Descovy

• See the individual drugs contained in Descovy: Emtriva (but TAF is not available separately for HIV).

• See package insert for more complete information on potential side effects and interactions. 

Overall, Descovy is well tolerated, but some may experience nausea, headache, stomach pain, or weight loss. Skin discoloration on palms and soles may also occur. May affect the bones and kidneys. In clinical trials, fewer bone and kidney issues were observed with the TAF formulation compared to the TDF formulation. Tell your provider about any pain in extremities, persistent or worsening bone pain and fractures, with or without muscular pain or weakness, as well as any concerning changes in urinary habits as these could be signs of kidney problems. If you have HIV and HBV, guidelines recommend treatment for both viruses. Descovy can be used to treat HIV and HBV simultaneously. If you are co-infected with HBV and HIV, you should not stop Descovy without medical supervision because it can cause your HBV to flare and cause you to experience signs and symptoms of acute hepatitis. HBV should be closely monitored by your provider.

Do not take with Epivir-HBV, Hepsera, or Vemlidy (TAF), used for the treatment of hepatitis B. Use caution with drugs that negatively affect the kidneys, including chronic use or high doses of anti-inflammatory drugs for pain like Advil or Motrin (ibuprofen) and Aleve (naproxen). Descovy should not be taken with certain anticonvulsants (including carbamazepine, oxcarbazepine, phenobarbital, and phenytoin), Aptivus/Norvir, rifabutin, rifampin, rifapentine, or St. John’s wort. Can be used with hepatitis C drugs such as Epclusa, Harvoni, Sovaldi, Olysio, Daklinza, Viekira Pak, or Zepatier. Tell your provider or pharmacist about all medications, herbals, and supplements you are taking or thinking of taking, prescribed or not, as there are other drug interactions which are not listed here.

Descovy is the newer version of Truvada. Instead of TDF, Descovy contains TAF (tenofovir alafenamide), which reduces serum tenofovir concentration by 90%. This results in lessened impact on kidney and bone mineralization but maintains potent antiviral activity in the CD4 cell. In clinical trials, fewer kidney and bone issues were observed with TAF than with TDF, and significant improvements were seen when switching from TDF to TAF. The long-term impact of TAF on patients with osteopenia or osteoporosis is unknown. Both Descovy and Truvada are currently recommended by DHHS HIV treatment guidelines for first-time therapy for most people. However, unlike Truvada, Descovy is not approved for and should not be used for PrEP. A clinical trial called DISCOVER is currently in progress comparing Descovy to Truvada for PrEP (prevention) in HIV-negative individuals. Because both FTC and TAF are also active against hepatitis B (HBV), Descovy is recommended by DHHS for individuals co-infected with both HIV and hepatitis B. Pediatric HIV guidelines added Descovy last year as part of a preferred regimen. There is insufficient data in pregnancy for the DHHS to recommend the routine use of Descovy in pregnant women at this time. Descovy tablets are relatively small compared to Truvada and other combination tablets, which may be a plus for patients who have difficulty swallowing.

See package insert for more complete information on potential side effects and interactions.

Dr. David Hardy says:

Descovy was approved in mid-2016 as the “new and improved” version of Truvada, as it maintained the Emtriva (FTC) and changed the Viread (tenofovir DF) to TAF. This change was prompted by the finding that TAF (originally discovered and developed in 2002, but then shelved for several years) produced similar HIV suppressing effects as Viread with much lower levels of the same drug in the blood. The lower tenofovir levels have been shown to have less harmful effects on the kidneys and bone mineral density (bone strength). Descovy (or its components TAF and Emtriva) is the most preferred two-nuke combination HIV treaters use when building first-time ART regimens for their patients living with HIV.

Activist Moisés Agosto-Rosario says:

Descovy is the new Truvada in that it contains emtricitabine plus tenofovir alafenamide (TAF) instead of tenofovir disoproxil fumarate (TDF). What is better about combining with TAF is that it does not cause the same level of kidney problems or lower bone density that TDF does. Both Descovy and Truvada are recommended as first-line therapies in the HHS HIV treatment guidelines. Both are approved and recommended for hepatitis B. Descovy has not been approved for PrEP, however. It is important not to combine with other antivirals not prescribed by a doctor. Many new STRs already contain TAF. Drug interactions may occur, so tell your doctor about all the medications your take, including those sold over the counter.