If you’re considering treatments for HIV, your doctor may recommend Biktarvy. It’s a prescription drug that’s used to treat HIV-1, which is the most common type of HIV.

Biktarvy is prescribed for HIV-1 in adults and children weighing at least 25 kilograms (about 55 pounds). It’s used for people who either:

  • haven’t taken HIV treatment in the past with antiretroviral medications (a kind of HIV drug) or
  • want to change their current HIV treatment regimen, in certain situations

To learn more about how Biktarvy is used, see the “What is Biktarvy is used for?” section below.

Biktarvy comes as a tablet you swallow.

You don’t need to take other HIV medications when you take Biktarvy. That’s because Biktarvy is a complete treatment for HIV. It contains three different active drugs that work together to treat the condition. These drugs are: bictegravir sodium, emtricitabine, and tenofovir alafenamide.

In this article we’ll discuss uses, side effects, cost, and other key information you need to know about Biktarvy.

Like most drugs, Biktarvy may cause mild or serious side effects. The lists below describe some of the more common side effects that Biktarvy may cause. These lists don’t include all possible side effects.

Your doctor or pharmacist can tell you more about the potential side effects of Biktarvy. They can also suggest ways to help reduce side effects.

Keep in mind that side effects of a drug can vary from person to person. And they depend on:

  • your age
  • any medical conditions you may have
  • other medications you may be taking

Mild side effects

Here’s a short list of some of the mild side effects that Biktarvy can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Biktarvy’s important facts.

Mild side effects of Biktarvy can include:

Mild side effects of many drugs may go away within a few days or a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

Serious side effects

Serious side effects from Biktarvy can occur, but they aren’t common. If you have serious side effects from Biktarvy, call your doctor right away. However, if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects can include:

* For more information about this side effect, see the “Side effect focus” section just below.

Suicide prevention

If you think someone is at immediate risk of self-harm or hurting another person:

  • Call 911 or your local emergency number.
  • Stay with the person until help arrives.
  • Remove any guns, knives, medications, or other things that may cause harm.
  • Listen, but don’t judge, argue, threaten, or yell.

If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.

Side effect focus

Learn more about some of the side effects Biktarvy may cause.

Boxed warning

Biktarvy has a boxed warning for worsening hepatitis B. A boxed warning is a serious warning from the Food and Drug Administration (FDA).

Biktarvy may worsen hepatitis B in people who have both HIV and hepatitis B, if Biktarvy is stopped.

This side effect was reported in people who were taking emtricitabine and/or tenofovir disoproxil fumarate. Biktarvy contains the drugs emtricitabine and tenofovir alafenamide, which is a slightly different form of tenofovir.

What might help

If you have both hepatitis B and HIV, and you stop taking Biktarvy, your doctor will monitor your liver for several months. This will help them make sure your hepatitis B infection isn’t getting worse.

In some cases, you may need treatment for hepatitis B if it becomes worse after stopping Biktarvy.

Weight gain

You may have some weight gain while you’re taking Biktarvy.

A recent review of people who took integrase inhibitors showed that the people had weight gain while taking the medications. Integrase inhibitors are a certain group of drugs used to treat HIV. And one of the active drugs contained in Biktarvy is an integrase inhibitor.

Another 2020 study showed that weight gain with use of integrase inhibitors was more common among females* of older age.

In addition, a study looked at weight gain in people who switched from nucleoside reverse transcriptase inhibitor medications containing tenofovir disoproxil fumarate to those containing tenofovir alafenamide. (Tenofovir alafenamide is an active drug in Biktarvy.) In the study, people making the switch had weight gain.

* In this article, the terms “male” and “female” refer to a person’s sex assigned at birth.

What might help

Your doctor will monitor your weight while you’re taking Biktarvy. If you notice changes in your weight, talk with your doctor about ways to manage a healthy body weight while you’re taking Biktarvy. Don’t stop taking Biktarvy without talking with your doctor.

Rash

Some people taking Biktarvy may develop a rash. In studies, this wasn’t a very common side effect in people taking Biktarvy.

What might help

Keep in mind that rash may be a sign of allergic reaction. So if you develop a rash while you’re taking Biktarvy, it’s important to call your doctor so they can check to see what’s causing your rash. And they’ll recommend treatment, if needed.

Allergic reaction

Some people may have an allergic reaction to Biktarvy.

