Symtuza (darunavir/cobicistat/emtricitabine/tenofovir alafenamide)

What is Symtuza?

Symtuza is a brand-name prescription medication used to treat HIV. It’s a four-drug combination pill that’s a complete treatment for HIV. This means you don’t need to take other HIV medications with Symtuza.

Symtuza is approved for use in adults and children who weigh at least 40 kilograms (kg), which is about 88 pounds (lb).

Your doctor may prescribe Symtuza if:

• you’ve just been diagnosed with HIV and haven’t started treatment yet, OR
• you’re changing from other HIV treatments, and you meet all the following requirements:
  • you haven’t had any changes to your HIV drugs for at least 6 months
  • your viral load (amount of HIV in your blood) is less than 50 copies per milliliter (mL)
  • the HIV in your blood isn’t known to have changes that make it less likely to respond to darunavir or tenofovir (two of the active drugs in Symtuza)

Drug details

Symtuza contains four active drugs from three different drug classes. A drug class is a group of medications that work in a similar way. Symtuza contains the following drugs:

• darunavir, which is a protease inhibitor
• cobicistat, which is a CYP3A inhibitor that boosts the effect of darunavir
• emtricitabine, which is a nucleoside reverse transcriptase inhibitor (NRTI)
• tenofovir alafenamide, which is also an NRTI

Symtuza comes as an oral tablet in one strength. Each tablet contains 10 milligrams (mg) of tenofovir alafenamide, 150 mg of cobicistat, 200 mg of emtricitabine, and 800 mg of darunavir.

FDA approval

The Food and Drug Administration (FDA) approved Symtuza for HIV in 2018. It’s currently the only combination treatment containing darunavir, cobicistat, emtricitabine, and tenofovir alafenamide approved by the FDA.

Effectiveness

For information about the effectiveness of Symtuza, see the “Symtuza uses” section below.

Symtuza generic

Symtuza is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

Symtuza use for HIV

The Food and Drug Administration (FDA) approves prescription drugs such as Symtuza to treat certain conditions.

Symtuza is FDA-approved to treat HIV-1 in adults and children who weigh at least 40 kilograms (kg), which is about 88 pounds (lb).

It’s approved for people who:

• have just been diagnosed with HIV and haven’t started treatment yet, OR
• are changing from another HIV treatment and:
  • have been on a stable antiretroviral regimen for at least 6 months (this means you haven’t had any changes to your HIV drugs for at least 6 months)
  • have a viral load (the amount of HIV in your blood) that’s less than 50 copies per milliliter (mL)
  • have HIV that doesn’t have mutations (changes) that could make it resistant (less likely to respond) to darunavir or tenofovir (two of the active drugs in Symtuza)

HIV explained

HIV stands for human immunodeficiency virus. There are two forms of this virus, HIV-1 and HIV-2. HIV-1 is the most common form. HIV is transmitted through body fluids, such as blood, semen, vaginal and rectal fluids, and breast milk.

HIV attacks white blood cells called CD4 cells. These cells usually help protect you from infections and cancers. If HIV is left untreated, your viral load can steadily increase. As a result, your CD4 count can steadily decrease. This can weaken your immune system and leave you vulnerable to serious infections and cancers. Eventually, it can lead to AIDS.

Some people may have flu-like symptoms about 2 to 4 weeks after contracting HIV. These symptoms can include fever, chills, and muscle aches. However, others may not have symptoms for months or even years. Either way, it’s still possible to transmit the virus to others if HIV is untreated.

Antiretrovirals

HIV is treated with drugs called antiretrovirals. These lower your viral load, often to undetectable levels. Undetectable means that lab tests can’t detect the virus in your blood. If your viral load is undetectable, this means you cannot transmit HIV through sex. It also means you’re much less likely to transmit it through pregnancy, breastfeeding, or sharing needles.

Taking antiretrovirals allows your CD4 count to increase. This lowers your risk of developing infections and cancers and helps you stay healthy.

Antiretroviral therapy involves taking a combination of drugs that attack the virus in different ways. This helps prevent the virus from developing changes that allow it to become resistant to treatment.

Symtuza contains four active drugs in one combination pill. It’s a complete treatment for HIV, which means you don’t need to take other HIV medications with it.

