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Generic Name:

Cobicistat-Elvitegravir-Emtricitabine-Tenofovir, Oral tablet

All Brands

  • Stribild
SECTION 1 of 4

Highlights for Cobicistat-Elvitegravir-Emtricitabine-Tenofovir

Oral tablet

The Stribild tablet contains four different drugs. Instead of taking four separate drugs, this is a complete treatment for HIV that you only have to take once a day.


This drug can be hard on the kidneys. It can make your kidneys run less efficiently, and they may not remove waste products as well. If your kidney function is already slower than normal, you have a greater risk of further effects from Stribild.


Stribild has many possible drug interactions. Your healthcare provider may alter your dose or change your treatment depending on what other drugs you’re taking.


This drug is effective if you take it every day. But if you skip doses or stop taking it, you could make your HIV infection and side effects worse.


Side effects may range from relatively mild (bad dreams) to severe (liver disease.)

  • warning icon

    FDA warning See Details

  • drug combination warning

    Don’t take large doses of ibuprofen, naproxen, piroxicam, or other anti-inflammatory drugs — or take them for a long time See Details

  • serious infections icon

    May cause immune reconstitution syndrome See Details

  • bone density warning

    May lead to changes in your bone density, increasing the risk of a bone break

FDA warning

This drug has a black box warning, the most serious warning from the U.S. Food and Drug Administration (FDA). Though the medication can still be sold and used, a black box warning alerts doctors and patients to potentially dangerous problems.


  • May cause lactic acidosis. In this condition, lactic acid builds up in the blood, and the amount of oxygen drops. This can cause:
    • nausea
    • weakness
    • unusual muscle pain
    • trouble breathing
    • fast heartbeat
    • coldness in feet or hands
    • dizziness
    This syndrome occurs more often in women, overweight people, and those who have been taking the drug for long periods of time.
  • Not approved to treat both HIV and hepatitis B. If you have hepatitis B, start this drug, and stop taking it, your hepatitis can worsen.

Don’t take large doses of ibuprofen, naproxen, piroxicam, or other anti-inflammatory drugs — or take them for a long time

These drugs and Stribild can slow your kidney function. Combining them may cause this drug to stay in your body longer than it should, which can increase its side effects.

May cause immune reconstitution syndrome

Improving the immune system by treating HIV can sometimes cause old infections to reappear and suddenly become worse. If you have worsening symptoms of old infections, call your doctor right away.

What is cobicistat-elvitegravir-emtricitabine-tenofovir?

This drug is a prescription drug. It is available in these forms: oral tablet.

This drug is a combination of two or more drugs in a single form. It is important to know about all the drugs in the combination because they each may have unique traits.

Why it's used

This drug treats adults with HIV who haven’t already been treated for the virus.

More Details

How it works

This drug contains four drugs: elvitegravir, cobicistat, emtricitabine, tenofovir.

More Details

Why it's used

This drug treats adults with HIV who haven’t already been treated for the virus.

It has four drugs in one tablet and is considered a complete HIV treatment. That means most people won’t need other drugs to treat the infection.

How it works

This drug contains four drugs: elvitegravir, cobicistat, emtricitabine, tenofovir.

  • Emtricitabine and tenofovir are both nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs prevent the HIV virus from multiplying.
  • Elvitegravir is an integrase strand inhibitor. It blocks the virus from being added to your DNA. HIV uses an enzyme called integrase to insert its viral DNA into the DNA of the host cell. Blocking integrase prevents HIV from replicating.
  • Cobicistat amplifies the effects of the drug and helps it to work longer in your body.

This drug helps increase CD4 counts in your blood. These are blood markers used to measure the number of CD4 T-cells in your body that help fight the infection.

This drug will help control your HIV or AIDS, but it will not cure it.

SECTION 2 of 4

Cobicistat-Elvitegravir-Emtricitabine-Tenofovir Side Effects

Oral tablet

Most Common Side Effects

The most common side effects that occur with Stribild include:

  • difficulty sleeping

  • tiredness

  • bad dreams

  • nausea, stomach upset, or diarrhea

  • protein in the urine, a possible sign of kidney effects

  • accumulation of fat around the neck and stomach

Serious Side Effects

If you experience any of these serious side effects, call your doctor right away. If your symptoms are potentially life-threatening, or if you think you’re experiencing a medical emergency, call 9-1-1.

Possible serious side effects include:

  • changes in bone density, which increases the risk of a bone break

  • symptoms of liver disease, such as light-colored bowel movements, yellowing of the eyes or skin, and others
  • symptoms of slower or less effective kidneys, including urinating less often, bone pain, or muscle pain

  • symptoms of lactic acidosis, including nausea, weakness, unusual muscle pain, trouble breathing, fast heartbeat, coldness in feet or hands, and dizziness

Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug does not cause drowsiness.

