Biktarvy (bictegravir sodium/emtricitabine/tenofovir alafenamide) and Truvada (emtricitabine/tenofovir disoproxil fumarate) are brand-name oral tablets. They’re both prescribed for treating HIV. Biktarvy may be used alone to treat HIV, while Truvada is prescribed together with other antiretroviral medications.
This article explains the main similarities and differences between Biktarvy and Truvada. If you’re considering taking one of these drugs, discussing this information with your doctor can help you decide whether one of these treatments may be right for you.
Note: For more comprehensive information about these two drugs, you can refer to our Biktarvy and Truvada articles.
Key differences between Biktarvy and Truvada
These are a few of the main differences between Biktarvy and Truvada:
- Conditions treated: Biktarvy and Truvada are both used to treat HIV, but Truvada is also used for HIV preexposure prophylaxis (PrEP). (See the “Uses of Biktarvy vs. Truvada” section below.)
- How they’re used. Biktarvy is a one-pill treatment for treating HIV, while Truvada is prescribed with other antiretroviral medications.
Here’s information about the generic status for Biktarvy and Truvada, as well as details on their active ingredients.
| Biktarvy | Truvada | |
| Generic available | no | no |
| Active ingredients | bictegravir sodium/emtricitabine/tenofovir alafenamide | emtricitabine/tenofovir disoproxil fumarate |
| Drug class | antiretroviral | antiretroviral |
Biktarvy and Truvada have been approved by the Food and Drug Administration (FDA) to treat the following.
- Both Biktarvy and Truvada are FDA-approved to treat:
- Truvada is also FDA-approved for:
Biktarvy or Truvada and children
Biktarvy and Truvada are both FDA-approved to treat HIV in certain children:
- Biktarvy may be prescribed for this use in children who weigh at least 14 kilograms (kg), which is about 30 pounds (lb).
- Truvada may be prescribed for this use in children who weigh at least 17 kg (about 37 lb).
Truvada may also be used for HIV PrEP in adolescents* weighing at least 35 kg (about 77 lb).
* “Adolescents” typically describes children ages 12 years and older.
Here’s a quick look at the dosage and administration of Biktarvy and Truvada for the conditions both drugs treat.
Dosage for HIV
The table below shows the dosages of Biktarvy and Truvada for treating HIV. Strength is measured in milligrams (mg).
| Biktarvy for HIV | Truvada for HIV | |
| Form | oral tablet | oral tablet |
| Strength | 50 mg bictegravir/ 200 mg emtricitabine/ 25 mg tenofovir alafenamide | 200 mg emtricitabine/ 300 mg tenofovir disoproxil fumarate |
| Dose | one tablet | one tablet |
| Frequency | once per day | once per day |
| Given by | self | self |
Children’s dosage
Biktarvy and Truvada may be prescribed to treat HIV in certain children and adolescents.
The dosages for this use are described below.
Dosage for HIV in children
For Biktarvy, children who weigh at least 25 kilograms (kg) (about 55 pounds [lb]) receive the same dose as adults. With Truvada, children who weigh at least 35 kg (about 55 lb) receive the same dose as adults. See the “Dosage for HIV” table above to view these dosages.
The table below describes Biktarvy and Truvada dosages for children and adolescents below a certain body weight.
| Biktarvy for HIV in children who weigh less than 25 kg | Truvada for HIV in children who weigh at least 17 kg but less than 35 kg | |
| Form | oral tablet | oral tablet |
| Strength(s) | 30 mg bictegravir/120 mg emtricitabine/ 15 mg tenofovir alafenamide | 167 mg emtricitabine/250 mg tenofovir disoproxil fumarate 133 mg emtricitabine/200 mg tenofovir disoproxil fumarate 100 mg emtricitabine/150 mg tenofovir disoproxil fumarate |
| Dose | one tablet | one tablet |
| Frequency | once per day | once per day |
| Given by | self | self |
Both Biktarvy and Truvada treat HIV. These drugs can cause some of the same side effects and some different ones. Some of the side effects reported in clinical trials of these drugs are mentioned below.
For more details about side effects of the two drugs, see our side effect articles about Biktarvy and Truvada. You can also refer to the Biktarvy prescribing information and Truvada prescribing information.
Mild side effects
The following table lists some of the more commonly reported mild side effects of Biktarvy and Truvada. The table may also include mild side effects that are less common but that you might have concerns about in some cases.
| Mild side effects | Biktarvy | Truvada |
| abdominal pain | ✓ | ✓ |
| diarrhea | ✓ | ✓ |
| dizziness | ✓ | ✓ |
| fatigue | ✓ | ✓ |
| headache | ✓ | ✓ |
| nausea and vomiting | ✓ | ✓ |
| skin rash | ✓ | ✓ |
| unusual dreams | ✓ | ✓ |
| mild allergic reaction* | ✓ | ✓ |
These side effects may be temporary, lasting a few days to weeks. If the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.
* An allergic reaction is possible after using Biktarvy or Truvada, but this side effect wasn’t reported in clinical trials.
Serious side effects
The following table lists the reported serious side effects of Biktarvy and Truvada.
| Serious side effects | Biktarvy | Truvada |
| bone loss | ✓ | |
| depression | ✓ | ✓ |
| immune reconstitution syndrome | ✓ | ✓ |
| lactic acidosis | ✓ | ✓ |
| liver problems, including liver damage | ✓ | ✓ |
| new or worsening kidney problems, including kidney failure | ✓ | ✓ |
| suicidal thoughts and behaviors | ✓ | |
| worsening hepatitis B after stopping treatment* | ✓ | ✓ |
| severe allergic reaction† | ✓ | ✓ |
If you have serious side effects while using Biktarvy or Truvada, call your doctor immediately. If the side effects feel life threatening or you believe you’re having a medical emergency, call 911 or your local emergency number right away.
