Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) is a prescription drug that’s used to treat HIV in adults and some children. Biktarvy comes as a tablet that you swallow.
Biktarvy is used in adults and certain children to treat HIV-1 (the most common type of HIV.) Children receiving Biktarvy must weigh at least 14 kilograms (kg).
To learn more about Biktarvy’s uses, see the “What is Biktarvy used for?” section below.
Biktarvy basics
Biktarvy contains three active ingredients: bictegravir, emtricitabine, and tenofovir alafenamide. Bictegravir belongs to a group of drugs called integrase strand transfer inhibitors. Emtricitabine and tenofovir alafenamide are nucleoside reverse transcriptase inhibitors.
Biktarvy is a brand-name medication. A generic version of the drug isn’t currently available.
Biktarvy has a boxed warning. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). For details, see the “What are Biktarvy’s side effects?” section just below.
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:
- abnormal dreams
- diarrhea
- rash*
- dizziness
- fatigue (low energy level)
- headache
- insomnia (difficulty sleeping)
- nausea
* For more information about this side effect, see the “Side effect focus” section just below.
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:
- new or worsening kidney problems, including kidney failure
- severe liver problems
- lactic acidosis (increased lactic acid level in your body)
- immune reconstitution syndrome (a condition that’s caused when your immune system flares up due to past infections, such as cytomegalovirus, fungal infections, or tuberculosis)
- depression
- boxed warning: worsening of hepatitis B*
- allergic reaction*
* For more information about this side effect, see the “Side effect focus” section just below.
SUICIDE PREVENTIONIf 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, tenofovir disoproxil fumarate, or a combination of both. 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.
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 a rash may be a sign of an 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 another treatment if needed.
Allergic reactionSome people may have an allergic reaction to Biktarvy.
Symptoms of a mild allergic reaction can include:
- skin rash
- itchiness
- flushing (warmth, swelling, redness, or deepening of color 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 difficulty 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.
Whether you have health insurance or not, cost may be a factor when you’re considering Biktarvy. What you’ll pay for Biktarvy may depend on several things, such as your treatment plan and the pharmacy you use.
Here are a few things to consider regarding cost:
- Cost information and savings coupons: You can visit Optum Perks to get price estimates of what you’d pay for Biktarvy when using coupons from the site. See the coupon options below. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)
- Savings program: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A program called Gilead Advancing Access may also be available. To find out if you’re eligible for this savings program, visit the program website.
You can also check out this article to learn more about saving money on prescriptions.
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Simply show the Optum Perks coupon at your preferred pharmacy or order online and instantly save up to 80% without using insurance. The coupon doesn’t expire, so be sure to save it for refills.
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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 14 kg (about 31 pounds[lb]).
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 have an undetectable viral load (a viral level that’s too low to detect on tests or to transmit to a sexual partner).
- 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 in 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 below to some commonly asked questions about Biktarvy.
Will I have weight gain from Biktarvy?
You may have some weight gain while you’re taking Biktarvy. Keep in mind that Biktarvy treats HIV, which can lead to weight loss in some people. So if your HIV is being treated, you may gain some weight.
Additionally, a
Another
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 body weight that’s healthy for you. Don’t stop taking Biktarvy without talking with your doctor.
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 per 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 preexposure prophylaxis (PrEP). For PrEP, certain medications are given to help prevent HIV. PrEP medications are given to people at risk for HIV to help lower their risk of getting the virus.
Currently, there are only three medications used for PrEP: Truvada, Descovy, and Apretude.
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 recommend the dosage of Biktarvy that’s right for you. Below are commonly used dosages, but always take the dosage your doctor prescribes.
Form and strengths
Biktarvy is a combination drug with three active ingredients: bictegravir (BIC), emtricitabine (FTC), and tenofovir alafenamide (TAF).
Biktarvy is available as an oral tablet in two strengths:
- 30 milligrams (mg) of BIC/120 mg of FTC/15 mg of TAF
- 50 mg of BIC/200 mg of FTC/25 mg of TAF
Recommended dosages
Your doctor will recommend the dosage of Biktarvy that’s right for you. Below are commonly used dosages, but the dosage you receive will be determined by your doctor.
Dosage for HIV
The dosage of Biktarvy for adults and children who weigh at least 25 kg is 50 mg BIC/200 mg FTC/25 mg TAF per day. This is taken as one tablet, once per day.
Biktarvy’s dosage for children weighing 14 to 25 kg is 30 mg BIC/120 mg FTC/15 mg TAF per day. This dosage is taken as one tablet per day.
You’ll usually take your dosage around the same time each day.
How to take
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.
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.
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, such as 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.
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? For children who weigh at least 14 kilograms (about 31 pounds) but less than 25 kilograms (about 55 pounds) and are unable to swallow Biktarvy, the tablet may be split. But all of the tablet pieces must be taken within 10 minutes. It’s not known if Biktarvy tablets can be chewed, crushed, or split for people weighing at least 25 kilograms. If you have difficulty 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 every day 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 doctorYou 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 professionals 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.
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:
- anticonvulsant medications, such as:
- carbamazepine
- phenobarbital
- phenytoin
- oxcarbazepine
- certain antibiotics, such as:
- rifampin (Rifadin)
- rifabutin (Mycobutin)
- rifapentine (Priftin)
- the atrial fibrillation medication dofetilide (Tikosyn)
- the type 2 diabetes medication metformin
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, and simethicone (Mylanta maximum strength liquid antacid/anti-gas)
- aluminum hydroxide and magnesium trisilicate (Gaviscon)
- calcium carbonate (Tums)
- calcium carbonate and 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.”
Before taking Biktarvy, talk with your doctor about whether this drug is recommended for you. Below, we describe certain warnings for Biktarvy and situations in which it may not be recommended.
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 the most serious warning from the 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 can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Biktarvy is a good treatment option for you.
Talk with your doctor about your health history before you take Biktarvy. Be sure to tell them if any of the following factors apply to you:
- kidney problems
- liver problems
- previous allergic reaction to Biktarvy
- depression or another mental health condition
- pregnancy
- breastfeeding
Drinking alcohol with Biktarvy may increase your risk for or worsen some side effects of Biktarvy. These include:
- liver damage
- nausea
- headache
- dizziness
- tiredness
If you drink alcohol, ask your doctor if it’s safe for you to do so while taking Biktarvy.
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 America’s Poison 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.
Q:
Which antacids can I take with Biktarvy for upset stomach?
AnonymousA:
A few examples of antacids that may be taken with Biktarvy to help treat your upset stomach include:
- aluminum hydroxide, magnesium hydroxide, and simethicone (Mylanta maximum strength liquid antacid/anti-gas)
- 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 as 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.
The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.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 another 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.