You can learn more about your condition by visiting our HIV and AIDS hub.

Effectiveness for HIV

Symtuza is an effective treatment for HIV. In clinical trials of people with newly diagnosed HIV, Symtuza effectively lowered the viral load to below 50 copies per mL. In clinical trials where people switched to Symtuza from other HIV drugs, Symtuza was effective at keeping viral load below 50 copies per mL.

To learn more about how Symtuza performed in clinical trials, see the drug’s prescribing information.

Symtuza contains a combination of active drugs recommended in guidelines for starting and switching HIV treatment.

Symtuza and children

Symtuza is FDA-approved to treat HIV in children weighing at least 40 kg (about 88 lb) who meet the requirements described above.

Symtuza side effects

Symtuza can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Symtuza. These lists do not include all possible side effects.

For more information about the possible side effects of Symtuza, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may concern or bother you.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Symtuza, you can do so through MedWatch.

Mild side effects

Below is a partial list of mild side effects of Symtuza. To learn about other mild side effects, talk with your doctor or pharmacist, or view Symtuza’s prescribing information.

Mild side effects of Symtuza can include:

• diarrhea
• nausea
• rash
• fatigue
• headache
• abdominal pain
• flatulence (gas)
• reduced appetite
• abnormal dreams
• mild allergic reaction*

Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or do not go away, talk with your doctor or pharmacist.

* For more information about allergic reaction and Symtuza, see “Allergic reaction” below.

Serious side effects

Serious side effects from Symtuza are not common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Serious side effects and their symptoms can include:

• Liver problems, such as raised liver enzymes and hepatitis (liver inflammation). Symptoms can include:
  • fatigue
  • loss of appetite
  • nausea
  • abdominal pain
  • dark urine
  • jaundice
• Kidney problems, such as kidney failure. Symptoms can include:
  • urinating less than usual
  • nausea and vomiting
  • swollen feet or ankles
  • shortness of breath
  • itchy skin
  • confusion
• Severe skin reactions, such as Stevens-Johnson syndrome or toxic epidermal necrolysis. Symptoms can include:
  • severe or widespread rash
  • skin blistering or peeling
  • sore, swollen eyes
  • mouth sores
  • fever
  • aching muscles or joints
• Lactic acidosis (high level of lactic acid in the blood). Symptoms can include:
  • fatigue or weakness
  • abnormal muscle pain
  • increased heart rate
  • fast breathing or shortness of breath
  • nausea and vomiting
  • dizziness
• Hyperglycemia (high blood sugar levels) and diabetes. Symptoms can include:
  • urinating more than usual
  • feeling unusually thirsty
  • headaches
  • blurry vision
  • weight loss
  • fatigue
• Changes in body fat. Symptoms can include:
  • increased fat in the upper back, neck, and abdomen
  • breast enlargement
  • loss of fat from the face, arms, and legs
• Immune reconstitution syndrome (a condition that can develop if your immune system gets stronger while taking Symtuza and reacts to infections that may be hidden in your body). Symptoms can vary depending on the type of infection that your immune system reacts to. Talk with your doctor if you develop any new symptoms after starting Symtuza.
• Increased cholesterol levels.
• Risk of worsening hepatitis B.*
• Severe allergic reaction.†

* Symtuza has a boxed warning for this side effect. This is a serious warning from the FDA. To learn more, see the “Symtuza precautions” section below.
† For details about allergic reaction and Symtuza, see “Allergic reaction” below.

ALLERGIC REACTION

As with most drugs, some people can have an allergic reaction after taking Symtuza. This was a rare side effect reported in clinical trials of this drug.

Symptoms of a mild allergic reaction can include:

• skin rash
• itchiness
• flushing

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
• swelling of your tongue, mouth, or throat
• trouble breathing

Call your doctor right away if you have an allergic reaction to Symtuza, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

Alternatives to Symtuza

Other drugs are available that can treat your condition. Some may be a better fit for you than others. If you’re interested in finding an alternative to Symtuza, talk with your doctor. They can tell you about other medications that may work well for you.

