Truvada (emtricitabine/tenofovir disoproxil fumarate) is a prescription drug that’s used to treat or help prevent HIV. Truvada can cause side effects that range from mild to serious. Examples include low energy, depression, and kidney problems.

Doctors prescribe Truvada specifically to:

  • treat HIV in adults and certain children
  • help prevent HIV in adults and certain adolescents at risk of contracting HIV through sexual activity*

Note that if you take Truvada to treat HIV, you’ll take it with other HIV drugs.

Truvada comes as a tablet that you swallow. For more information about Truvada, including details about its uses, see this in-depth article.

Like other drugs, Truvada can cause mild to serious side effects. Keep reading to learn more.

Below are just a few of the more common side effects reported by people taking Truvada in studies. These side effects can vary depending on whether Truvada is taken to treat or prevent HIV.

Some of the more common side effects in people taking Truvada to treat HIV include:

More common side effects in people taking Truvada for preexposure prophylaxis (PrEP) to help prevent HIV include:

Examples of mild side effects that have been reported with Truvada include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking Truvada unless your doctor recommends it.

Truvada may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Truvada, visit MedWatch.

Serious side effects have been reported with Truvada. These include:

If you develop serious side effects while taking Truvada, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

* Truvada has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.
† To learn more about this side effect, see the “Side effects explained” section below.
‡ Lactic acidosis wasn’t reported during studies of Truvada. But it has been reported with both tenofovir disoproxil fumarate and emtricitabine, the active ingredients in Truvada. (An active ingredient is what makes a drug work.) For more information, see the “Side effects explained” section below.
** An allergic reaction is possible after taking Truvada. This side effect wasn’t reported in studies of Truvada. But it was reported since the drug came on the market. To learn more about this side effect, see the “Side effects explained” section below.

Get answers to some frequently asked questions about Truvada’s side effects.

When Truvada is taken for PrEP, are certain side effects more common?

Yes, some mild side effects may be more common when Truvada is taken as preexposure prophylaxis (PrEP) to help prevent HIV.

In studies, the more common side effects reported with Truvada used for PrEP were:

If you’re taking Truvada as PrEP and have concerns about its side effects, talk with your doctor or pharmacist.

How long do Truvada side effects last?

How long Truvada’s side effects last can vary, depending on the side effect and other factors. These include how your body responds to Truvada, your overall health, other conditions you may have, and other drugs you take.

Most of Truvada’s mild side effects tend to improve in a few days or weeks, as your body gets used to the drug. But if you have certain serious side effects, such as liver or kidney problems, these may last a long time or even be permanent.

If you have any side effects that are ongoing or bother you, talk with your doctor or pharmacist. They can recommend ways to help manage your symptoms. But do not stop taking Truvada unless your doctor recommends it.

Does Truvada cause any long-term side effects?

It might, but this is rare. Most of Truvada’s side effects are mild and short-lived. But some serious side effects may last a long time. These include:

  • depression
  • liver problems
  • kidney problems
  • weakened bones

In some cases, liver or kidney problems could even be permanent.

Taking Truvada for a long time may increase your risk of developing kidney problems or weakened bones.

Truvada’s effect on your long-term bone health and risk of fractures isn’t known. But your doctor may recommend taking a calcium and vitamin D supplement to help strengthen your bones. This may reduce your risk of long-term bone problems.

Tenofovir disoproxil fumarate, one of the active ingredients of Truvada, has been reported to cause kidney injury and acute (sudden) kidney failure. Before starting Truvada and during Truvada treatment, your doctor will monitor your kidney function to check for kidney problems.

If you’re concerned about the risk of long-term side effects with Truvada, talk with your doctor.

How do the side effects of Truvada and Tivicay compare with those of Truvada and Isentress?

If you take Truvada to treat HIV, you’ll always take it with at least one other HIV drug. Examples of these include Tivicay (dolutegravir) and Isentress (raltegravir).

Tivicay and Isentress belong to the same group of drugs, so they have some similar side effects. For example, both drugs can cause trouble sleeping, fatigue (low energy), and headache. Truvada can also cause these side effects.

But Tivicay and Isentress also have some different side effects. For example, Tivicay can sometimes cause serious liver problems, while Isentress can sometimes cause serious skin reactions.

To find out more about the possible side effects of taking Truvada with Tivicay or Isentress to treat HIV, talk with your doctor.

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

Risk of worsening hepatitis B

Truvada has a boxed warning about the risk of worsening hepatitis B, a condition caused by infection from the hepatitis B virus (HBV). A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

This side effect could occur if you have hepatitis B and you stop taking Truvada. Worsening hepatitis B could lead to liver failure.