Symptoms of a mild allergic reaction can include:

  • skin rash
  • itchiness
  • flushing (warmth, swelling, or redness in your skin)

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include swelling under your skin, typically in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Biktarvy. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Costs of prescription drugs can vary depending on many factors. These factors include what your insurance plan covers and which pharmacy you use. To find current prices for Biktarvy in your area, visit GoodRx.com.

If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. You can also visit the Biktarvy manufacturer’s website to see if they have support options.

If you’re considering HIV treatments, your doctor may recommend that you take Biktarvy. It’s used to treat HIV-1 in adults and children weighing at least 25 kilograms (about 55 pounds).

HIV-1 is the most common type of HIV. HIV weakens your immune system, making your body more susceptible to certain conditions such as infections and cancers.

Biktarvy is prescribed for people who:

  • have never taken antiretroviral medications (a kind of HIV drug) in the past.
  • are changing their current HIV treatment, in certain situations. For this use, Biktarvy can be prescribed for people when:
    • their HIV isn’t resistant (unresponsive) to any of the ingredients of Biktarvy.
    • they haven’t had an HIV treatment that didn’t work for them in the past.

Biktarvy contains three active drugs that work together to stop HIV from making copies of itself in your body. This lowers the level of HIV of your body and helps treat the condition.

HIV isn’t cured with Biktarvy. But if the drug is taken as prescribed, it can keep the level of HIV low in your body so that it’s not detectable.

Find answers to some commonly asked questions about Biktarvy.

How are Biktarvy and Genvoya alike and different?

Biktarvy and Genvoya have quite a few similarities and some slight differences. They have some of the same active drugs and side effects. And they have the same uses.

Both Biktarvy and Genvoya are complete treatments for HIV in certain situations. As complete treatments, they don’t need to be taken with other HIV drugs. For more information about how Biktarvy is used, see the “What is Biktarvy used for?” section just above.

Biktarvy and Genvoya have slightly different active ingredients:

  • Biktarvy contains emtricitabine, tenofovir alafenamide, and bictegravir.
  • Genvoya contains emtricitabine, tenofovir alafenamide, elvitegravir, and cobicistat.

Both medications come as tablets you swallow once a day. Biktarvy can be taken with or without food, but Genvoya needs to be taken with food.

To learn about side effects of these drugs, see the “What are Biktarvy’s side effects?” section above. And view Genvoya’s patient information.

If you’d like to know more about the differences and similarities of these drugs, talk with your doctor.

Can Biktarvy be used for PrEP?

No, Biktarvy isn’t used as pre-exposure prophylaxis (PrEP). For PrEP, certain medications are given to help prevent HIV. PrEP medications are given to people at risk for getting HIV to help lower their risk for contracting the virus.

Currently, there are only two medications used for PrEP: Truvada and Descovy.

If you’d like to learn more about PrEP, ask your doctor for more information.

Can I take ibuprofen or Tylenol while I’m taking Biktarvy?

Maybe. But you should always talk with your doctor before taking any other drugs with Biktarvy.

Ibuprofen, and other nonsteroidal anti-inflammatory drugs (NSAIDs), can increase your risk for kidney problems when taken with Biktarvy. And Biktarvy can also increase your risk for kidney damage. So it’s best to ask your doctor before taking any NSAIDs with Biktarvy.

Biktarvy doesn’t interact with acetaminophen (Tylenol). But taking large doses of acetaminophen can cause liver damage. And Biktarvy may also cause liver problems. Be sure to ask your doctor about safe doses of acetaminophen to take with Biktarvy.

Your doctor will explain how you should take Biktarvy. They’ll also explain how much to take and how often. Be sure to follow your doctor’s instructions. Below are commonly used dosages but always take the dosage your doctor prescribes.

Taking Biktarvy

Biktarvy comes as tablets that you’ll take by mouth.

It’s important to take Biktarvy daily without missing doses. Here are a few tips that may help you keep a regular dosing schedule:

  • try to take Biktarvy on a regular time schedule, like first thing in the morning every day
  • mark down on a calendar or diary when you’ve taken your dose of Biktarvy
  • use a reminder app so you don’t miss any doses of Biktarvy

Dosage

You’ll take a Biktarvy tablet by mouth once each day.

It’s a complete HIV treatment, meaning you won’t have to take other HIV medications with it.

