If you’re at risk for HIV or you’ve been recently diagnosed with it, your doctor might prescribe a once-daily pill that combines two antiviral drugs: emtricitabine and tenofovir alafenamide (Descovy). 

Here are some common questions asked about this medication. 

It’s a prescription medication taken by mouth as a pill every day. It’s designed to treat and manage HIV infection in adults and adolescents. But it can’t cure HIV or stop you from spreading it through blood or sex.   

The FDA has also approved it as pre-exposure prophylaxis (PrEP). That means it can help prevent, or lower your chances of, getting HIV infection through sex. 

If you’re planning to take it to prevent HIV, you’ll first need to test negative for HIV. When you’re taking this drug, you’ll need to keep testing for HIV every 3 months. 

The two-drug combo that makes up this pill belongs to a class of drugs called nucleoside reverse transcriptase inhibitors (NRTIs). They bind and block an HIV enzyme called reverse transcriptase, which helps prevent the HIV virus from multiplying in your body. 

This then lowers the amount of HIV in your blood. Doctors call this a low viral load.

Emtricitabine/tenofovir alafenamide alone isn’t enough to manage HIV. In fact, if you take it, it might be harder to treat and control your HIV viral load in the future. Usually, your doctor will recommend other HIV medication or other prevention measures like condoms along with this drug to keep your health in check. 

It’s FDA-approved for use by gay, heterosexual, and bisexual men as well as transgender women. It’s not known if this drug is effective in preventing HIV infection for those having vaginal sex. 

To see whether emtricitabine/tenofovir alafenamide is right for you, check with your doctor. You might benefit from taking the drug if you:

  • Don’t use condoms during sex
  • Don’t know whether your sexual partner has tested positive for HIV
  • Are more likely to be exposed to HIV due to your location
  • Have or had an STI

This medication isn’t recommended for everyone. 

It’s not known if it’s effective in preventing HIV infection for those having vaginal sex because it hasn’t been studied much in that population. If you’re planning to take it as PrEP and you’ve been diagnosed with HIV, talk to your doctor to see if it’ll work for you. Also, this medication isn’t recommended for those weighing less than 77 pounds. 

It’s important to have an open conversation with your doctor to see if this drug is the right fit for you. 

During your doctor’s visit, discuss:

  • Your previous medical history in detail
  • Any food and drug allergies you might have
  • Prescription or over-the-counter medications, vitamins, and supplements you take
  • Sexual history
  • Family medical history
  • If you have kidney disease
  • If you’re pregnant or plan to get pregnant
  • If you’re currently breastfeeding or you plan to
  • If you’ve been tested for HIV
  • If you’ve had HIV exposure

Certain medications, when taken with emtricitabine/tenofovir alafenamide, can cause you to have a bad reaction or worsen your health. Tell your doctor if you’re taking any of the following medications:

  • Carbamazepine
  • Oxcarbazepine
  • Rifampin
  • Phenobarbital
  • Phenytoin
  • Rifabutin
  • Rifapentine
  • St. John's wort
  • Tipranavir plus ritonavir

This will help your doctor rule out any possible drug-to-drug interactions and maybe suggest another kind of treatment, if necessary. 

While both medications are FDA-approved oral pills that combine two drugs and are used to treat and prevent HIV, there are some key differences. 

Descovy is a brand name of emtricitabine/tenofovir alafenamide. Truvada is the brand name of emtricitabine/tenofovir disoproxil fumarate. Truvada is available in generic form, but there’s no generic option for Descovy. Truvada is also a larger pill compared to Descovy. 

Anyone diagnosed with HIV or at risk for an HIV infection can take Truvada. This includes gay, bisexual, and heterosexual men and women, transgender men and women, and people who inject substances into their veins using a syringe. 

Doctors don’t recommend Truvada for people who have osteoporosis or issues with bone health. Descovy might be a safer option if you have bone issues. But if you have issues with kidney health, Truvada might be your best option.   

If you’re not sure which is the right fit for you, check with your doctor. 

For the medicine to be effective, take it exactly as your doctor suggests. Usually, you’ll need to take the pill by mouth once daily. You can take it with or without food. Once you start it, don’t skip, stop, or change your dosage without talking to your doctor first. 

If you’re taking this drug to treat an existing HIV infection, take it along with your other HIV medications. If you’re taking it to prevent HIV, you need to take it daily – not just when you’ve been exposed to HIV. Make sure to combine it with other safe-sex practices like condom use, spermicide, or other barrier methods to prevent STIs.

If you have kidney issues and need regular dialysis treatments – procedures to clear toxins and waste from your kidneys – take emtricitabine/tenofovir alafenamide after dialysis. 

If you’ve been diagnosed with hepatitis B virus infection (HBV) along with HIV, it’s important to not skip emtricitabine/tenofovir alafenamide because that could cause your HBV to flare up. 

While rare, it’s possible for this drug to cause mild, moderate, or severe, life-threatening side effects. Side effects include diarrhea, nausea, stomach pain, fatigue, and headache. If they’re bothersome or severe, let your doctor know. 

Get medical help right away if you notice:

  • Signs of allergic reactions like itching, hives, or rashes
  • Tightness in your chest or throat
  • Difficulty breathing or swallowing
  • Swelling in your mouth, lips, face, or tongue
  • Difficulty peeing
  • Blood in your urine
  • Sudden weight gain
  • Liver problems like yellow skin, throwing up, dark-colored urine, and lack of appetite

After you start taking the drug, if you notice new signs of HIV infection such as sore throat, cough, fever, or shortness of breath, tell your doctor right away. It’s also possible to develop a new infection several months after you start taking it. 

The retail cost of emtricitabine/tenofovir alafenamide (Descovy) is over $2,400 for a 30-day supply. 

But most people taking it don’t pay the full price. Your cost will depend on whether or not you have certain types of health insurance coverage. Most plans will cover some part of your monthly medication expenses. As for how much you’ll have to pay out of pocket, that varies. 

Your cost will depend on what type of coverage you have and your deductible – the amount you pay before your health coverage kicks in. It also depends on whether you have drug manufacturer discount coupons or government medical assistance programs like Medicaid and Medicare. 

For those enrolled in Medicare Part D, nearly all plans cover most of your monthly cost for this drug.

If you don’t have insurance coverage but you meet requirements for the drug manufacturer’s medical assistance program, you may be able to get the medication free of charge. Contact the drug manufacturer to see if you’re eligible. 

You can also check out your state’s Medicaid program to see if you qualify. Medicaid coverage depends on how much you make and where you live. Eligibility varies from state to state. 

HIV advocacy groups, nonprofit organizations, and federal programs like the AIDS Drug Assistance Program (ADAP) can help you find resources to cover your HIV medication costs. 

Show Sources

SOURCES:

UpToDate: “Tenofovir alafenamide and emtricitabine: Patient drug information.”

FDA: “FDA approves second drug to prevent HIV infection as part of ongoing efforts to end the HIV epidemic.”

IAPAC: “Descovy.”

Descovy: “Understanding HIV Risk,” “What is Descovy for PrEP?” “Important Safety Information,” “Advancing Access® is more than a co-pay card.”

PrEPdaily.org: “Gay, Straight, Bisexual, Trans: Who Should Take PrEP for HIV?”

San Francisco AIDS Foundation: “Side-by-side comparison: Truvada and Descovy for PrEP.”

HIV.gov: “Drug Database: Emtricitabine / Tenofovir Alafenamide.”

Consumer Reports: “Here's How to Get the PrEP Drugs Descovy and Truvada to Prevent HIV for Free.”

AIDS Education and Training Center Program: “HIV Medication Assistance Programs.”

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