Descovy vs Truvada

Descovy (emtricitabine/tenofovir alafenamide) and Truvada (emtricitabine/tenofovir disoproxil fumarate) are brand names for two drugs used to prevent infection in people who don’t have HIV.

Here we will explain how they work, their similarities and differences, their side effects, and more. This should provide you with the basics to better understand your options.

What is Descovy?

Descovy is manufactured by Gilead Sciences, Inc. It has FDA approval (U.S. Food and Drug Administration) to be used to either treat an HIV-1 infection or to reduce the chances of getting HIV-1 infection. It is an antiretroviral agent prescribed to:

1. Adults who have HIV-1 infection, together with other HIV-1 medications
2. Children who have an HIV-1 infection who weigh at least 77 pounds (35kg), together with other HIV-1 medications
3. Adult men, to reduce the risk of getting an HIV-1 infection from certain types of sex
4. Adolescent men who weigh at least 77 pounds (35kg), to reduce the risk of getting an HIV-1 infection from certain types of sex

If you or your child has an HIV-1 infection, your doctor may have prescribed Descovy to you to help treat the infection. Descovy won’t cure an HIV-1 infection, but it will help to reduce how much virus you or your child has in their body. This can limit the damage to the immune system the virus causes and helps the immune system to continue fighting other infections and certain types of cancer. Descovy is usually used alongside other HIV-1 medications that also help to suppress the virus and reduce viral load.

Alternatively, you may be prescribed Descovy if you don’t have HIV-1, to help reduce your chances of getting the HIV infection through sex (HIV pre-exposure prophylaxis/PrEP). This will be when you have a sexual partner who has an HIV-1 infection. Descovy is only approved as PrEP medication in cisgender males and transgender women, but not for cisgender women at risk of HIV from vaginal sex because Descovy’s effectiveness for this has not been studied. Truvada in comparison has also been studied for PrEP in IV drug users and heterosexuals.

While PrEP is an excellent tool for HIV prevention, it’s not for everyone. Descovy is a safer treatment for the kidneys and bone health. Descovy is also seen to be as effective as Truvada with vast improvements in kidney function and bone mineral density.

Descovy contains two active ingredients, emtricitabine and tenofovir alafenamide (TAF). They’re both antiviral drugs that can stop the spread of the HIV-1 virus if you have an infection, and can stop the virus from taking hold if you don’t have an infection already.

When the HIV-1 virus invades your T-cells, it inserts itself into your 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. Descovy helps to stop this from happening.

Emtricitabine and tenofovir alafenamide block a step in the DNA copying process that the virus exploits to copy itself. This makes it harder for the virus to multiply, limiting the amount of virus you have in your body (your viral load).

Descovy dosage

Descovy is available in tablet form, in the following doses: 200 mg of FTC and 25 mg of TAF.

Test for hepatitis B and HIV-1 infection before starting treatment with Descovy. The recommended dosage for the treatment of HIV infection is one tablet once daily with or without food in those patients weighing at least 25 kg. For HIV-1 PrEP, take one tablet once daily with or without food in patients weighing at least 35 kg.

What is Truvada?

Truvada is an FDA (U.S. Food and Drug Administration) approved HIV medication manufactured by Gilead Sciences, Inc. Truvada is an antiretroviral agent used to:

• Treat an HIV-1 infection, alongside other HIV-1 medications, in adults and children who weigh at least 37 pounds (17 kg)
• Reduce the risk of adults getting an HIV-1 infection through sex (when taken every day as a preventative measure and used together with safer sex practices)

If you have HIV-1 infection, your doctor may prescribe Truvada to you to help treat your infection. Truvada won’t cure your HIV-1 infection, but it will help to reduce how much virus you have in your body (your viral load). This can limit the damage to your immune system the virus causes and can better help your immune system fight other infections and some types of cancer.

Alternatively, you may be prescribed Truvada if you don’t have HIV-1, to help reduce your chances of getting the infection through sex (pre-exposure prophylaxis). This will be because you have a sexual partner who has an HIV-1 infection.

Truvada contains two active ingredients, emtricitabine, and tenofovir disoproxil fumarate (TDF). They’re both antiretroviral drugs that treat a group of viruses called retroviruses (the HIV-1 virus is a type of retrovirus). Emtricitabine and tenofovir disoproxil fumarate block the step in the DNA copying process that allows the virus to copy itself, making it harder for the virus to multiply and limiting the viral load.

Truvada dosage

Truvada is available in tablet form, in the following doses: 200 mg/300 mg, 167 mg/250 mg, 133 mg/200 mg, and 100 mg/150 mg of emtricitabine and tenofovir disoproxil fumarate, respectively.