Alternatives for HIV

Examples of other drugs that may be used to treat HIV include:

• Combination drugs such as:
  • abacavir and lamivudine (Epzicom)
  • abacavir, lamivudine, and dolutegravir (Triumeq)
  • abacavir, lamivudine, and zidovudine (Trizivir)
  • atazanavir and cobicistat (Evotaz)
  • bictegravir sodium, emtricitabine, and tenofovir alafenamide (Biktarvy)
  • darunavir and cobicistat (Prezcobix)
  • dolutegravir and lamivudine (Dovato)
  • dolutegravir and rilpivirine (Juluca)
  • doravirine, lamivudine, and tenofovir disoproxil fumarate (Delstrigo)
  • efavirenz, lamivudine, and tenofovir disoproxil fumarate (Symfi)
  • efavirenz, emtricitabine, and tenofovir disoproxil fumarate (Atripla)
  • elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide (Genvoya)
  • elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate (Stribild)
  • emtricitabine, rilpivirine, and tenofovir alafenamide (Odefsey)
  • emtricitabine, rilpivirine, and tenofovir disoproxil fumarate (Complera)
  • emtricitabine and tenofovir alafenamide (Descovy)
  • emtricitabine and tenofovir disoproxil fumarate (Truvada)
  • lamivudine and tenofovir disoproxil fumarate (Cimduo)
  • lamivudine and zidovudine (Combivir)
  • lopinavir and ritonavir (Kaletra)
• Fusion inhibitors such as:
  • enfuvirtide (Fuzeon)
  • maraviroc (Selzentry)
• Integrase strand transfer inhibitors (INSTIs) such as:
  • dolutegravir (Tivicay)
  • raltegravir (Isentress)
• Nucleoside reverse transcriptase inhibitors (NRTIs) such as:
  • abacavir (Ziagen)
  • emtricitabine (Emtriva)
  • lamivudine (Epivir)
  • tenofovir disoproxil fumarate (Viread)
  • zidovudine (Retrovir)
• Non-nucleoside reverse transcriptase inhibitors (NNRTIs) such as:
  • doravirine (Pifeltro)
  • efavirenz
  • etravirine (Intelence)
  • nevirapine (Viramune)
  • rilpivirine (Edurant)
• Protease inhibitors such as:
  • atazanavir (Reyataz)
  • darunavir (Prezista)
  • fosamprenavir (Levixa)
  • ritonavir (Norvir)
  • tipranavir (Aptivus)

Symtuza dosage

The following information describes dosages that are typically used or recommended. However, be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Symtuza comes as an oral tablet in one strength. Each tablet contains:

• 10 milligrams (mg) of tenofovir alafenamide
• 150 mg of cobicistat
• 200 mg of emtricitabine
• 800 mg of darunavir

Dosage for HIV treatment

The usual dosage of Symtuza for adults weighing at least 40 kilograms (kg), which is about 88 pounds (lb), is one tablet daily.

Children’s dosage

The usual dosage of Symtuza for children weighing at least 40 kg (about 88 lb) is one tablet daily.

What if I miss a dose?

If you miss a dose of Symtuza, take it as soon as possible. However, it’s important that you don’t miss doses of Symtuza.

Missing a dose can allow the amount of medication in your body to fall below the level where it can work effectively against the virus. This can allow the virus to develop changes that make it resistant to the drugs in Symtuza. As a result, Symtuza may not work as well to manage your HIV. Your HIV may also become harder to treat with other drugs.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or putting a note where you’ll see it, such as on your bathroom mirror or bedside table. You could also download a reminder app on your phone.

Will I need to use this drug long term?

Symtuza is meant to be a long-term treatment. If you and your doctor determine that Symtuza is safe and effective for you, you’ll likely take it long term.

Common questions about Symtuza

Here are answers to some frequently asked questions about Symtuza.

Does Symtuza cause long-term side effects?

It’s possible Symtuza can cause some long-term side effects, but these are not common. Most of Symtuza’s side effects are mild and get better quickly as your body gets used to the medication.

Long-term side effects that are possible with Symtuza include:

• diabetes
• changes in body fat
• raised cholesterol levels
• kidney or liver problems

If you have symptoms of long-term side effects with Symtuza, see your doctor. They can establish how to best manage these side effects, which might involve switching to a treatment other than Symtuza. To learn more about possible symptoms of these serious side effects, see the “Symtuza side effects” section above.

