Stribild (elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarate) is a brand-name tablet that’s prescribed for HIV. As with other drugs, Stribild can cause side effects, such as nausea and diarrhea.

Stribild belongs to a drug class called antiretrovirals. The drug isn’t available in a generic version.

Read on to learn about potential common, mild, and serious side effects of Stribild. For a general overview of the drug, including details about its uses, see this article.

Stribild can cause certain side effects, some of which are more common than others. These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

These are just a few of the more common side effects reported by people who took Stribild in clinical trials:

  • diarrhea
  • rash
  • atypical dreams
  • headache
  • nausea*

* For more information about this side effect, see “Side effect specifics” below.

Mild side effects can occur with Stribild use. This list doesn’t include all possible mild side effects of the drug. For more information, you can refer to Stribild’s prescribing information.

Mild side effects that have been reported with Stribild include:

These side effects may be temporary, lasting a few days to weeks. However, if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you develop a side effect while taking Stribild and want to tell the FDA about it, visit MedWatch.

* For more information about this side effect, see “Side effect specifics” below.

Stribild may cause serious side effects. The list below may not include all possible serious side effects of the drug. For more information, you can refer to Stribild’s prescribing information.

If you develop serious side effects while taking Stribild, 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.

Serious side effects that have been reported and their symptoms include:

  • Kidney problems, including kidney failure. Symptoms can include:
    • swelling in the legs, ankles, or feet
    • fatigue
    • shortness of breath
    • urinating less than usual
    • nausea and vomiting
  • Serious liver problems. Symptoms can include:
    • urine that’s darker than usual
    • pale stool
    • pain in the upper right side
  • Bone loss. Symptoms can include:
    • bone pain
  • Lactic acidosis.*
  • Immune reconstitution syndrome*
  • Risk of worsening hepatitis B.†
  • Severe allergic reaction.‡

* For more information about this side effect, see “Side effect specifics” below.
† Stribild has a boxed warning for this side effect. This is a serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effect specifics” section below.
‡ An allergic reaction is possible after using Stribild. However, this side effect wasn’t reported in clinical trials. To learn more, see the “Side effect specifics” section below.

Stribild may cause several side effects. Here are some frequently asked questions about the drug’s side effects and their answers.

Can Stribild cause anaphylaxis?

It’s not likely. Anaphylaxis (a severe allergic reaction) was not a reported side effect in Stribild’s clinical trials. There’ve been some cases of anaphylaxis in people taking this drug after it was made available on the market. However, it’s not known if Stribild was the cause.

If you have questions about anaphylaxis and Stribild, talk with your doctor or pharmacist.

How do the side effects of Stribild compare with the side effects of Biktarvy?

Stribild and Biktarvy belong to the same drug class. Each drug is used to treat HIV in adults and certain children. Both drugs can cause:

Biktarvy isn’t known to cause any different serious side effects. In clinical trials, Biktarvy caused a few mild side effects that weren’t reported with Stribild. These include upset stomach, bloating, and abdominal pain.

For more information about Stribild’s side effects, see the “Mild side effects of Stribild” and “Serious side effects of Stribild” sections above.

* For more information about this side effect, see “Side effect specifics” below.
† Stribild has a boxed warning for this side effect. This is a serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effect specifics” section below.

Learn more about some of the side effects that Stribild may cause. To find out how often side effects occurred in clinical trials, see the prescribing information for Stribild.

Risk of worsening hepatitis B

Stribild carries a boxed warning about the risk of worsening hepatitis B. This is the most serious warning from the FDA. A boxed warning alerts doctors and patients about drug effects that may be dangerous.

If you have HIV and hepatitis B virus (HBV) and stop taking Stribild, your hepatitis B may worsen. This can lead to serious liver problems, including liver failure. Symptoms of hepatitis B include:

  • fever
  • joint pain
  • urine that’s darker than usual
  • abdominal pain
  • nausea and vomiting
  • fatigue
  • yellowing of the whites of the eyes or change in skin tone

What you can do

Because of the risk of worsening HBV, your doctor will likely test you for HBV before starting treatment with Stribild. Tell your doctor if you’re receiving treatment for HBV or have received treatment.

Do not stop taking Stribild on your own. If your doctor recommends stopping Stribild, they’ll likely monitor your liver function for several months after you stop taking the drug.

If your hepatitis B gets worse, they may recommend starting treatment for it. Talk with your doctor if you notice any of the symptoms of hepatitis B.

Nausea

In Stribild’s clinical trials, nausea was a commonly reported side effect. Symptoms can include:

  • decreased appetite
  • sweating
  • feeling like you’re going to vomit
  • stomach ache
  • retching
  • pressure in your belly or the back of your throat

What you can do

Let your doctor know about any nausea that’s bothersome or doesn’t improve over time. They may offer tips to help manage this side effect. Your doctor may recommend:

  • eating a bland diet
  • eating smaller, more frequent meals
  • avoiding exercise after eating
  • sipping on cold beverages throughout your day

Immune reconstitution syndrome

It’s possible to have immune reconstitution syndrome as a side effect of Stribild. However, it isn’t known whether this side effect was reported in clinical trials or how common it may be in people taking the drug.

