidosis.

Learn more about the side effects of Biktarvy and what you can do to avoid them.

What is Biktarvy?

Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) is a complete HIV treatment used to treat HIV infection in adults, and children with a weight of at least 55 pounds (25kg).

If you or your child have an HIV-1 infection, your doctor may have prescribed Biktarvy to treat it. Biktarvy can’t cure an HIV-1 infection, but it can help to reduce how much of the virus you or your child have in your body (viral load), limiting the damage it can do to your or your child’s immune system.

Biktarvy contains three active ingredients: bictegravir (BIC), emtricitabine (FTC), and tenofovir alafenamide (TAF). They are each an antiviral drug that can stop the spread of the HIV-1 virus through your T-cells.

When the HIV-1 virus invades your T-cells, it inserts itself into the DNA. The virus then takes advantage of the cell’s natural DNA copying process to reproduce itself. As more copies of the virus are made, eventually the T-cell dies, and the viruses spread to other T-cells, continuing the cycle. Biktarvy helps to stop this from happening.

Bictegravir, emtricitabine, and tenofovir alafenamide each interrupt a step in the DNA copying process that the HIV-1 virus exploits to copy itself. They do this by blocking different enzymes involved in the copying process. This makes it harder for the virus to multiply, limiting the amount of virus you have in your body (your viral load).

Biktarvy dosage

Biktarvy is available in tablet form in the following doses: 50 mg BIC, 200 mg FTC, and 25 mg TAF, and 30 mg BIC, 120 mg FTC, and 15 mg TAF.

You take Biktarvy as a tablet with or without food, usually once a day. If you take a supplement containing iron or calcium, take it at the same time as your Biktarvy. If you take antacids containing aluminum or magnesium, take these 2 hours before or 6 hours after you take Biktarvy. If you miss a dose of Biktarvy take it as soon as you remember, but do not take the missed dose if it is nearly time for your next dose. Store Biktarvy tablets at room temperature, away from heat and moisture.

If have had hepatitis B (HBV) in the past, it may become active after you stop using Biktarvy. You will need regular liver function tests while using Biktarvy and for a few months after stopping treatment.

You are advised to read the medication guide provided with this medicine for the drug information and patient information, and always speak with your healthcare professional for medical advice about any changes to your dose so they can monitor and evaluate your condition.

What are the side effects of Biktarvy?

The most common possible side effects of Biktarvy include:

• Headaches
• Nausea
• Stomach pain
• Loss of appetite
• Tiredness
• Diarrhea

Biktarvy can cause more serious side effects, including:

• Severe allergic reactions to the medication
• A worsening or reemergence of an existing hepatitis B virus infection if you have or previously have had one
• New or worsening kidney problems, including kidney failure
• Severe liver problems, including liver failure (yellowing of your skin or eyes, upper right-sided abdominal pain)
• Too much lactic acid in your blood (lactic acidosis), can cause serious health problems and can be fatal. Symptoms include muscle pain, a numb feeling, stomach pain, trouble breathing,  dizziness, or feeling weak or tired
• Strengthening of your immune system (immune reconstitution syndrome) – your immune system may fight infections that have been hidden in your body for a long time

If you experience any of these serious side effects, stop taking Biktarvy and seek medical attention immediately. You are recommended to report any negative side effects of this medication to the FDA. Visit www.fda.gov/medwatch, or call 1-800-FDA-1088.

What are the long-term side effects of Biktarvy?

Long-term side effects may include liver damage, depression, or worsening kidney problems.

