Biktarvy
Pronunciation: bik-TAR-vee
Generic name: bictegravir, emtricitabine, tenofovir [bik-TEG-ra-vir, EM-trye-SYE-ta-been, and-ten-OF-oh-vir]
Dosage form: tablet (Bictegravir 50 mg/emtricitabine 200 mg/tenofovir alafenamide 25 mg), (Bictegravir 30 mg/emtricitabine 120 mg/tenofovir alafenamide 15mg)
Drug class: Antiviral combinations
What is Biktarvy?
Biktarvy is a complete HIV-1 treatment in a once-a-day single tablet containing three antiviral medicines bictegravir, emtricitabine, and tenofovir. Biktarvy works by preventing HIV from multiplying in your body and lowers HIV blood levels, which decreases your chance of developing AIDS and HIV-related illnesses such as cancer or serious infections. Biktarvy is not a cure for HIV.
Human immunodeficiency virus type 1 (HIV-1) is the virus that causes acquired immune deficiency syndrome (AIDS).
Who can take Biktarvy?
Biktarvy is an FDA-approved medicine used as a complete regimen for the treatment of HIV-1 infection in adults and pediatric patients who weigh at least 14 kg. Bikarvy can be used by patients who:
- have not taken HIV-1 medicine in the past OR
- to replace their current HIV-1 medicine if they are virologically suppressed (HIV-1 RNA less than 50 copies per mL), on a stable antiretroviral regimen with no history of treatment failure and with no known substitutions associated with resistance to bictegravir or tenofovir.
How does Biktarvy work?
Biktarvy contains three antiviral medicines that stop viruses from replicating and therefore reduces the number of viruses in your body.
Bictegravir is from a class of medications called integrase strand transfer inhibitors (INSTIs). Emtricitabine and tenofovir alafenamide are from the class of medications called nucleoside reverse transcriptase inhibitors (NRTIs). Bictegravir, emtricitabine, and tenofovir are antiviral medicines that stop the HIV virus from multiplying.
Biktarvy Side Effects
Common Biktarvy side effects
The most common Biktarvy side effects include diarrhea, nausea, and headache.
Serious Biktarvy side effects
Allergic reaction: Get emergency medical help if you have signs of an allergic reaction to Biktarvy hives, difficulty breathing, or swelling of your face, lips, tongue, or throat.
Kidney problems: New or worse kidney problems, including kidney failure. Your healthcare provider should organize blood and urine tests to check your kidneys when starting and during treatment with this medicine. Avoid taking Biktarvy with other medications that also harm your kidneys. If you develop new or worse kidney problems, your healthcare provider may tell you to stop taking this medicine. Symptoms of kidney problems include:
- little or no urination
- swelling in your feet or ankles
- feeling tired
- shortness of breath.
Changes in your immune system (Immune Reconstitution Syndrome): This can happen when you start taking HIV-1 medicines. Your immune system may get stronger and begin to fight infections that have been hidden in your body for a long time. Tell your healthcare provider right away if you start having any new symptoms after starting your HIV-1 medicine.
Severe liver problems. In rare cases, severe liver problems can happen that can lead to death. Tell your healthcare provider right away if you get these symptoms:
- skin or the white part of your eyes turns yellow,
- dark "tea-colored" urine,
- light-colored stools,
- loss of appetite for several days or longer,
- nausea,
- stomach-area pain.
Too much lactic acid in your blood (lactic acidosis). Too much lactic acid is a serious but rare medical emergency that can lead to death. Tell your healthcare provider right away if you get these symptoms:
- weakness or being more tired than usual
- unusual muscle pain
- being short of breath or fast breathing
- stomach pain with nausea and vomiting
- cold or blue hands and feet
- feel dizzy or lightheaded
- a fast or abnormal heartbeat.
This is not a complete list of side effects and others may occur. Talk to your doctor, pharmacist, or healthcare provider for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.
