Descovy
For adults and children weighing at least 31 pounds (14 kg). For children who are not also taking a boosted protease inhibitor, use one tablet for children weighing at least 25 kg to less than 35 kg (55 to 77 pounds) and use one pediatric tablet (120 FTC/15 mg TAF) for children weighing at least 14 kg to less than 25 kg (31 to 55 pounds).
Take a missed dose as soon as possible, unless it is closer to the time of your next dose. Do not double up on your next dose. Descovy’s prescribing information indicates that it should not be used if CrCl is less than 30 mL/min, but data have shown that it can be used safely in people with end stage renal disease on hemodialysis and with CrCl less than 15 mL/min. Descovy was approved for HIV prevention (pre-exposure prophylaxis, or PrEP) in October 2019; SEE “Descovy for PrEP” page.
- HHS recommended as a component for rapid ART for someone newly diagnosed or entering care with no or minimal labs available.
- See the individual drugs contained in Descovy: Emtriva (TAF is not available separately for HIV, but is used to treat hepatitis B under the brand name Vemlidy).
- See package insert for more complete information on potential side effects and interactions.
gilead.com; descovy.com
(800) GILEAD-5 (445–3235)
JO-ANN JOSE, MD, MPH:
Descovy, like Truvada, is recommended for initial therapy for most people when combined with an integrase inhibitor. Descovy’s TAF/FTC combo is a component of Symtuza, Genvoya and Odefsey. TAF is often associated with less kidney and bone health impairment. However, if you have pre-existing bone health issues, or are diagnosed with bone health issues, talk with your care provider.
Do not take with Cimduo, Emtriva, Epivir-HBV, Hepsera, Truvada, Viread 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 such as 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 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 that are not listed here.
Overall, Descovy is well tolerated, but some people may experience nausea, headache, stomach pain or changes in weight. Data associate INSTIs and TAF with potential weight gain. 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, as well as any concerning changes in urinary habits. At initiation and during treatment, assess kidney lab tests: serum creatinine, estimated creatinine clearance, urine glucose and urine protein. In people with chronic kidney disease, also assess serum phosphorus. Discontinue Descovy if clinically significant decreases in kidney function or signs of Fanconi syndrome develop. 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 bone or kidney problems. Bone mineral density (BMD) tests may be recommended in people with history of or risk factors for bone fractures or osteoporosis. Prior to initiation, people should be tested for hepatitis B virus (HBV). Severe exacerbations of hepatitis B have been reported in people co-infected with HBV who have discontinued Descovy (due to elimination of both emtricitabine and TAF, which also treat hepatitis B). Monitor liver enzymes closely in people co-infected with HBV and, if appropriate, initiation of anti-hepatitis B therapy may be warranted upon Descovy discontinuation. Call your health care provider right away if you develop any of the following signs or symptoms of hepatitis: yellowing of the skin or whites of the eyes; dark or tea-colored urine; pale-colored bowel movements; nausea or vomiting; loss of appetite or pain, aching or tenderness on the right side below the ribs.
Descovy is similar to Truvada, except that instead of TDF (tenofovir disoproxil fumarate), Descovy contains TAF (tenofovir alafenamide), which reduces serum tenofovir concentration by up to 90%. This results in a decreased impact on kidney and bone demineralization 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 observed when switching from TDF to TAF. The long-term impact of TAF on people with osteopenia or osteoporosis is unknown. Both Descovy and Truvada are currently recommended by HHS HIV treatment guidelines for components of first-time therapy for most people—in fact, one or the other combination is found in some of the single-tablet regimens. Descovy can be used for HIV prevention; see “Descovy for PrEP” page. Because both FTC and TAF are also active against hepatitis B (HBV), Descovy is recommended by HHS for individuals co-infected with HIV and HBV. Pediatric HIV guidelines recommend Descovy as part of a preferred regimen. Descovy (as well as Truvada and Epzicom) are recommended with Tivicay as a preferred complete regimen in pregnancy. Descovy tablets are relatively small compared to Truvada and other combination tablets, which may be helpful to people who have difficulty swallowing. Pregnant individuals can voluntarily enroll in the Antiretroviral Pregnancy Registry through their provider; GO TO apregistry.com.
JUAN MICHAEL PORTER II:
Descovy (TAF) is marketed as the “safer” and “better” version of Truvada (TDF). But that’s only if the person has side effects from Truvada. Some people experience side effects from Descovy as well. Others swear that it has caused them to gain weight. Talk to your doctor first before jumping on the bandwagon. My doctor said it wasn’t an option for me because she was concerned about potential issues with my kidneys.