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

Is weight gain a side effect of Symtuza?

No, it’s not known to be. People who took Symtuza in clinical trials did not report weight gain. However, Symtuza can sometimes cause changes in your body fat that may make it appear that you’ve gained weight.

For example, Symtuza can sometimes cause an increase in fat around your belly, upper back, or neck. However, this is usually accompanied by loss of fat from other parts of your body, such as your arms, legs, or face.

If you gain weight or notice any changes in your body fat while taking Symtuza, talk with your doctor. They can determine the possible cause and suggest how to manage any weight changes.

Will Symtuza cure HIV?

No, Symtuza won’t cure HIV. Currently, there is no cure for HIV. However, taking antiretroviral drugs such as Symtuza can help lower your viral load to undetectable levels. Your viral load is the amount of HIV in your blood. Undetectable means that blood tests cannot detect the virus in your body.

When your viral load becomes undetectable, it is not possible to transmit HIV to another person through sex. Your risk of HIV-related health problems is also greatly reduced. However, this does not mean that your HIV is cured. If you stop treatment, the HIV in your body can start increasing in numbers again, and your viral load can quickly increase. You’ll need to take antiretroviral drugs such as Symtuza for the rest of your life to manage the virus.

If you have questions about Symtuza for HIV treatment, talk with your doctor.

Symtuza interactions

Symtuza can interact with several other medications. It can also interact with certain supplements as well as certain foods.

Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe. Drug-condition interactions can also cause certain effects. For information about these interactions, see the “Symtuza precautions” section below.

Symtuza and other medications

Below is a list of medications that can interact with Symtuza. This list does not contain all drugs that may interact with Symtuza.

Before taking Symtuza, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also, tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

There are certain drugs that you should not take with Symtuza because they can cause serious side effects or make Symtuza less effective at treating HIV. Drugs that you should not take with Symtuza include:

• alfuzosin (Uroxatral)
• carbamazepine (Carbatrol, Tegretol, others)
• colchicine (Colcrys, Mitigare, others) in people with liver or kidney problems
• dihydroergotamine (Migranal, Trudhesa)
• dronedarone (Multaq)
• elbasvir/grazoprevir (Zepatier)
• ergotamine (Ergomar)
• ivabradine (Corlanor)
• lomitapide (Juxtapid)
• lovastatin (Altoprev)
• lurasidone (Latuda)
• methylergonovine (Methergine)
• midazolam (Nayzilam, Seizalam)
• naloxegol (Movantik)
• phenobarbital (Sezaby)
• phenytoin (Dilantin, Phenytek)
• pimozide
• ranolazine (Aspruzyo sprinkle)
• rifampin (Rifadin, Rimactane)
• sildenafil (Revatio), when used for pulmonary arterial hypertension
• simvastatin (FloLipid, Zocor)
• triazolam (Halcion)

Other drugs that can interact with Symtuza include:

• Antiarrhythmics. Antiarrhythmics are used to treat an irregular heartbeat. Taking Symtuza with antiarrhythmics could raise your risk of side effects. Examples of these drugs include:
  • amiodarone (Nexterone, Pacerone)
  • digoxin (Lanoxin)
  • disopyramide (Norpace)
  • propafenone (Rhythmol SR)
  • quinidine
• Anticoagulants. Anticoagulants (blood thinners) are used to treat and prevent blood clots. Taking Symtuza with an anticoagulant can raise the risk of anticoagulant side effects. Examples of these drugs include:
  • apixaban (Eliquis)
  • dabigatran (Pradaxa)
  • edoxaban (Savaysa)
  • warfarin (Jantoven)
• Certain antiplatelets. Antiplatelet drugs are used to help prevent blood clots. Taking Symtuza with certain antiplatelet drugs could raise the risk of antiplatelet side effects or make the antiplatelet less effective. Examples of these drugs include clopidogrel (Plavix) and ticagrelor (Brilinta).
• Certain antibiotics. Antibiotics can be used to help treat bacterial infections. Taking Symtuza with certain antibiotics could raise your risk of side effects with both drugs. Examples of these drugs include:
  • gentamicin
  • clarithromycin
  • erythromycin (Eryc, Ery-tab, others)
• Certain antifungals. Antifungals are used to help treat fungal infections. Taking Symtuza with certain antifungal drugs could raise your risk of side effects with both drugs. Examples of these drugs include:
  • itraconazole (Sporanox, Tolsura)
  • ketoconazole
  • voriconazole (Vfend)
• Certain antivirals. Antivirals are used to help treat viral infections such as herpes. Taking Symtuza with certain antivirals could raise your risk of side effects with both drugs. Examples of these drugs include:
  • acyclovir (Zovirax, Sitavig)
  • cidofovir
  • valganciclovir (Valcyte)
• Certain anticonvulsants. Taking Symtuza with certain anticonvulsants could make Symtuza less effective. Examples of these drugs include eslicarbazepine (Aptiom) and oxcarbazepine (Trileptal, Oxtellar XR).
• Certain antidepressants. Taking Symtuza with certain antidepressants could raise your risk of side effects with the antidepressant. Examples of these drugs include:
  • amitriptyline
  • imipramine (Tofranil)
  • paroxetine (Brisdelle, Paxil, others)
  • trazodone
• Certain antipsychotics. Taking Symtuza with certain antipsychotics could raise your risk of side effects with the antipsychotic. Examples of these drugs include:
  • quetiapine (Seroquel)
  • risperidone (Risperdal)
  • thioridazine
• Certain beta-blockers. Beta-blockers are used to treat conditions such as high blood pressure, angina, and heart failure. Taking Symtuza with certain beta-blockers could raise your risk of side effects with the beta-blocker. Examples of these drugs include:
  • carvedilol (Coreg)
  • metoprolol (Lopressor, Toprol XL, others)
  • timolol
• Certain calcium-channel blockers. Calcium-channel blockers are used to treat high blood pressure and angina. Taking Symtuza with certain calcium-channel blockers could raise your risk of side effects with the calcium-channel blocker. Examples of these drugs include:
  • amlodipine (Katerzia, Norvasc, others)
  • diltiazem (Cardizem CD, Cartia XT, others)
  • felodipine
  • nifedipine (Procardia)
  • verapamil (Verelan, Calan SR, others)
• Certain cancer drugs. Taking Symtuza with certain cancer drugs could raise your risk of side effects with the cancer drug. Examples of these drugs include:
  • nilotinib (Tasigna)
  • dasatinib (Sprycel)
  • vincristine
  • vinblastine
• Corticosteroids. Corticosteroids are used to reduce inflammation (swelling). Taking Symtuza with certain corticosteroids could make Symtuza less effective. Taking Symtuza with certain other corticosteroids could raise your risk of side effects with the corticosteroid. Examples of these drugs include:
  • betamethasone (Diprolene, Sernivo, Luxiq, others)
  • budesonide (Uceris, Entocort EC, Pulmicort Flexhaler, others)
  • dexamethasone (Hemady, Maxidex, others)
  • fluticasone (Arnuity Ellipta, Flovent HFA, Xhance, others)
  • methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol)
• Hormonal contraceptives (birth control). Taking Symtuza with hormonal forms of birth control, such as the pill or patch, could make the birth control less effective. Your doctor may recommend using a backup or nonhormonal form of birth control. Examples of hormonal birth control include:
  • drospirenone/ethinyl estradiol (Yaz, Loryna, others)
  • levonorgestrel/ethinyl estradiol (Twirla, Daysee, others)
  • norethindrone/ethinyl estradiol (Aranelle, Dasetta, others)
• Certain immunosuppressants. Immunosuppressants are used to help prevent rejection of organ transplants. Taking Symtuza with certain immunosuppressants could raise your risk of side effects with the immunosuppressant. Examples of these drugs include:
  • cyclosporine (Neoral, Sandimmune, others)
  • everolimus (Afinitor, Zortress)
  • tacrolimus (Astagraf XL, Prograf, others)
• Non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs are used to reduce pain and inflammation (swelling). Taking Symtuza with NSAIDs could raise your risk of side effects with both drugs. Examples of NSAIDs include ibuprofen (Advil, Motrin) and naproxen (Naprosyn, Aleve, others).
• Certain opioids. Opioids are strong pain relievers. Some are also used to treat opioid use disorder. Taking Symtuza with certain opioids could raise your risk for opioid side effects. Examples of these drugs include:
  • buprenorphine (BuTrans, Subutex)
  • fentanyl (Fentora, Actiq, others)
  • methadone (Methadose)
  • oxycodone (Oxaydo, Oxycontin, others)
  • tramadol (Conzip, Qdolo)
• Phosphodiesterase (PDE)-5 inhibitors. PDE-5 inhibitors are used to treat erectile dysfunction. Taking Symtuza with one of these drugs could raise your risk of side effects with the PDE-5 inhibitor. Examples of these drugs include:
  • avanafil (Stendra)
  • sildenafil (Viagra)
  • tadalafil (Cialis)
  • vardenafil
• Certain sedatives and hypnotics. Sedatives and hypnotics are used to treat anxiety or help with sleep problems. Taking Symtuza with certain sedatives and hypnotics could raise your risk of side effects with the sedative or hypnotic. Examples of these drugs include:
  • buspirone
  • diazepam (Valium)
  • zolpidem (Ambien, Edluar)
• Statins. Statins are used to treat high cholesterol. Taking Symtuza with a statin could raise your risk of side effects with the statin. Examples of these drugs include:
  • atorvastatin (Atorvaliq, Lipitor)
  • fluvastatin (Lescol XL)
  • pravastatin
• Certain urinary antispasmodics. Urinary antispasmodics are used to treat overactive bladder and urinary incontinence. Taking Symtuza with certain urinary antispasmodics could raise your risk of side effects with the antispasmodic. Examples of these drugs include fesoterodine (Toviaz) and solifenacin (Vesicare).
• Bosentan (Tracleer). Bosentan (Tracleer) is used to treat pulmonary arterial hypertension (high blood pressure in the blood vessels that supply blood to the lungs). Taking Symtuza with bosentan could raise your risk of side effects with bosentan.
• Glecaprevir/pibrentasvir (Mavyret). Doctors will likely not prescribe Symtuza with glecaprevir/pibrentasvir (Mavyret), which is used to treat hepatitis C. Taking Symtuza with glecaprevir/pibrentasvir may raise your risk of side effects with glecaprevir/pibrentasvir.
• Salmeterol (Serevent). Salmeterol (Serevent) is used to treat asthma and chronic obstructive pulmonary disease (COPD). Taking Symtuza with salmeterol could raise your risk of side effects with salmeterol.