Symptoms of worsening hepatitis B can include:

What might help

Before you start Truvada, your doctor will test you for HBV. If you test positive, it’s safe to take Truvada. But you should not stop taking this drug unless your doctor recommends it. If you stop Truvada, your doctor will likely monitor your liver function for several months to see whether your hepatitis B is getting worse. Tell them if you have new or worsening symptoms. If needed, your doctor may prescribe medication to treat hepatitis B.

If you test negative for HBV, it’s also safe to take Truvada. But your doctor may recommend getting vaccinated against HBV.

Risk of resistance to Truvada

Truvada has a boxed warning about the risk of resistance to Truvada. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

You should take Truvada only for preexposure prophylaxis (PrEP) to help prevent HIV if you test negative for HIV. If you take Truvada for PrEP and you already have HIV, the virus could develop resistance to Truvada. This can make the HIV infection harder to treat.

What might help

Your doctor will test you for HIV before you start taking Truvada for PrEP. They’ll also test you every 3 months while you continue taking it for PrEP. This is to make sure you haven’t contracted HIV without knowing.

To reduce your risk of getting HIV, it’s important to take Truvada every day. Missing doses of Truvada makes it less effective at preventing HIV. It’s also important to continue to use condoms to help prevent HIV and other sexually transmitted infections (STIs). Having another STI can make it easier to contract HIV. If you have another STI, be sure to get it treated right away.

If you develop any early symptoms of HIV while taking Truvada for PrEP, you should see your doctor right away to get tested. Early symptoms of HIV may include:

You should also see your doctor to get tested for HIV if you:

If you test positive for HIV while taking Truvada for PrEP, you’ll need to start treatment for HIV. To treat HIV, Truvada must be used with other drugs. Your doctor may prescribe other HIV drugs to take along with Truvada, or they may prescribe a different combination of HIV drugs.

Kidney problems

You may have new or worsening problems with your kidneys while taking Truvada. Kidney side effects, such as acute (sudden) kidney failure, have been reported with tenofovir disoproxil fumarate, one of the active ingredients in Truvada. (An active ingredient is what makes a drug work.)

It’s not known how often kidney problems occur with Truvada. But they weren’t seen in studies of the drug and are thought to be rare. There have been reports of this side effect in people taking Truvada since the drug came on the market. But it’s unclear how often this has happened or whether Truvada was the cause.

Your risk of kidney problems may be higher if you take Truvada with other drugs that can affect your kidneys, such as:

Symptoms of kidney problems may include:

What might help

Your doctor will likely order blood and urine tests to check your kidney function before you start taking Truvada. They’ll also order these tests from time to time while you’re taking the drug so they can monitor your kidney health.

If you have any new or worsening symptoms of kidney problems while taking Truvada, talk with your doctor. If you develop a problem with your kidneys, they may recommend you take Truvada every other day instead of every day. Or they may recommend switching from Truvada to a different HIV drug.

Liver problems

You may have problems with your liver while taking Truvada. Liver side effects, such as enlarged or fatty liver, have been reported with both tenofovir disoproxil fumarate and emtricitabine, the active ingredients in Truvada. (An active ingredient is what makes a drug work.)

It’s not known how often liver problems occur with Truvada, but they’re likely to be rare. In studies of Truvada, altered results in liver function tests occurred in rare instances, but enlarged and fatty liver weren’t reported. There have been reports of these side effects in people taking Truvada since it came on the market, but it’s unclear how often this has happened or whether Truvada was the cause.

Symptoms of liver problems may include:

What might help

Your doctor may order blood tests to check your liver function from time to time while you’re taking Truvada. You should see your doctor right away if you have any symptoms of liver problems. If you develop severe liver problems while taking Truvada, your doctor will likely recommend switching to a different HIV drug.

Lactic acidosis

You may develop a side effect called lactic acidosis while taking Truvada. This is a condition caused by a buildup of lactic acid in your blood. It’s a medical emergency that can be life threatening. Lactic acidosis has been reported with both tenofovir disoproxil fumarate and emtricitabine, the active ingredients in Truvada. (An active ingredient is what makes a drug work.)

It’s not known how often lactic acidosis occurs with Truvada, but it’s likely to be rare. Lactic acidosis wasn’t seen during studies of Truvada. There have been reports of this side effect in people taking Truvada since it came on the market. But it’s unclear how often this has happened or whether Truvada was the cause.

Symptoms of lactic acidosis may include:

What might help

If you have symptoms of lactic acidosis while taking Truvada, call your doctor right away. But if your symptoms feel life threatening, call 911 or your local emergency number.