Take at the middle of, or immediately after, a meal.

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this information includes all possible side effects. This information is not a substitute for medical advice. Always discuss possible side effects with a healthcare provider who knows your medical history.
SECTION 3 of 4

Cobicistat-Elvitegravir-Emtricitabine-Tenofovir May Interact with Other Medications

Oral tablet

Stribild can interact with other medications, herbs, or vitamins you might be taking. That’s why your doctor should manage all of your medications carefully. If you’re curious about how this drug might interact with something else you’re taking, talk to your doctor or pharmacist.

Note: You can reduce your chances of drug interactions by having all of your prescriptions filled at the same pharmacy. That way, a pharmacist can check for possible drug interactions.

Don’t take this treatment with other drugs for HIV. It is a complete HIV treatment. If you’re taking Stribild, you will likely not have to take anything else for your HIV.

Alcohol Interaction

Alcohol doesn't directly interact with Stribild, but it's not a good idea to consume alcohol when being treated for HIV. Alcohol and HIV treatment both put stress on your liver.

Medications That Might Interaction with This Drug


Don’t take this drug within two hours of antacids. Take the antacids at least two hours before or after taking Stribild. Antacids include:

  • Gaviscon
  • Alamag
  • Mylanta
  • Maalox


It’s not recommended to use salmeterol (in Serevent and Advair) with this drug. The combination may increase risk of heart rhythm changes. The combination may cause your heart to beat faster or slower than normal, which could be dangerous.

Hepatitis C virus drugs

Taking these drugs may increase the levels of tenofovir, one of the components of this medication, in your body. You shouldn’t take these drugs with this drug.

These drugs include:

  • ledipasvir/sofosbuvir

Drugs that Follow the Same Pathway

Some drugs are processed the same way in your body as Stribild. If you combine them, your body’s processing system can get overloaded. This can cause the other drugs to build up in your body and you could have more side effects from them. These include:

  • acyclovir
  • valacyclovir
  • nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, aspirin, naproxen, and others

Other Drugs

Many drugs, over-the-counter drugs, and herbal products can interact with Stribild. Your doctor may still prescribe them for you, but may need to change the dose. Examples include:

  • alpha-1-adrenoceptor antagonists, such as alfuzosin
  • antibiotics, including:
    • erythromycin
    • clarithromycin
    • aminoglycosides
  • anticonvulsants, such as:
    • carbamazepine
    • phenytoin
  • antiarrhythmics, including:
    • digoxin
    • amiodarone 
  • antidepressants, such as:
    • amitriptyline
    • bupropion
    • paroxetine
  • rifampin
  • beta blockers, such as:
    • metoprolol
    • timolol
  • calcium channel blockers, such as:
    • amlodipine
    • diltiazem
  • ergot derivatives, including:
    • dihydroergotamine (Migranal)
    • ergonovine
    • ergotamine
    • methylergonovine
  • drugs that stimulate your digestive system, such as cisapride
  • adefovir (Hepsera), used to treat hepatitis B
  • HMG-CoA reductase inhibitors (statins), such as:
    • lovastatin (Mevacor)
    • Lipitor
    • Zocor
  • some herbal remedies, including St. John’s wort
  • itraconazole and ketoconazole (anti-fungal drugs you take by mouth) 
  • neuroleptic medications, such as pimozide
  • phosphodiesterase-5 (PDE5) inhibitors, such as sildenafil (Viagra)
  • sedative or hypnotic medications, including triazolam (Halcion)
  • warfarin

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs interact differently in each person, we cannot guarantee that this information includes all possible interactions. This information is not a substitute for medical advice. Always speak with your healthcare provider about possible interactions with all prescription drugs, vitamins, herbs and supplements, and over-the-counter drugs that you are taking.
Drug warnings
liver icon
People with hepatitis B

This drug isn’t approved to treat both HIV and hepatitis B. If you have hepatitis B, start taking it, and then stop, your hepatitis can worsen. Your doctor will need to perform extra monitoring for you. This could include liver function tests. You may need treatment for hepatitis B.

liver icon
People with liver disease

If you have any liver disease, such as hepatitis B or cirrhosis, talk to your doctor before taking this drug. 

slow kidneys
People with slow kidneys

Kidneys filter out impurities and waste products from your body. When you take this drug, it can make your kidneys run less efficiently and slow them down. This means that your kidneys can’t remove waste products as efficiently.