Symtuza and herbs and supplements

You should not take the herb St. John’s wort with Symtuza. It could make Symtuza less effective.

There aren’t any other herbs or supplements that have been specifically reported to interact with Symtuza. However, you should still check with your doctor before taking any herbs or supplements with Symtuza.

Symtuza and foods

There aren’t any foods that have been specifically reported to interact with Symtuza. If you have any questions about eating certain foods with Symtuza, talk with your doctor.

Symtuza and alcohol

Symtuza hasn’t been reported to interact with alcohol. However, alcohol and Symtuza can both cause nausea and headache. So, if you drink alcohol with Symtuza, you may be more likely to have these side effects.

Additionally, drinking excessively can lead to liver damage. Symtuza can also have side effects that affect your liver. If you drink excessively while taking Symtuza, you may have a higher risk of developing liver problems.

If you have questions about drinking alcohol while taking Symtuza, talk with your doctor or pharmacist.

Symtuza cost

As with all medications, the cost of Symtuza can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Symtuza. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance company.

Before approving coverage for Symtuza, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Symtuza, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Symtuza, or if you need help understanding your insurance coverage, help is available.

A program called Janssen CarePath is available for Symtuza. For more information and to find out if you’re eligible for support, call 866-836-0114 or visit the program website.

To learn more about saving money on prescriptions, check out this article.

Mail-order pharmacies

Symtuza may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Symtuza, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor, pharmacist, or insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Symtuza is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

How to take Symtuza

You should take Symtuza according to the instructions your doctor gives you.

Symtuza comes as a tablet that you swallow.

When to take

You should take Symtuza once a day, at the same time each day. Taking the medication around the same time of day helps keep a steady level of the drug in your body. This helps Symtuza work effectively.