Biktarvy drug interactions

Biktarvy can interact with other medications. This can change how Biktarvy and the other medications work and can make some side effects more likely. Tell your prescribing doctor about all drugs you’re taking, including vitamins, antacids, and herbal and dietary supplements, particularly:

• An antiarrhythmic agent called dofetilide, used to treat a range of heart rhythm and heart rate problems

• Rifamycins such as rifampin, rifabutin, and rifapentine
• St. John’s wort
• Treatments for seizures such as carbamazepine, and phenytoin

Biktarvy warnings & precautions

Biktarvy should not be used to treat HIV-1 infection in children who weigh less than 55 pounds (25kg). Don’t take Biktarvy if you:

• Are allergic to the active ingredients bictegravir, emtricitabine, or tenofovir alafenamide
• Are allergic to any of the other ingredients in Biktarvy
• Are allergic to any other form of tenofovir

Talk to your doctor before starting to take Biktarvy if you:

• Are taking any of the medications that could interact with Biktarvy
• Have or have ever had a hepatitis B infection
• Have any liver problems
• Have kidney diseases or any other kidney problems
• Are pregnant or are planning to become pregnant
• Are breastfeeding or are planning to breastfeed – It is unknown if this medication passes into breast milk

You should always check with your doctor or pharmacist before taking any medication, including Biktarvy, to make sure it is safe for you.

How long does Biktarvy work for?

Bictegravir has a half-life of around 17 hours. FTC and TAF have half-lives of 40 and 150 hours each. The half-life is the time it takes for half of the medication to leave your body.

Does Biktarvy cause weight gain?

Weight gain has not been reported in clinical trials for Biktarvy.

Is Biktarvy a high-risk medication?

Biktarvy can cause drug interactions, lactic acidosis, and worsening of kidney problems, including kidney failure, and liver problems.

Do Biktarvy side effects go away?

Most of the milder side effects of Biktarvy go away and do not need further medical attention. However, the more serious side effects may require further medical attention.

How does Biktarvy make you feel?

Biktarvy may cause side effects such as diarrhea, nausea, vomiting, headaches, dizziness, tiredness, and muscle pain.

Is Biktarvy a stimulant?

Biktarvy is not a stimulant. It contains a combination of antiretroviral drugs. Emtricitabine and tenofovir alafenamide belong to a drug class known as NRTIs (nucleoside reverse transcriptase inhibitors). Bictegravir is classed as an HIV integrase inhibitor.

Does Biktarvy make you feel depressed?

Depression is a less common side effect of Biktarvy. Depression with suicidal thoughts is even less common. Speak to your doctor if you experience these side effects.

How to avoid Biktarvy side effects

The best way to avoid side effects is to take Biktarvy as directed by your doctor. Follow your doctor’s instructions carefully and do not take more or less than prescribed.

If you experience any side effects, talk to your doctor or pharmacist. They may be able to recommend ways to help reduce or prevent some of the side effects.

1. Stick to the recommended dosage

Take your prescribed dose of Biktarvy that has been recommended by your healthcare professional. Do not take more or less than prescribed.

2. Monitor your blood sugar levels

If you have diabetes, it is important to monitor your blood sugar levels closely while taking Biktarvy. Check your blood sugar levels as directed by your doctor and report any changes to your doctor immediately.

3. Drink plenty of fluids

Drink eight to 10 glasses of water or fluids every day to help prevent dehydration, which can make side effects worse.

4. Avoid alcohol

Alcohol does not interact with Biktarvy. However, those with HIV, taking Biktarvy or other antiviral medication, are advised not to drink alcohol.

5. Don’t skip meals

Eating regular meals and snacks will help to prevent low blood sugar levels (hypoglycemia).

6. Check your feet

If you have diabetes, check your feet for any cuts, sores, or redness regularly. Tell your doctor if you experience any problems with your feet while taking Biktarvy.

7. Know the signs and symptoms of Biktarvy side effects

Signs and symptoms of side effects include stomach pain and loss of appetite. If you experience any of these symptoms speak to your doctor for medical advice.

8. Tell your doctor about all medications you’re taking

Be sure to tell your doctor about all other medications you’re taking, including over-the-counter drugs, vitamins, and herbal supplements, as they can interact with Biktarvy.

9. Get regular medical check ups

It is important to get regular medical check ups and monitor your medical conditions. Your doctor will monitor your side effects and may adjust your dose of Biktarvy as needed.