If your kidneys already work slower than normal, you should talk to your doctor before taking this drug. People with slow kidneys often opt for a lower dose of a drug. However, the drug comes in only one strength.

bone fracture or disease
People with bone fracture or disease

If you’ve previously had a bone fracture or bone disease, ask your healthcare provider or pharmacist whether you need to take extra vitamin D or calcium.

pregnant woman icon
Pregnant women

This drug is a pregnancy category B drug. That means two things:

  1. Studies of the drug in pregnant haven’t shown risk to the fetus.
  2. There aren’t enough studies done in humans to show the drug poses a risk to the fetus.

Pregnant women should only use this drug if the benefit outweighs the risk to the baby. There are other HIV drugs that are more commonly used in pregnancy. If you’re pregnant or plan to become pregnant, talk to your doctor before taking this drug.

breastfeeding icon
Women who are breast-feeding

This drug can be passed through breast milk. Breastfeeding infants exposed to this drug can develop a resistance to the drug. It’s not recommended to breastfeed while taking the drug.

SECTION 4 of 4

How to Take Cobicistat-Elvitegravir-Emtricitabine-Tenofovir (Dosage)

Oral tablet

All possible dosages and forms may not be included here. Your dose, form, and how often you take it will depend on:

  • your age
  • the condition being treated
  • how severe your condition is
  • other medical conditions you have
  • how you react to the first dose

What Are You Taking This Medication For?


Brand: Stribild

Form: Oral Tablet
Strength: elvitegravir 150 mg, cobicstat 150 mg, emtricitabine 200 mg, tenofovir disoproxil fumarate 300 mg
Adult Dosage (ages 18-64 years)

Take one tablet once a day with a full meal, not just a snack. Food helps your body absorb Stribild.

Child Dosage (ages 0-17 years)

This medicine has not been studied in children and should not be used in children under the age of 18 years.

Senior Dosage (ages 65 years and older)
  • There are no specific recommendations for senior dosing. Older adults may process drugs more slowly. A normal adult dose may cause levels of the drug to be higher than normal.
  • If you’re a senior, you may need a lower dose or you may need a different schedule

Disclaimer: Our goal is to provide you with the most relevant and current information. However, because drugs affect each person differently, we cannot guarantee that this list includes all possible dosages. This information is not a substitute for medical advice. Always to speak with your doctor or pharmacist about dosages that are right for you.
Pharmacist's Advice
Clinical Associate Professor, University of Illinois at Chicago College of Pharmacy

This drug will help control your HIV, not cure it. When it works well, it will help reduce the number of virus particles in your blood. It works best if you take it every day.

If you skip doses or stop

If you skip doses or stop taking this drug, you risk making your HIV worse. You may have to restart the drug and adjust to its side effects all over again. Usually when you start a drug, you will have an adjustment period when the side effects will be more difficult. Over time they will be much less noticeable.

If you stop and restart

If you stop and restart this drug, it might not work well again for you. Your side effects can also be worse the second time you use the drug.

If you miss a dose

If you forget to take a dose, take it as soon as you remember. If it’s just a few hours until it’s time to take another dose, take just one tablet at that time.

Do not take two tablets.

How can I tell if the drug is working?

Your healthcare provider will run lab tests to see if the drug is working well for you.  These could include:

  • liver function tests
  • kidney function tests
  • several kinds of monitoring tests for HIV, including CD4 count tests.
Important considerations for taking this drug

Store at room temperature: 68 – 77°F (20 – 25°C)

Keep the medication tightly closed and in its original container.

Clinical monitoring

You will need occasional lab tests and appointments to check the drug’s effects and to see how well the drug is working.  Your doctor may order tests to:

  • check kidney function
  • check liver function
  • see how well this drug is keeping your viral count under control

Not every pharmacy stocks this drug, so call ahead

If you only need a few tablets, you should call and ask if your pharmacy dispenses only a small number of tablets. Some pharmacies can’t dispense only part of a bottle.

This drug is often available from specialty pharmacies through your insurance plan. These pharmacies operate like mail order pharmacies and ship the drug to you.

In larger cities, there will often be HIV pharmacies where you can have your prescriptions filled. Ask your doctor if there’s a local HIV pharmacy in your area.

Hidden costs

This drug may be very expensive without insurance coverage.


Many insurance companies will require a prior authorization (P.A.) before approving and paying for this drug. Check with your insurance plan.

Are there any alternatives?

There are many drugs and combinations that can treat HIV. Some may be more suitable for you than others. Talk to your doctor about possible alternatives.

Show Sources

Content developed in collaboration with Susan J. Bliss, RPh, MBA

Medically reviewed by Stacey Boudreaux, PharmD and Alan Carter, PharmD on January 22, 2015

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up-to-date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or other healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.