It’s important not to miss doses of Symtuza or run out of the medication.

Missing just a few doses can allow the amount of medication in your body to fall below the level where it can work effectively against the virus. This can allow the virus to develop changes that make it become resistant to the drugs in Symtuza. As a result, Symtuza may not work as well to manage your HIV. Your HIV may also become harder to treat with other drugs.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Be sure to order more Symtuza from your doctor or pharmacy before your current supply runs out.

Accessible labels and containers

If your prescription label is hard to read, talk with your doctor or pharmacist. Some pharmacies offer labels that have large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist may be able to direct you to one that does.

If you have trouble opening medication bottles, talk with your pharmacist. Symtuza must be kept in the bottle it’s supplied in. However, your pharmacist may be able to recommend tools that can make it simpler to open lids.

Taking Symtuza with food

You should always take Symtuza with food. You can take it with a meal or snack. Taking Symtuza with food helps make sure that your body absorbs enough of the drug for it to be effective. It may also help decrease any stomach upset that the medication could cause.

Can Symtuza be crushed, split, or chewed?

Symtuza is not meant to be crushed or chewed. However, if you have trouble swallowing the tablets whole, you can split them in half with a tablet cutter. If you do this, you should take both halves of the tablet right away. Don’t save one half for later.

How Symtuza works

Symtuza is used to treat HIV. It’s a combination treatment that contains four active drugs in one pill.

What happens with HIV

HIV is a virus that infects white blood cells called CD4 cells. These cells usually help protect you from infections and cancers.

HIV replicates (makes copies of itself) inside CD4 cells. The CD4 cells release new copies of the virus, and the CD4 cells die. The new copies of the virus infect more CD4 cells, and the process repeats.

Without treatment, the amount of HIV in your blood (your viral load) will continue to increase. And the number of CD4 cells in your blood (your CD4 count) will continue to fall. This weakens your immune system and can make you more vulnerable to infections and cancers. Eventually, it can lead to AIDS.

What Symtuza does

Symtuza works by stopping HIV from replicating. It contains four active drugs from three different drug classes. A class of drugs is a group of medications that work in a similar way. Symtuza contains the following drugs:

• darunavir, which is a protease inhibitor
• cobicistat, which is a CYP3A inhibitor that boosts the effect of darunavir
• emtricitabine, which is a nucleoside reverse transcriptase inhibitor (NRTI)
• tenofovir alafenamide, which is also an NRTI

The drugs in Symtuza block the action of certain enzymes that HIV uses to replicate. (An enzyme is a type of protein that helps chemical reactions occur.) Specifically, darunavir stops an enzyme called protease from working. Emtricitabine and tenofovir alafenamide stop an enzyme called reverse transcriptase from working.

Cobicistat does not affect HIV replication directly. Instead, it blocks the action of an enzyme that breaks down darunavir in your body. This enzyme is called cytochrome p450 (CYP) 3A. Blocking CYP3A boosts the effect of darunavir against HIV.

The combined effect of the active drugs in Symtuza reduces your viral load. This allows your CD4 count to increase.

How long does it take to work?

Symtuza starts working as soon as you start taking it. However, you may not notice that it’s working. Your doctor will likely monitor your viral load to check that Symtuza is working for you.

Symtuza and pregnancy

It’s unknown if Symtuza can harm a developing fetus if taken during pregnancy. However, Symtuza may not be as effective as usual during pregnancy. It’s not recommended for use during pregnancy.

In clinical trials, some people took Symtuza during the second or third trimesters (last 6 months) of pregnancy. These people had lower levels of darunavir and cobicistat (two of the active drugs in Symtuza) than people who were not pregnant.

Having low blood levels of these drugs could make Symtuza less effective against HIV. It could also allow the virus to develop changes that make it become resistant to the drugs in Symtuza. As a result, Symtuza may not work as well to control your HIV. Your HIV may also become harder to treat with other drugs.

If you’re pregnant or plan to become pregnant, your doctor will likely not prescribe Symtuza. Talk with your doctor about alternative HIV treatments that are better options for you.

If you become pregnant while taking Symtuza, talk with your doctor. They’ll likely recommend switching to a different HIV medication.