Test for hepatitis B and HIV-1 infection before starting treatment with Truvada. The recommended dosage for the treatment of HIV-1 Infection in adults and pediatric patients weighing at least 35 kg is one tablet (200 mg of FTC and 300 mg of TDF) once daily with or without food. The recommended dosage in pediatric patients weighing at least 17 kg is one tablet (100 mg/150 mg, 133 mg/200 mg, or 167 mg/250 mg) once daily. For PrEP the recommended dosage in HIV-1 uninfected adults and adolescents weighing at least 35 kg is one tablet (200 mg of FTC and 300 mg of TDF) once daily.

Always speak with a healthcare professional about any changes to your dose so they can monitor and evaluate your condition. A generic version of Descovy is not available but is for Truvada.

Common side effects of Descovy and Truvada

The most common side effects of Descovy in the discover trials (The Discover Trial is actively evaluating the safety and effectiveness of Descovy vs Truvada for PrEP):

• Nausea and diarrhea
• Weight gain
• Mild increase in LDL cholesterol and triglycerides.

More serious side effects of Descovy include:

• Severe allergic reactions to the medication
• New or worsening kidney problems, including kidney disease
• Severe liver problems, including liver failure
• Lactic acidosis
• Worsening of an existing hepatitis B infection

The most common side effects of Truvada in clinical trials include:

• Nausea, diarrhea
• Skin rashes
• Headaches, dizziness
• Tiredness
• Stomach pain
• Problems sleeping, abnormal dreams
• Decreased weight
• Depression

More serious side effects of Truvada include

• Severe allergic reactions to the medication
• New or worsening renal problems, including renal failure
• Liver problems, including liver failure
• Lactic acidosis
• Worsening of an existing hepatitis B infection
• Bone pain, softening, or thinning (osteoporosis)
• Changes in body fat distribution – more fat accumulating on the back and neck (buffalo hump), the chest, and breast, and around the middle of the body

These aren’t all the side effects Descovy or Truvada can cause. You can find more details in the patient leaflet that comes with your medication. If you have any concerns about side effects, talk to your physician or pharmacist.

Descovy and Truvada drug interactions

Descovy can interact with other medications. These include:

• Any medications that contain emtricitabine, tenofovir alafenamide, or tenofovir disoproxil fumarate
• Any medications that contain lamivudine
• Didanosine
• Atazanavir
• Ledipasvir with sofosbuvir
• Darunavir
• Lopinavir with ritonavir

Truvada can interact with other medications. These include:

• Any medications that contain emtricitabine or tenofovir disoproxil fumarate
• Any medications that contain tenofovir alafenamide
• Any medications that contain lamivudine
• Didanosine
• Atazanavir
• Ledipasvir with sofosbuvir
• Darunavir
• Lopinavir with ritonavir

Descovy and Truvada can interact with other medications. This can change how Descovy and Truvada and other medications work and can make side effects more likely. Tell your prescribing physician about all your drugs, including vitamins and dietary supplements.

Descovy and Truvada contraindications

You should not use Descovy if you:

• Are allergic to the active ingredients emtricitabine and tenofovir alafenamide, or are allergic to any of the other ingredients in Descovy
• Are allergic to any other form of tenofovir
• Are a child weighing less than 77 pounds (35kg)
• Descovy should only be used as pre-exposure HIV-1 prophylaxis if you don’t already have an HIV-1 infection
• Descovy should not be used as pre-exposure HIV-1 prophylaxis by women who want to reduce the risk of catching HIV-1 from vaginal sex
• Descovy should not be used alone if you have HIV-1 infection, it must be used alongside other HIV-1 medications

Talk to your doctor before using Descovy if you:

• Are taking any of the medications that could interact with Descovy
• Have or have ever had a hepatitis B infection
• Have any liver problems
• Have any kidney problems
• Are pregnant or are planning to become pregnant
• Are breastfeeding or are planning to breastfeed

You should not use Truvada if you:

• Are allergic to the active ingredients emtricitabine or tenofovir disoproxil fumarate
• Are allergic to any of the other ingredients in Truvada
• Are allergic to any other form of tenofovir

Talk to your doctor before using Truvada if you:

• Are taking any of the medications that could interact with Truvada
• Have a hepatitis B infection
• Have any liver problems
• Have any kidney problems
• Have any bone problems
• Are pregnant or are planning to become pregnant
• Are breastfeeding or are planning to breastfeed

Other HIV treatments

• Atripla
• Dovato
• Genvoya
• Norvir
• Symtuza
• Ziagen

If you have any concerns about Descovy or Truvada side effects, talk to your physician, or pharmacist for medical advice. Also inform your healthcare provider about any medical conditions, supplements, and over-the-counter meds you are taking. You are also encouraged to report side effects to the FDA: visit http://www.fda.gov/medwatch or call 1-800-FDA-1088.