Truvada (emtricitabine/tenofovir disoproxil fumarate) and Descovy (emtricitabine/tenofovir alafenamide) are both prescription brand-name medications. They’re approved by the Food and Drug Administration (FDA) to:

Truvada is also available as a generic called emtricitabine/tenofovir disoproxil fumarate. Descovy isn’t available in generic form.

Both Truvada and Descovy are made by the same manufacturer: Gilead Sciences.

There are some similarities and differences between the two medications, including their uses, side effects, and effectiveness. These will be discussed in this article.

Note: For more information about these two drugs, visit our Truvada and Descovy articles.

Truvada contains two active ingredients: emtricitabine and tenofovir disoproxil fumarate. Descovy also contains two active ingredients: emtricitabine and tenofovir alafenamide.

Both Truvada and Descovy contain two active ingredients in one tablet. They have one common active ingredient: emtricitabine. The second active ingredient, tenofovir, is a little different in each drug. This affects how the body absorbs the medications.

Truvada and Descovy both belong to a class of medications known as nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs are antiviral medications used to treat HIV. They block the action of key enzymes to stop HIV from multiplying and growing.

Truvada and Descovy are both approved by the Food and Drug Administration (FDA) to:

HIV treatment

For the treatment of HIV, both Truvada and Descovy are approved for use in adults and children of a certain weight.

For Truvada, you must weigh at least 37 pounds (lb) (17 kilograms [kg]). For Descovy, you must weigh at least 55 lb (25 kg). Truvada and Descovy are both approved to treat HIV in males and females.*

PrEP use

Truvada and Descovy are approved for PrEP use in adults and adolescents who weigh at least 77 lb (35 kg). If you’re using Truvada or Descovy for PrEP, you must not have HIV before and while you take the medication.

Truvada is approved for PrEP use in males and females. Descovy isn’t approved for PrEP use in females at risk for HIV through vaginal sex. The drug hasn’t been tested in this group of people in clinical trials.

* Use of the terms “male” and “female” within this article refers to a person’s sex assigned at birth.

How much Truvada and Descovy cost depends on the treatment plan your doctor prescribes, your insurance plan, and your pharmacy. You can find price estimates for the medications on GoodRx.com.

Truvada is a brand-name drug that’s also available as a generic called emtricitabine/tenofovir disoproxil fumarate. Descovy is also a brand-name drug, but it’s not available in generic form. Brand-name medications are often more expensive than generics. Talk with your doctor or pharmacist to learn about the generic form of Truvada.

Both Truvada and Descovy are effective for the treatment and prevention of HIV. For HIV treatment, they’re used in combination with other approved antiviral medications.

If you experience bothersome side effects or have other concerns while taking Truvada or Descovy, your doctor may switch you from one medication to the other. There aren’t any special dosing instructions regarding this switch.

But keep in mind that Truvada and Descovy aren’t interchangeable, so you shouldn’t mix doses. For example, you shouldn’t take one dose of Truvada, then one of Descovy, then one dose of Truvada.

It’s also important to know that both Truvada and Descovy are formulated to be effective for their approved uses. One drug isn’t considered better or more effective than the other. For more information, see the “Effectiveness of Truvada vs. Descovy” section below.

Truvada is available as a generic (emtricitabine/tenofovir disoproxil fumarate). This form costs less than Descovy, which is a brand-name drug. Generics are often less expensive than brand-name medications. Talk with your doctor about the best option for you.

Note: You shouldn’t switch medications on your own without first talking with your doctor.

Truvada and Descovy both come as oral tablets that you swallow. Truvada tablets are larger than Descovy tablets. Both Truvada and Descovy contain two drugs per single pill.

Truvada and Descovy have one common active ingredient: emtricitabine. Both drugs also contain the active ingredient tenofovir, but in different chemical forms. Truvada contains tenofovir disoproxil fumarate, while Descovy contains tenofovir alafenamide.

The strengths of Truvada are:

  • 100 milligrams (mg) emtricitabine/150 mg tenofovir disoproxil fumarate
  • 133 mg emtricitabine/200 mg tenofovir disoproxil fumarate
  • 167 mg emtricitabine/250 mg tenofovir disoproxil fumarate
  • 200 mg emtricitabine/300 mg tenofovir disoproxil fumarate

Descovy is available in one strength: 200 mg emtricitabine/25 mg tenofovir alafenamide.