Related/similar drugs
Descovy, Truvada, Atripla, Stribild, Complera, Epzicom
Warnings
Worsening of hepatitis B virus (HBV) infection.
Your healthcare provider will test you for HBV infection before or when you start treatment with this medicine. If you have HBV infection and take Biktarvy, your HBV may get worse (called a flare-up) if you stop taking Biktarvy. A "flare-up" is when your HBV infection suddenly returns worse than before.
Do not run out of Biktarvy. You should refill your prescription or talk to your healthcare provider before your Biktarvy is all gone.
Do not stop taking this medicine without first talking to your healthcare provider.
If you stop taking this medicine, your healthcare provider will need to check your health often and do blood tests regularly for several months to check your liver and may need to give you a medicine to treat hepatitis B. Tell your healthcare provider about any new or unusual symptoms you may have after you stop taking this medicine.
Before taking this medicine
You should not use Biktarvy if you are allergic to antiviral medicines bictegravir, emtricitabine, or tenofovir contained in medicines such as Atripla, Complera, Emtriva, Descovy, Genvoya, Odefsey, Stribild, or Truvada.
Some medicines can cause unwanted or dangerous effects when used with Biktarvy, and your doctor may need to change your treatment plan. Do not take Biktarvy if you also take a medicine that contains:
- dofetilide; or
- rifampin.
Tell your doctor if you have or ever had:
- liver disease (especially cirrhosis)
- hepatitis B virus (HBV)
- kidney disease
Before starting Biktarvy treatment, you will be tested for hepatitis B virus infection.
Before starting Biktarvy treatment and during treatment, your serum creatinine, estimated creatinine clearance, urine glucose, and urine protein will be monitored as clinically appropriate. In patients with chronic kidney disease, serum phosphorus will also be assessed.
Pregnancy
Tell your healthcare provider if you are pregnant or plan to become pregnant during treatment with Biktarvy. There is a pregnancy registry for women who take this medicine during pregnancy. The purpose of this registry is to collect information about your and your baby's health. Talk with your healthcare provider about how you can take part in this registry by calling the Antiretroviral Pregnancy Registry (APR) at 1-800-258- 4263.
Breastfeeding
Tell your healthcare provider if you are breastfeeding or planning to breastfeed. Biktarvy passes to your baby in your breast milk. Talk to your healthcare provider about the following risks to your baby from breastfeeding during treatment with Biktarvy:
- the HIV-1 virus may pass to your baby if your baby does not have HIV-1 infection.
- the HIV-1 virus may become harder to treat if your baby has HIV-1 infection.
- your baby may get side effects from Biktarvy.
Talk with your healthcare provider about the best way to feed your baby.
How should I take Biktarvy?
Take Biktarvy exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets. Use the medicine exactly as directed.
Biktarvy is a complete HIV-1 treatment regimen. You should not take it with other HIV-1 medicines.
- Take one Biktarvy tablet once a day, with or without food.
- If you are unable to swallow a whole tablet, you can split the tablet in half and swallow each part separately, as long as all parts are swallowed within about 10 minutes.
- You should not change your dose, or stop taking this medicine without first talking with your healthcare provider. Stay under a healthcare provider's care during treatment with this medicine.
- If you take antacids or supplements that contain iron or calcium, take Biktarvy with food at the same time that you take these antacids or supplements.
- If you take antacids that contain aluminum or magnesium, take Biktarvy at least 2 hours before or 6 hours after you take these antacids.
- If you are on dialysis, take your daily dose of Biktarvy following dialysis.
- When your medicine supply starts to run low, get more from your healthcare provider or pharmacy, so you do NOT run out. This is very important because if the medicine is stopped for even a short time, the amount of virus in your blood may increase and the virus may develop resistance to Biktarvy and become harder to treat.
- You will need frequent medical tests.
- Do not miss a dose of Biktarvy.