Allergic reaction

Like most drugs, Truvada can cause an allergic reaction in some people. This side effect wasn’t reported in studies of Truvada. But it was reported since the drug came on the market.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an antihistamine you take by mouth, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Truvada, they’ll decide whether you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Truvada, they may have you switch to a different treatment.

Keeping track of side effects

During your Truvada treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Truvada affects you. They can then use this information to adjust your treatment plan if needed.

Truvada may not be safe for everyone and comes with several warnings.

Boxed warnings

Truvada has boxed warnings about the risk of worsening hepatitis B and the risk of resistance to Truvada. Boxed warnings are the most serious warnings from the Food and Drug Administration (FDA).

To learn more, see the “Side effects explained” section above.

Other warnings

Truvada may not be right for you if you have certain medical conditions. (This is known as a drug-condition interaction.) Other factors may also affect whether Truvada is a good treatment option for you. Talk with your doctor about your health history before starting Truvada. Below are several factors to consider.

Allergic reaction: If you’ve had an allergic reaction to Truvada or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other medications that might be better options.

Weak bones: Truvada may weaken your bones, which could increase your risk of breaking a bone. If you have weak bones or osteoporosis or you’ve had bone fractures, your doctor may order tests to check your bone strength before prescribing Truvada. They may recommend taking a calcium and vitamin D supplement to help strengthen your bones while you take this drug. And they may monitor your bone health.

Liver problems: If you have a liver problem, Truvada could make it worse. Your doctor may order blood tests to monitor your liver function while you take this drug.

Kidney problems: If you have a kidney problem, Truvada could build up in your body. This could increase your risk of side effects. Also, Truvada could worsen your kidney problem.

Your doctor will likely order blood and urine tests to check your kidney function before you start Truvada. If you have kidney problems, your doctor probably won’t prescribe Truvada for preexposure prophylaxis (PrEP). If your doctor prescribes Truvada to treat HIV, they may recommend taking it every other day instead of every day.

Your doctor will monitor your kidney function while you take Truvada. If it gets worse, they may recommend switching to a different HIV drug.

Alcohol and Truvada

Alcohol doesn’t affect the way Truvada works. But if you drink alcohol while taking Truvada, you may have an increased risk of certain side effects, such as:

  • nausea
  • headache
  • dizziness
  • liver or kidney problems

If you drink alcohol, talk with your doctor about how much is safe to drink with Truvada.

Pregnancy and breastfeeding while taking Truvada

While there aren’t many known specifics, below is some general information regarding taking Truvada while pregnant or breastfeeding.

Pregnancy

It’s not known for sure whether Truvada is safe to take during pregnancy. But information from the Antiretroviral Pregnancy Registry (APR) suggests that Truvada does not increase the risk of problems with fetal development (commonly known as birth defects).

Antiretrovirals are drugs used to treat or prevent HIV. The APR collects health information about pregnant people who take antiretrovirals and their babies, both before and after birth. This helps healthcare professionals understand how safe HIV drugs are for use during pregnancy.

If you’re pregnant and have HIV, it’s recommended that you take HIV medication to treat your condition. This can help protect your health and the health of your baby. These guidelines also recommend that if you’re pregnant and do not have HIV, you can take Truvada for PrEP to help prevent HIV.

If you’re pregnant or planning to become pregnant, talk with your doctor about your treatment options. If you decide to take Truvada during pregnancy, you’re encouraged to enroll in the Antiretroviral Pregnancy Registry. Discuss this with your doctor, who can enroll you in this registry.

Breastfeeding

The active drugs in Truvada may pass into breast milk. This could cause side effects in a child who’s breastfed. If you take Truvada for PrEP, talk with your doctor about the best way to feed your child.

If you take Truvada to treat HIV, you should not breastfeed your child. It is possible to pass HIV through breast milk. Talk with your doctor about healthy ways to feed your child.

Side effects aren’t common with Truvada, especially when it’s used as preexposure prophylaxis (PrEP) to help prevent HIV. Most of the drug’s side effects are mild and easily managed.

But as with most medications, some serious side effects are possible with Truvada. You can talk with your doctor about your risk of these side effects. They can help you determine whether Truvada is a good option for you. Examples of questions you might want to ask include:

  • Do I have a high risk of side effects with Truvada?
  • Do my other medications or health conditions increase my risk of side effects with Truvada?
  • Can HIV become resistant to Truvada when it’s used to treat HIV infection?
  • How do the side effects of Truvada compare with those of other drugs used for PrEP, such as Descovy or Apretude?

To learn more about Truvada, see these articles:

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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.