Which medicines should not be taken with Biktarvy?

Official answer

by Drugs.com

Key Points

What are drug interactions?

Anytime you take a medication and mix it with other medications, or certain foods, beverages, over-the-counter (OTC) medications, or herbal supplements you are at risk of a drug interaction.

Most drug interactions are not serious; however, a few are so it’s important to understand the possible outcome before you combine medications with other drugs, alcohol, certain foods or other substances.

The more medications you take, the greater the chance for your drug interacting with another medicine or substance. Drug-drug interactions can decrease how well your medications work, may increase minor or serious unexpected side effects, or even increase the blood level and toxicity of a certain drug.

Many drug interactions, including those with Biktarvy, occur if one drug affects another drug’s absorption through the stomach or intestine, distribution throughout the body, metabolism (break down) in the liver, or excretion through the kidneys.

Drug interactions can be complicated, especially if you take several medications, so always consult with your health care professional.

Drug Interactions with Biktarvy

Drug interactions with Biktarvy can lead to several outcomes, including:

Note: There are many other possible drug interactions with Biktarvy. Have your doctor or pharmacist screen for drug interactions each time you start - or even stop - a medication. Discuss these selected drug interactions with your health care providers.

Table 1: Selected Biktarvy Drug Interactions

Certain enzymes and transporters found in your body, often in your kidney or liver, can affect your drug therapy. Your pharmacist or doctor can check to see if you take any drugs that affect these compounds that may alter your response to Biktarvy or other medicines. These include:

Because emtricitabine and tenofovir, two components of Biktarvy, are primarily excreted by your kidneys, use of Biktarvy with drugs that affect kidney function may increase concentrations of emtricitabine, tenofovir, and other drugs that go through the kidney. This may increase the risk of side effects.

Examples of drugs that may be affected include, acyclovir, cidofovir, ganciclovir, valacyclovir, valganciclovir, aminoglycosides (e.g., gentamicin), and high-dose or multiple nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen or naproxen.

The manufacturer of Biktarvy notes that NO clinically significant drug interactions have been observed when Biktarvy is combined with:

Review these, and other potential Biktarvy drug interactions in the Drugs.com Drug Interaction Checker.

What health conditions are a concern if I take Biktarvy?

Drug interactions don’t always occur with just other drugs or foods. Your existing medical conditions can impact Biktavry, too.

For example, if you have ongoing liver, kidney or bone disease you may be at greater risk of worsening these conditions when you take Biktarvy. Tell your doctor if any of these conditions affect you.

There are several disease interactions with Biktarvy which include:

Other serious side effects for Biktarvy, which might affect these conditions, include:

Kidney disease

Biktarvy is not recommended in patients with severe renal impairment (estimated CrCl <30 mL/min) or severe hepatic impairment (Child-Pugh Class C). Your doctor can determine if you have kidney impairment with lab tests.

Tell your doctor immediately if any new or worsening side effects occur. Tell your doctor right away if you get any of these symptoms, which may be a signal of lactic acidosis:

Hepatitis B (HBV) infection and liver toxicity

Biktarvy may worsen hepatitis B (HBV) infection. If you have both HIV-1 and HBV and stop taking Biktarvy, your HBV may suddenly become worse. Do not stop taking Biktarvy without first talking to your health care provider, as they will need to monitor your health.

Tell your doctor right away if you get any of these symptoms, which may be a signal of liver toxicity:

How is Biktarvy used?

Biktarvy, from Gilead, is an oral, 3-drug combination tablet used to treat immunodeficiency virus type 1 (HIV-1). It contains the integrase strand transfer inhibitor (INSTI) bictegravir, along with the nucleoside analog reverse transcriptase inhibitors (NRTIs) emtricitabine (FTC) and tenofovir alafenamide (TAF).

Biktarvy is FDA-approved as a complete regimen for the treatment of HIV-1 infection in adults and children weighing at least 14 kg (31 lbs):

Biktarvy is taken once a day, every day, with or without food. Biktarvy is taken by itself (not with other HIV-1 medicines) to treat HIV-1 infection. It is considered a complete regime in one pill. Do not miss any doses.

The most common side effects you might experience with Biktarvy include:

Bottom Line

Biktarvy contains three different medications used to treat HIV-1, so this can greatly increase your risk for a drug interaction. (see Table 1)

Not all drug interactions are serious, but some may be, so it is important to have a review of drug interactions each time you start or stop a medication. There are hundreds of possible drug interactions with Biktarvy, and not all Biktarvy drug interactions are listed in this review.

Always have your doctor or pharmacist review for possible drug interactions each time you start or stop a medication. Discuss these selected drug interactions with your health care providers. Never stop a medication without talking to your doctor first.