Emtricitabine/tenofovir alafenamide (Descovy) can cause common side effects. Most of these are manageable and tend to go away after your body adjusts to the drug. But in rare cases, they can be life-threatening.
Here’s a look at symptoms to watch out for and what you can do to manage them.
How to Manage Common Side Effects With Emtricitabine/Tenofovir Alafenamide (Descovy)
Side effects from this drug are usually mild to moderate. They don’t require treatment unless they affect your quality of life. Here are some common ones and tips for coping with them:
Diarrhea. In a large-scale study, about 5% of people noticed diarrhea as a common side effect of taking this drug. You’re more likely to get diarrhea if you take this drug to prevent an HIV infection.
In most cases, diarrhea clears up within a few days without treatment. But until it goes away, you can try these:
- Drink plenty of liquids like water and drinks with electrolytes to prevent dehydration.
- Avoid caffeine and alcohol. They can make your symptoms worse.
- Choose easy-to-digest semi-solid and low-fiber foods like saltine crackers, toast, eggs, chicken, and white rice with light seasonings until your gut settles.
- Avoid fatty foods, high-fiber foods, and dairy products.
If your symptoms are too bothersome, you can take diarrhea meds over the counter. Check with your doctor before taking them.
Nausea. It’s one of the most commonly reported side effects in those who take this drug. Symptoms may include a queasy feeling or discomfort in your belly that causes you to throw up. Usually, the nausea is short-lived and goes away after a few hours. You’re more likely to get nausea or an upset stomach if you take this drug to treat HIV. In fact, it happens to 1 in 10 people.
To help prevent or lessen this symptom:
- Take your daily HIV pill with a meal or a light snack.
- Check with your doctor about taking this drug at bedtime.
- Stay hydrated.
- Try not to lie down after you take it. Sit up or walk around.
- Avoid vigorous physical activity for up to 30 minutes after you take it.
- Take over-the-counter nausea meds.
- Suck on ice chips, drink lemon water, or try ginger or peppermint to ease your stomach.
- Avoid greasy, fatty foods.
If your nausea doesn’t go away or it’s severe, tell your doctor. Don’t skip or stop taking this drug without checking with your doctor first.
Headache. Studies show that taking this drug can cause headaches. If this happens to you, try to rest in a quiet, dark space. Place a cold pack or cloth on your forehead for some relief. Massaging your head and neck area could help relieve some tension. You can also take ibuprofen or acetaminophen to ease your pain.
Fatigue. Taking this drug every day may leave you feeling tired, weak, and lacking energy. To help, try light exercises like walking. That can help strengthen your muscles and also boost your mood and energy level.
Aim to get plenty of sleep during the night, or try short naps during the day to recharge. Also, budget your energy for the most important things you need to do in your daily routine. Try to finish them when you’re likely to have the most energy.
If your fatigue affects your quality of life, tell your doctor about it.
How to Manage Serious Side Effects With Emtricitabine/Tenofovir Alafenamide (Descovy)
In rare cases, you may have serious side effects from this drug. These may include:
Hepatitis B flare-up. If you have hepatitis B virus infection (HBV) along with HIV, it’s important to closely follow your doctor’s instructions for taking this medication. If you skip a dose or stop taking it, your HBV may flare up worse than it’s been before.
Symptoms can include:
- Stomach pain
- Dark-colored pee
- Joint pain
- Fever
- Nausea and vomiting
- Lack of appetite
- Weakness
- Jaundice (a condition that causes yellowing in your skin and the white part of your eyes)
If you notice these signs, tell your doctor right away. You may not need treatment. That’s because your body usually gets rid of the infection within 6 months. But your doctor will run blood tests and closely monitor your health.
If your flare-up is severe, you’ll need antiviral medications to fight the infection. In extreme cases, you might need a liver transplant. To avoid flare-ups and to protect your liver from further damage, you should:
- Take your HIV medication regularly.
- Avoid alcohol.
- Get vaccinated against hepatitis A, the flu, pneumonia, and other viral diseases.
- Check with your doctor before taking over-the-counter drugs that might cause damage to your liver.
Kidney problems. In some cases, taking this HIV oral pill every day may trigger kidney problems or worsen ones you already have. Research shows that kidney issues like acute renal failure, proximal renal tubulopathy (PRT), and Fanconi syndrome are often linked to drugs that contain tenofovir alafenamide. Symptoms of Fanconi syndrome include bone pain, muscle pain, arm, leg, or hand pain, or broken bones. Other signs of kidney failure include:
- Peeing less than usual
- Dehydration
- Confusion
- Feeling sick
- Drowsiness
If you notice these signs, alert your doctor right away. They’ll likely tell you to stop taking it.
To avoid kidney issues, your doctor will test your creatinine levels (to see how well your kidneys function) before they prescribe this drug, and also while you’re taking it.
Lactic acidosis. It’s a rare, serious medical emergency that can happen when there’s too much lactic acid in your bloodstream. Symptoms like sudden weakness or dizziness, shallow breathing, muscle pain, or clammy hands and feet can develop quickly.
If this happens to you, call 911 or go to the nearest hospital immediately. If it’s left untreated, it could lead to death.
Liver problems. Once you start this drug for treatment or prevention, it’s possible to develop severe liver issues. Tell your doctor if you notice symptoms like dark-colored pee, nausea, belly pain, or light-colored poop, or if you don’t feel hungry for many days.
They’ll likely stop the medication, run tests, and closely monitor your health. If left untreated, in serious cases, liver problems might lead to death. To avoid this, make sure to tell your doctor if you have liver problems or have a history of them before you start taking any HIV medicines.
HIV drug resistance. If you’re planning to take this drug as PrEP to prevent HIV, it’s important to test negative for HIV before you start. You also need to test negative for the virus every 3 months while you’re on it or if you test positive for a sexually transmitted infection (STI), as that increases your odds for HIV.
Why is that? If you’re infected with HIV, it mutates to different strains by making new copies all the time. If you take an antiviral drug and you’re HIV positive, the virus may become resistant to the drug. This can make the medication stop working.
Over time, the virus may become resistant to multiple HIV drugs and the medication might stop working for you. This is called cross-resistance and it can happen quickly.
To avoid this, learn about your HIV status before your doctor prescribes this drug. Make sure to learn about your partner’s HIV status, too. While you’re taking this drug, practice safe-sex measures like wearing condoms and using other barrier methods to prevent STIs.
It’s possible to develop other side effects, too. In rare cases, you might be allergic to one or more ingredients that make up this drug. If you develop rashes or have difficulty breathing, itching, or swelling, tell your doctor right away.
If it’s an emergency, call 911 or head to a hospital near you. You can also report drug-related side effects to the drug manufacturer directly or to the FDA at 800-FDA-1088.