With immune reconstitution syndrome, the immune system starts working better after beginning treatment with Stribild. This means that your body may start clearing infections you had that you didn’t know about. These infections are also known as AIDS defining illnesses and can include:

What you can do

Tell your doctor right away if you notice any symptoms of infection, such as fever, fatigue, or swollen lymph nodes. But if your symptoms seem severe or life threatening, call 911 or your local emergency number right away.

Your doctor can give you tests to check for infection. They’ll recommend whether treatments are needed for your infection or to ease your symptoms. Your doctor will also advise you on whether it’s safe to continue taking Stribild.

Problems sleeping

In Stribild’s clinical trials, some people reported having problems sleeping. Symptoms can include:

  • difficulty falling or staying asleep
  • waking up too early
  • excessive tiredness during the day
  • feeling irritable, anxious, or depressed

What you can do

Tell your doctor if you have problems sleeping that don’t improve over time or get worse. You can also try:

  • daytime exercise
  • keeping your room cool and dark
  • drinking the recommended amount of water
  • cognitive behavior therapy or relaxation techniques

Lactic acidosis

With lactic acidosis, there’s a buildup of lactic acid in the body. There’ve been some cases of this side effect along with swelling of the liver in people taking this drug after it was made available on the market. However, it’s not known how common this side effect may be or whether Stribild was the cause. In some cases, people have died from lactic acidosis.

Symptoms of lactic acidosis can include:

  • pain in the abdomen or stomach
  • diarrhea
  • fast or shallow breathing
  • fast or irregular heart rate
  • muscle cramps
  • decreased appetite
  • confusion
  • weakness or fatigue
  • cold or blue hands and feet

What you can do

Call 911 or go to the emergency room right away if you experience symptoms of lactic acidosis while taking Stribild. This condition can be life threatening.

Your doctor will likely order blood tests to check for lactic acidosis during your treatment with Stribild. If develop lactic acidosis, they may recommend that you stop taking Stribild.

Allergic reaction

As with most drugs, Stribild can cause an allergic reaction in some people. However, this side effect wasn’t reported in clinical trials. It’s been reported since the drug has been on the market.

Symptoms can be mild or serious and can include:

  • skin rash
  • itching
  • flushing
  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What you can do

For mild symptoms of an allergic reaction, call your doctor right away. They may recommend ways to ease your symptoms and determine whether you should keep taking Stribild. However, if your symptoms are serious and you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Stribild carries a boxed warning.

Boxed warning: Risk of worsening hepatitis B

This drug has a boxed warning for risk of worsening hepatitis B. This is a serious warning from the Food and Drug Administration (FDA). For details, see the “Side effect specifics” section above.

Other precautions

Be sure to talk with your doctor about your health history before you take Stribild. This drug may not be the right treatment for you if you have certain medical conditions or other factors that affect your health. These are considered drug-condition or drug-factor interactions. The conditions and factors to consider include:

Mental health conditions, including depression. If you have a mental health condition, such as depression, you may have a higher risk of suicidal thoughts or actions if you take Stribild. Let your doctor know whether you have a mental health condition or received treatment for one. If you have thoughts about suicide or hurting yourself while taking Stribild, call 911 or go to the nearest emergency room.

Kidney problems. If you have kidney failure or other kidney problems, Stribild could worsen these conditions. Let your doctor know if you have any kidney problems before taking Stribild. They may recommend a different medication to treat your HIV.

Liver problems. If you have liver problems, taking Stribild could make them worse. These problems can include fatty liver disease and enlarged liver. Let your doctor know if you have any liver problems. They’ll likely prescribe a different medication to treat your HIV.

Bone problems. Let your doctor know if you have any bone loss, fractures, or osteoporosis before taking Stribild. Taking this drug may worsen any bone problems you may have. Your doctor may recommend a different medication for your HIV or may recommend ways to manage this side effect.

Allergic reaction. If you’ve had an allergic reaction to Stribild or any of its ingredients, your doctor will likely not prescribe Stribild. Ask your doctor what other medications may be better options for you.

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 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.

Click here for more links and local resources.

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Alcohol with Stribild

There aren’t any known interactions between Stribild and alcohol. However, both Stribild and alcohol can cause liver problems, including fatty liver disease and enlarged liver. Talk with your doctor if you have questions about drinking alcohol while taking Stribild.

Pregnancy and breastfeeding while taking Stribild

It’s not recommended to take Stribild during pregnancy. That’s because this drug may not work as well to treat HIV during the second and third trimesters. In animal studies, Stribild didn’t cause fetal harm. However, animal studies don’t always predict what may happen in humans.

If you’re pregnant and taking Stribild, your doctor can enroll you in a registry to track pregnancy outcomes. For more information about the registry, visit the registry website or call 800-258­ 4263.

It’s unknown if Stribild causes harm to a breastfed. However, breastfeeding isn’t recommended if you’re HIV positive. That’s because you could pass the virus to your child through nursing. Talk with your doctor about safe ways to feed your child.

Like other medications, Stribild can cause side effects. Some are mild and may improve over time. Others are serious and require medical care. If you’d like to learn more about Stribild, talk with your doctor or pharmacist. They can help answer any questions you have about side effects from taking the drug.

Besides talking with your doctor, you can do some research on your own. These articles might help:

  • More information about Stribild. For details about other aspects of Stribild, refer to this article.
  • Drug comparison. To learn how Stribild compares with Genvoya, read this article.
  • A look at HIV. For details about HIV, see our HIV & 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.