Dosing information
Usual Biktarvy dose in adults and pediatric patients weighing at least 25 kg, or virologically-suppressed adults with estimated creatinine clearance below 15 mL/min receiving chronic hemodialysis:
- Biktarvy (Bictegravir 50 mg/emtricitabine 200 mg/tenofovir alafenamide 25 mg) one tablet once a day, with or without food.
Recommended dosage in pregnant individuals who are virologically suppressed (HIV-1 RNA less than 50 copies per mL) on a stable antiretroviral regimen with no known substitutions associated with resistance to the individual components of Biktarvy:
- Biktarvy (Bictegravir 50 mg/emtricitabine 200 mg/tenofovir alafenamide 25 mg) one tablet once a day, with or without food.
Usual dose for HIV infection in children weighing at least 14 kg to less than 25 kg:
- Biktarvy (Bictegravir 30 mg/emtricitabine 120 mg/tenofovir alafenamide 15mg) one tablet once a day, with or without food.
Renal impairment: Biktarvy is not recommended in patients with estimated creatinine clearance of 15 to below 30 mL/min, or below 15 mL/min who are not receiving chronic hemodialysis, or below 15 mL/min who have no antiretroviral treatment history.
Hepatic impairment: Biktarvy is not recommended in patients with severe hepatic impairment.
Comments:
For children who are at least 14 kg to less than 25 kg, and are unable to swallow a whole tablet, the tablet can be split, and each part can be taken separately as long as all parts are ingested within about 10 minutes.
For more detailed Bikarvy dosing information, click the link below.
What happens if I miss a dose?
Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not use two doses at one time.
When your Biktarvy supply starts to run low, get more from your healthcare provider or pharmacy. This is very important because the amount of virus in your blood may increase if the medicine is stopped for even a short time. The virus may develop resistance to BIKTARVY and become harder to treat.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.
What other drugs will affect Biktarvy?
Sometimes it is not safe to use certain medications at the same time as taking Biktarvy. Drugs can affect your blood levels of other drugs you take, which may increase side effects or make the medications less effective.
You should not take Biktarvy with
- dofetilide; or
- Rifampin.
It is not recommended to take Biktarvy with:
- Rifabutin
- Rifapentine
- St. John's wort
When taking Biktarvy, alternative anticonvulsants should be considered instead of:
- carbamazepine
- oxcarbazepine
- phenobarbital
- phenytoin.
Avoid taking Biktarvy with other medications that may also harm the kidneys. Serious side effects, such as acute renal failure, have been reported in postmarketing studies.
Supplements or antacids that contain aluminum, magnesium, iron, or calcium, may interact with Biktarvy and Biktarvy should be taken at least 2 hours before or 6 hours after the antacid.
Many drugs can interact with Biktarvy. This includes prescription, over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here. Tell your doctor about all your current medicines and any medicine you start or stop using. To check for drug interactions with Biktarvy click the link below.
General information
Medicines are sometimes prescribed for purposes other than those listed in a Patient Information leaflet. Do not use Biktarvy for a condition for which it was not prescribed. Do not give this medicine to other people, even if they have the same symptoms you have. It may harm them. If you would like more information, talk with your healthcare provider. For information about Biktarvy that is written for health professionals click the Prescribing Information link at the bottom of this page.
Storage
- Store Biktarvy tablets in the original bottle below 86 °F (30 °C).
- Keep the bottle tightly closed.
- This medicine contains a desiccant packet to help keep your medicine dry (protect it from moisture). Keep the desiccant packet in the bottle. Do not eat the desiccant packet.
- Store the Biktarvy blister pack at room temperature between 68 °F to 77 °F (20 °C to 25 °C).
- Keep Biktarvy in its original bottle or blister pack.
- Biktarvy comes in a child-resistant package.
What are the ingredients in Biktarvy?
Active ingredients: bictegravir, emtricitabine, and tenofovir alafenamide.
Inactive ingredients: croscarmellose sodium, magnesium stearate, and microcrystalline cellulose.
