Truvada (emtricitabine / tenofovir disoproxil) vs Biktarvy (bictegravir, emtricitabine, tenofovir alafenamide)

Truvada (emtricitabine / tenofovir disoproxil) vs Biktarvy (bictegravir, emtricitabine, tenofovir alafenamide)

Truvada, containing emtricitabine and tenofovir disoproxil, is primarily used for pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV-1 in adults and adolescents, and also as part of combination therapy for existing HIV-1 infection. Biktarvy combines bictegravir, emtricitabine, and tenofovir alafenamide into a single tablet regimen for the treatment of HIV-1 infection and is not approved for PrEP. When deciding between the two, one must consider the intended use: Truvada for prevention in HIV-negative individuals or part of a treatment regimen for those with HIV, and Biktarvy solely for the treatment of HIV-1 in infected individuals, with the added benefit of a single-tablet regimen and a newer formulation of tenofovir that may have fewer kidney and bone-related side effects.

Difference between Truvada and Biktarvy

Metric Truvada (emtricitabine / tenofovir disoproxil) Biktarvy (bictegravir, emtricitabine, tenofovir alafenamide)
Generic name Emtricitabine / Tenofovir disoproxil Bictegravir, Emtricitabine, Tenofovir alafenamide
Indications HIV-1 infection treatment and pre-exposure prophylaxis (PrEP) HIV-1 infection treatment
Mechanism of action Reverse transcriptase inhibitors Integrase inhibitor and reverse transcriptase inhibitors
Brand names Truvada Biktarvy
Administrative route Oral Oral
Side effects Diarrhea, nausea, fatigue, headache, dizziness, depression, insomnia, abnormal dreams, rash Diarrhea, nausea, headache, fatigue
Contraindications Patients with prior hypersensitivity to any component, renal impairment, concurrent or recent use of nephrotoxic agents Patients with prior hypersensitivity to any component
Drug class Nucleoside reverse transcriptase inhibitors (NRTIs) Integrase strand transfer inhibitor (INSTI) and NRTIs
Manufacturer Gilead Sciences Gilead Sciences

Efficacy

Truvada for HIV/AIDS Prevention and Treatment

Truvada, a combination of emtricitabine and tenofovir disoproxil, is an antiretroviral medication used for the treatment and prevention of HIV/AIDS. As a part of antiretroviral therapy (ART), Truvada is effective in reducing the viral load in individuals infected with HIV, thereby improving immune function and reducing the risk of HIV-related illnesses. Its efficacy in treatment is generally high when used in combination with other antiretroviral agents, as part of a complete treatment regimen. For HIV prevention, Truvada is used as pre-exposure prophylaxis (PrEP) and has shown to significantly reduce the risk of HIV infection in high-risk populations when taken consistently.

Biktarvy as a Single-Tablet Regimen for HIV/AIDS

Biktarvy combines bictegravir, emtricitabine, and tenofovir alafenamide into a single-tablet regimen for the treatment of HIV-1 infection. This medication has demonstrated high efficacy in suppressing viral loads and is considered a first-line treatment option for many patients with HIV. The inclusion of bictegravir, an integrase strand transfer inhibitor (INSTI), allows for the blocking of HIV replication by preventing the viral DNA from integrating into the host cell's genome. The efficacy of Biktarvy is supported by clinical trials that have shown it to be highly effective in achieving and maintaining viral suppression in a wide range of patients, including those who are treatment-naive or who have been previously treated with other antiretroviral medications.

Comparative Efficacy in Treatment

When comparing the efficacy of Truvada and Biktarvy for the treatment of HIV/AIDS, it is important to note that Biktarvy is a more recent medication that offers a complete treatment regimen in a single pill, while Truvada is typically used in combination with other drugs. The efficacy of both medications in reducing viral load and increasing CD4+ cell counts is well-documented. However, the single-tablet regimen of Biktarvy may offer improved adherence and convenience for patients, which can be critical factors in the long-term management of HIV.

Considerations for Use

Both Truvada and Biktarvy are generally well-tolerated, but they do have different side effect profiles and considerations for use. Patients must consult with their healthcare provider to determine the most appropriate treatment option based on their individual health status, potential drug interactions, and other factors. Regular monitoring of kidney function and bone density is recommended for patients on these medications, as tenofovir, a component of both Truvada and Biktarvy, has been associated with kidney and bone-related side effects. Ultimately, the choice between Truvada and Biktarvy will depend on patient-specific factors and the evolving landscape of HIV treatment guidelines.

Regulatory Agency Approvals

Truvada
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA
  • Therapeutic Goods Administration (TGA), Australia
Biktarvy
  • European Medical Agency (EMA), European Union
  • Food and Drug Administration (FDA), USA
  • Health Canada
  • Therapeutic Goods Administration (TGA), Australia

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