Symtuza and birth control

Symtuza isn’t recommended for use during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs while you’re using Symtuza.

For more information about taking Symtuza during pregnancy, see the “Symtuza and pregnancy” section above.

Note that Symtuza could make hormonal forms of birth control, such as the pill or patch, less effective at preventing pregnancy. Your doctor may recommend using an extra or alternative nonhormonal form of birth control, such as condoms while you’re taking Symtuza.

Symtuza and breastfeeding

It’s unknown if the drugs in Symtuza can pass into breast milk. However, HIV can pass into breast milk and can be transmitted to a child who’s breastfed. Even if Symtuza has made your viral load undetectable, it’s still possible to transmit HIV through breast milk. (An undetectable viral load means the amount of virus in your blood is so low that blood tests cannot detect it.)

The Centers for Disease Control and Prevention (CDC) recommends that people in the U.S with HIV should not breastfeed a child.

If you have HIV, talk with your doctor about the best way to feed your child.

Symtuza precautions

This drug comes with several precautions. These are considered drug-condition interactions.

FDA warning: Risk of worsening hepatitis B

This drug has a boxed warning. This is a serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous.

Your doctor will typically test you for hepatitis B before prescribing Symtuza.

If you have hepatitis B, stopping treatment with Symtuza could worsen your hepatitis B. This could lead to liver failure. It’s important not to run out of Symtuza or stop taking it without talking with your doctor first.

If your doctor recommends stopping Symtuza, they’ll typically monitor your liver function closely for several months. Sometimes, your doctor may prescribe medication to treat the hepatitis B.

Other precautions

Before taking Symtuza, talk with your doctor about your health history. Symtuza may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

• Liver problems. Symtuza may affect your liver. If you already have a liver problem, such as hepatitis (liver inflammation) or cirrhosis (liver scarring), there’s a risk Symtuza could worsen your condition. If you have a severe liver problem, you doctor will likely not prescribe Symtuza. Your doctor will order tests to check your liver function before you start Symtuza. And they’ll monitor your liver while you’re taking Symtuza.
• Kidney problems. Symtuza may affect your kidneys. If you already have a kidney problem, such as kidney failure, taking Symtuza could worsen it. If you have a severe kidney problem, your doctor will likely not prescribe Symtuza. Your doctor will check your kidney function before you start Symtuza. And they’ll monitor your kidney function during treatment.
• Allergic reaction. If you’ve had an allergic reaction to Symtuza or any of its ingredients, your doctor will likely not prescribe Symtuza. Ask your doctor what other medications may be better options for you.
• Sulfa allergy. Symtuza contains a drug that’s related to sulfonamides (sulfa drugs). If you’ve had a past allergic reaction to sulfa drugs, taking Symtuza may cause an allergic reaction. Examples of sulfa drugs include sulfamethoxazole/trimethoprim (Septra, Bactrim) and sulfasalazine (Azulfidine). If you have a sulfa allergy, talk with your doctor about whether Symtuza is right for you.
• Diabetes. Symtuza can sometimes cause increased blood sugar levels. If you have diabetes, this could make your blood sugar harder to manage. Talk with your doctor about whether Symtuza is right for you. If you take Symtuza, your doctor may recommend checking your blood sugar level more often. If needed, your doctor may adjust your dosage of diabetes medication.
• Hemophilia. If you have hemophilia, Symtuza may raise your risk of bleeding. Talk with your doctor about whether Symtuza is right for you.
• Pregnancy. Symtuza may not work as well in people who are pregnant. It’s not recommended for use during pregnancy. If you’re pregnant or plan to become pregnant, your doctor will likely not prescribe Symtuza. Ask your doctor what other medications may be better options for you. For more information, see the “Symtuza and pregnancy” section above.
• Breastfeeding. You should not breastfeed if you have HIV because you could transmit HIV to a child who is breastfed. For more information, see the “Symtuza and breastfeeding” section above.

Note: For more information about the potential negative effects of Symtuza, see the “Symtuza side effects” section above.

Symtuza overdose

Do not use more Symtuza than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Symtuza

If you think you’ve taken too much of this drug, call your doctor. You can also call America’s Poison Centers at 800-222-1222 or use its online tool. However, if your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.