Both Truvada and Descovy are typically taken once daily. The dosage of either drug that your doctor prescribes for you will depend on your:

  • age
  • health conditions, such as kidney disease
  • weight

If you have kidney disease, liver disease, or another health condition that might increase your risk for side effects, your doctor may adjust your dosage.

Truvada and Descovy have similar ingredients, so these drugs can cause some of the same side effects. But because they’re not exactly alike, there are some different side effects as well. Some of these side effects are mentioned below. For more information about the side effects of these two drugs, see Truvada’s medication guide and Descovy’s medication guide.

Mild side effects

The following lists address a few common mild side effects of Truvada and Descovy, as well as some that both drugs share.

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

Serious side effects

The following lists address some serious side effects of Truvada and Descovy, as well as some that both drugs share.

If you have serious side effects while using Truvada or Descovy, 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.

Note: For more information about mild and serious side effects, see the side effects sections in our Truvada and Descovy articles.

* There were no reported allergic reactions in the clinical trials of Truvada or Descovy. But allergic reaction is a possibility with any medication. To learn about the symptoms, see this article.
† Truvada and Descovy have a boxed warning for the worsening of hepatitis B infection. A boxed warning is a more serious warning from the Food and Drug Administration (FDA). For details, see the “Warnings of Truvada and Descovy” section below.

A review of studies that compared Truvada with Descovy found that both drugs are effective in treating and preventing HIV. One study found that tenofovir alafenamide, an active ingredient in Descovy, caused fewer bone- and kidney-related problems than tenofovir disoproxil fumarate, an active ingredient in Truvada.

According to HIV treatment guidelines, Truvada and Descovy are both considered first-choice options when beginning HIV treatment when used with another antiviral drug. Examples of other antiviral drugs include raltegravir (Isentress) and dolutegravir (Tivicay).

The Centers for Disease Control and Prevention (CDC) lists both Truvada and Descovy as pre-exposure prophylaxis (PrEP) treatments.

If your doctor prescribes either Truvada or Descovy, you should take the medication daily and exactly as recommended. These drugs won’t be effective if you don’t take them every day.

Ask your doctor about the best treatment plan for you based on your medical history.

Truvada and Descovy may not be right for you if you have certain medical conditions or other factors that affect your health. Here, these are referred to as warnings. The two drugs share some of the same warnings, but they also have different ones. Some of these warnings are mentioned below. Before you start using Truvada or Descovy, be sure to talk with your doctor to see if these warnings apply to you.

Boxed warnings for both Truvada and Descovy

Truvada and Descovy have boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). The warning alerts doctors and patients about drug effects that may be dangerous.

Your doctor will do blood tests to monitor you before you start Truvada or Descovy and while you’re taking it.

  • Worsening of hepatitis B infection. If you have a hepatitis B infection and stop taking Truvada or Descovy, the infection could worsen. To help prevent this, you’ll typically have blood tests before, while, and after you use Truvada or Descovy. This allows your doctor to monitor your liver function. If necessary, they can treat the infection.
  • Resistance to treatment. To use either Truvada or Descovy for pre-exposure prophylaxis (PrEP), you must not have HIV before and while you take the medication. Your doctor will test you before you start taking Truvada or Descovy and at least every 3 months during use. If you do have HIV, you may develop viral resistance, which means that the drug may not work to prevent HIV.

Other warnings

In addition to boxed warnings, Truvada and Descovy have other warnings.

If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before using Truvada or Descovy.

Note: For more information about these two drugs, visit our Truvada and Descovy articles.

Truvada and Descovy are both approved to treat HIV and be used as pre-exposure prophylaxis (PrEP) to help prevent HIV in people at high risk for it.

Some of the key points to remember when comparing these drugs include:

  • The strengths, the tablet sizes, and certain side effects of Truvada and Descovy differ.
  • Descovy causes fewer kidney- and bone-related problems than Truvada. If you have kidney problems or bone problems, such as osteoporosis, your doctor can advise you on the risks and benefits of the two drugs.
  • Truvada is available as a generic, which is less expensive than the brand-name versions of both Truvada and Descovy.

If you’d like to learn more about Truvada or Descovy, talk with your doctor or pharmacist. They can help answer any questions you have about the side effects of each and which medication is right for you.

For more information on HIV, see our list of HIV articles.

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 other 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.