Questions about taking Biktarvy

  • What if I miss a dose of Biktarvy? If you miss a dose of Biktarvy, take it as soon as you remember. But don’t take two doses at once. It’s very important to stay on course with HIV treatment. Missing doses of Biktarvy can increase the risk of viral resistance to the ingredients in Biktarvy. And with viral resistance, HIV won’t respond to Biktarvy like usual.
  • Will I need to use Biktarvy long term? Your doctor will monitor how you’re doing with Biktarvy. If it’s working well to manage your HIV, your doctor may recommend that you take it long term.
  • Can Biktarvy be chewed, crushed, or split? No, don’t crush, chew, or split Biktarvy tablets. It’s not known if doing so changes how the drug works. If you have trouble swallowing pills, here are a few tips that might help. You can also ask your pharmacist or doctor for options on taking Biktarvy if you can’t swallow pills.
  • Should I take Biktarvy with food? Biktarvy can be taken with or without food any time of the day. But try to stay on the same schedule everyday so you’ll more easily remember to take Biktarvy.
  • How long does Biktarvy take to work? Biktarvy starts to work around an hour after you take a dose. Keep in mind, it may take several months for Biktarvy to lower the level of HIV in your body to an undetectable level. Talk with your doctor about how they’ll monitor your treatment progress with Biktarvy.
Questions for your doctor

You may have questions about Biktarvy and your treatment plan. It’s important to discuss all your concerns with your doctor.

Here are a few tips that might help guide your discussion:

  • Before your appointment, write down questions like:
    • how will Biktarvy affect my body, mood, or lifestyle?
  • Bring someone with you to your appointment if doing so will help you feel more comfortable.
  • If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.

Remember, your doctor and other healthcare providers are available to help you. And they want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.

Before you start taking Biktarvy, your doctor will check to see how well your liver and kidneys are working. And they’ll check to see if you have hepatitis B.

If you have kidney or liver problems, including hepatitis, or you’re pregnant or breastfeeding, ask if Biktarvy is safe for you to take. Your doctor can discuss with you the benefits and risks of using this drug.

Here’s a look at some of the risks and precautions you should consider before taking Biktarvy.

Interactions

Taking medications, vaccines, foods, and other things with a certain drug can affect how the drug works. These effects are called interactions.

Before taking Biktarvy, be sure to tell your doctor about all the medications you take (including prescription and over-the-counter types). Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Biktarvy.

Interactions with drugs or supplements

Biktarvy can interact with several types of drugs, including some over-the-counter products. Some interactions can affect how well Biktarvy works, while others can increase side effects of the drug.

The lists that follow don’t contain all types of drugs that may interact with Biktarvy. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with use of Biktarvy.

Some drugs that interact with Biktarvy include:

Interactions with antacids

You should avoid taking certain antacids together with Biktarvy. This is because antacids can affect how well Biktarvy works.

Examples of antacids include:

  • aluminum hydroxide/magnesium hydroxide (Mylanta)
  • aluminum hydroxide/magnesium trisilicate (Gaviscon)
  • calcium carbonate (Tums)
  • calcium carbonate/magnesium hydroxide (Rolaids)

If you have dyspepsia (indigestion), ask your doctor or pharmacist what medications are safe to take with Biktarvy. Consider eating smaller meals and avoiding foods that irritate your stomach, such as spicy foods.

If you’d like to know more about taking antacids while using Biktarvy, see the last section of this article called “Ask a pharmacist.”

Boxed warning

Biktarvy has a boxed warning. This is a serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

Boxed warning: Worsening hepatitis B

Biktarvy has a boxed warning for worsening hepatitis B. A boxed warning is a serious warning from the Food and Drug Administration (FDA).

Biktarvy may worsen hepatitis B in people who have both HIV and hepatitis B, if Biktarvy is stopped.

If you have both hepatitis B and HIV, and you stop taking Biktarvy, your doctor will monitor your liver for several months. This will help them make sure your hepatitis B infection isn’t getting worse.

In some cases, you may need treatment for hepatitis B if it becomes worse after stopping Biktarvy.

If you’d like to know more about this boxed warning, see the “What are Biktarvy’s side effects?” section above.

Other warnings

Biktarvy may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before you take Biktarvy. Factors to consider include those in the list below.