* Biktarvy and Truvada have a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Precautions for Biktarvy and Truvada” section below.
† An allergic reaction is possible after using Biktarvy or Truvada, but this side effect wasn’t reported in clinical trials.
Suicide prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects if it’s safe to do so.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
Below are answers to some common questions about Biktarvy and Truvada.
How does Biktarvy and Truvada compare with Descovy?
Descovy has some similarities to Biktarvy and Truvada, and some differences as well.
Like Truvada, Descovy may be used for HIV preexposure prophylaxis (PrEP). Biktarvy is not approved for this use.
And Biktarvy, Truvada, and Descovy are all approved to treat HIV. But only Biktarvy is approved to treat HIV when used by itself. Truvada and Descovy must be used with other antiretroviral medications to treat HIV.
Talk with your doctor or pharmacist if you’d like to learn more about how Biktarvy and Truvada compare with similar drugs such as Descovy.
Is Biktarvy a better treatment option than Truvada or vice versa?
It depends. Whether Biktarvy or Truvada is a better treatment option for you depends on several factors, including your medical needs and health history.
For example, if you need HIV PrEP, Truvada may be a better treatment option. Truvada is FDA-approved to be used for HIV PrEP, but Biktarvy is not approved for this use.
Both Biktarvy and Truvada are approved to treat HIV. But the drugs differ in how they’re administered. If you’re looking for a single pill to take, Biktarvy is approved for use as a single medication to treat HIV. On the other hand, Truvada must be taken with other antiretroviral medications for treating HIV.
Your doctor can help determine whether Biktarvy or Truvada is a better treatment option for you.
You may wonder how Biktarvy and Truvada compare for treating HIV.
Comparison review of studies. Here’s a brief look at whether Biktarvy or Truvada was more effective for helping prevent or treat certain conditions.
Separate studies of the two drugs were compared in a larger
Treatment guidelines. Another way to check whether a drug is considered effective is to look at treatment guidelines.
When an organization includes certain drugs in treatment guidelines, this means research has shown the drug to be safe and effective. Both Truvada and Biktarvy are recommended as treatment options for people with HIV in guidelines from the U.S. Department of Health and Human Services. Whether one drug or the other is a better choice depends on your health and certain other factors, which your doctor can discuss and review with you.
How much Biktarvy or Truvada costs depends on the treatment plan your doctor prescribes, your insurance plan, and your pharmacy. You can visit Optum Perks* for price estimates of Biktarvy and Truvada.
Both Biktarvy and Truvada are brand-name drugs. Neither medication is available in a generic form.
* Optum Perks is a sister site of Medical News Today.
Biktarvy and Truvada may not be right for you if you have certain medical conditions or other factors that affect your health. The two drugs share some of the same precautions, but they also have different ones. Some of these precautions are mentioned below.
Boxed warnings
These drugs have boxed warnings. These are the most serious warnings from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.
- Risk of worsening hepatitis B. If you have hepatitis B infection and HIV, stopping treatment with Truvada or Biktarvy may cause the hepatitis B infection to suddenly worsen. If you have hepatitis B and need to stop taking Biktarvy or Truvada, your doctor will closely monitor you for at least several months after you stop treatment. They may prescribe medications to treat worsening hepatitis B infection should you experience this side effect.
- Risk of resistance to Truvada when used for preexposure prophylaxis (PrEP). Doctors will typically not prescribe Truvada for HIV PrEP to people who already have HIV. Taking Truvada alone when you already have HIV may cause viral resistance to Truvada. Viral resistance means that HIV can no longer be treated with emtricitabine and tenofovir disoproxil fumarate, the two drugs Truvada contains. Before prescribing Truvada for HIV PrEP, your doctor will order blood tests to check for HIV infection. They’ll order this test for you every 3 months while you’re using Truvada for HIV PrEP.
Precautions
In addition to boxed warnings, Biktarvy and Truvada have other warnings.
If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before using Biktarvy or Truvada.
| Precaution | Biktarvy | Truvada |
| if you’ve had an allergic reaction to either drug or any of its ingredients | ✓ | ✓ |
| if you’re pregnant or thinking about becoming pregnant | ✓ | ✓ |
| if you’re breastfeeding or thinking about breastfeeding | ✓ | ✓ |
| if you have a history of certain infections, including tuberculosis and hepatitis B | ✓ | ✓ |
| if you have depression or another mental health condition | ✓ | |
| if you have a bone condition, such as osteoporosis | ✓ | |
| if you have a kidney condition | ✓ | ✓ |
| if you have a liver condition | ✓ | ✓ |
Switching between Biktarvy and Truvada might be possible.
If you’d like to know more about switching between Biktarvy and Truvada, talk with your doctor. They can give you additional details and help determine the best course of action for your personal situation. Even if two drugs treat the same condition or are in the same drug class, your body can still respond differently.
It’s important that you do not stop, start, or switch any of your drug treatments without your doctor’s recommendation.
Some key points to remember when comparing Biktarvy and Truvada include:
- Truvada may be used for HIV preexposure prophylaxis (PrEP), but Biktarvy isn’t prescribed for this use.
- Biktarvy may be used as a one-pill treatment for HIV, while Truvada must be used with other medications for treating HIV.
If you’d like to learn more about Biktarvy or Truvada, talk with your doctor or pharmacist. They can help answer any questions you have about similarities and differences between the drugs. They can also help determine whether one drug or the other might work well for you.
Note: For more information about HIV, see our HIV and AIDS hub.
Disclaimer: Medical News Today 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.