The tablets are film-coated with a coating material containing iron oxide black, iron oxide red, polyethylene glycol, polyvinyl alcohol, talc, and titanium dioxide.
Manufacturer
Gilead Sciences, Inc. Foster City, CA 94404
Popular FAQ
Does Biktarvy have a copay card?
Yes, the Gilead Advancing Access copay program can help eligible patients who need financial assistance with their copays. The Biktarvy copay card is for commercially insured patients only. If you’re eligible, you may be able to pay as little as $0 for your co-pay. Contact Gilead Sciences at 1-800-226-2056 M–F, 9am–8pm ET for more information.
Which medicines should not be taken with Biktarvy?
- Biktarvy is a complete regimen and use with other antiretroviral medications for the treatment of HIV-1 infection is not recommended.
- Biktarvy is associated with many drug interactions as it contains three different medicines, increasing your risk for interactions. Have your health care provider check for possible interactions with other prescription medicines, OTCs or herbal you take.
- You should not take Biktarvy with dofetilide (Tikosyn), a drug used for heart rhythm disorders or rifampin (Rifadin), a medicine for tuberculosis (TB). These drugs are contraindicated with the use of Biktarvy.
Can Biktarvy be used for PrEP or PEP?
Biktarvy (bictegravir, tenofovir, and emtricitabine) is not FDA approved for use as an HIV-1 preventive for pre-exposure prophylaxis (PrEP) or as a post-exposure prophylaxis (PEP) treatment. Biktarvy is used for HIV treatment (not for prevention) as a once-daily, oral complete regimen in adults and children.
Medications approved by the FDA for use in PrEP are emtricitabine plus tenofovir alafenamide (oral Descovy), emtricitabine plus tenofovir disoproxil (oral Truvada) and the long-acting injection cabotegravir (Apretude). Continue reading
What if I miss a dose of Biktarvy?
If you miss one dose of Biktarvy (bictegravir, tenofovir, and emtricitabine), take the missed dose as soon as you remember it. If it is almost time for your next dose, just skip the missed dose and take your next dose at the regular time. Try not to miss doses. Taking your medicine as prescribed will help you to keep your HIV under control and help prevent drug resistance. Continue reading
Does Biktarvy cause weight gain?
Weight gain is a side effect with Biktarvy, but it was reported after the drug was approved and it's not known if it was caused by the drug. Studies have shown a weight gain of between 1 and 4 kg (2.2 to 8.8 lbs) over 2 years with integrase inhibitors. Continue reading
Does Dovato cause weight gain?
Studies have shown that weight gain with Dovato can range from 2.4 to 6 kg (5.3 to 13.2 lb) or more after one year of treatment. Integrase inhibitors have been associated with significant weight gain in people living with HIV, although the exact mechanism is not fully understood. Continue reading
Is Biktarvy covered by insurance?
Most commercial and government health insurance plans in the U.S. cover some portion of the cost for Biktarvy. Typically a person taking Biktarvy pays between $0 and $5 per month. A co-pay card program for Biktarvy offers up to $7,200 in cost-sharing assistance per year with no monthly limit. Continue reading
Can I drink alcohol while taking Biktarvy?
There is not a specific warning in the product label against alcohol (ethanol) consumption with Biktarvy, a medication used for HIV treatment. But drinking too much alcohol can damage your liver. Ask your doctor if it is safe and how much alcohol you can drink while taking Biktarvy. Continue reading
Does Biktarvy cause hair loss?
References
More about Biktarvy (bictegravir / emtricitabine / tenofovir alafenamide)
- Check interactions
- Compare alternatives
- Pricing & coupons
- Reviews (210)
- Drug images
- Side effects
- Dosage information
- Patient tips
- During pregnancy
- Support group
- FDA approval history
- Drug class: antiviral combinations
- En español
Professional resources
- Biktarvy prescribing information
- Bictegravir, Emtricitabine, and Tenofovir Alafenamide (AHFS Monograph)
Related treatment guides
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.