  • Kidney problems. Biktarvy can cause new or worsening kidney problems. Your doctor will monitor how your kidneys are working before you start Biktarvy and while you’re taking the drug.
  • Liver problems. Biktarvy may cause problems with your liver. Talk with your doctor if you’ve had liver disease or hepatitis in the past or currently. Your doctor will monitor how well your liver is working before you start Biktarvy and while you’re taking the drug. And if you have hepatitis B, your doctor will continue to check your liver function after you stop taking Biktarvy.
  • Allergic reaction. If you’ve had an allergic reaction to Biktarvy or any of its ingredients, you shouldn’t take Biktarvy. Ask your doctor about other options that may be better choices.
  • Depression or mental health condition. If you have depression or thoughts of self-harm, or you’ve had these in the past, Biktarvy may not be suitable for you. Be sure tell your doctor if you have these conditions. And if you experience mood or mental health changes while you’re taking Biktarvy, call your doctor right away.

Use with alcohol

Drinking alcohol with Biktarvy may increase your risk for or worsen some side effects of Biktarvy. These include:

If you drink alcohol, ask your doctor if it’s safe for you to do so while taking Biktarvy.

Pregnancy and breastfeeding

It’s not known if Biktarvy is safe to take during pregnancy. So be sure to talk with your doctor before taking this drug during pregnancy. Your doctor can help you understand the risks of Biktarvy use during pregnancy.

Biktarvy does pass into breast milk. So you should avoid breastfeeding while taking Biktarvy. Additionally, the Centers for Disease Control and Prevention (CDC) recommends that in the United States, breastfeeding should be avoided if you have HIV. Talk with your doctor about healthy ways to feed your child other than breastfeeding.

Don’t take more Biktarvy than your doctor prescribes. Using more than this can lead to serious side effects.

What to do in case you take too much Biktarvy

Call your doctor if you think you’ve taken too much Biktarvy. You can also call 800-222-1222 to reach the American Association of Poison Control Centers or use their online resource. However, if you have severe symptoms, immediately call 911 (or your local emergency number) or go to the nearest emergency room.

Biktarvy is a complete treatment for HIV, making it a convenient regimen because it can be taken alone. But there are also other treatment options available for HIV.

Talk with your doctor about all of your treatment choices based on your:

  • age
  • medical and health history
  • other medications you take

You may find complementary therapies helpful when used together with medications for HIV. These complementary therapies include activities such as mindfulness practice, meditation, or yoga. Take a look at these yoga apps.

Before taking Biktarvy, ask your doctor about what you can expect with treatment. Here are some possible questions to get you started:

  • Can I take vitamins with Biktarvy?
  • How will I know if Biktarvy is working for me?
  • Will I gain weight with Biktarvy?

To learn more about HIV and new treatment options, you can sign up for Healthline’s HIV newsletter.

Q:

Which antacids can I take with Biktarvy for upset stomach?

Anonymous patient

A:

A few examples of antacids that may be taken with Biktarvy to help treat your upset stomach include:

  • aluminum hydroxide and magnesium hydroxide (Mylanta)
  • aluminum hydroxide and magnesium trisilicate (Gaviscon)
  • calcium carbonate (Tums)
  • calcium carbonate and magnesium hydroxide (Rolaids)

But it’s important that the time you take antacids is spaced out from the time you take Biktarvy.

Aluminum, calcium, iron, and magnesium may lower your body’s absorption of bictegravir (one of the active drugs in Biktarvy). This interaction can decrease your level of bictegravir, putting you at risk for viral resistance. (With viral resistance, HIV won’t respond to Biktarvy like usual.)

Biktarvy can be taken at least 2 hours before or 6 hours after you’ve taken antacids containing aluminum or magnesium. You should be careful not to take Biktarvy at the same time or within 2 hours after you’ve taken antacids containing aluminum or magnesium.

Additionally, it’s not recommended that you take antacids containing calcium on an empty stomach or within 2 hours after you’ve taken Biktarvy. If you take any antacids containing calcium, Biktarvy can be taken at the same time as the antacid as long these medications are taken together with food.

Talk with your doctor or pharmacist about which antacid would be best to help treat your upset stomach while taking Biktarvy. And ask for instructions if you have questions about the timing of taking the antacid.

Melissa Badowski, PharmD, MPH, FCCPAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Healthline

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.