Is Descovy the same as Truvada?
Descovy is a trading name for an antiviral medication used to treat HIV. Furthermore, Descovy is an approved medication for PrEP (Pre-exposure prophylaxis) for HIV.
What does Descovy contain?
Descovy is consisted of 200 mg of emtricitabine ( Brand name: Emtriva) and 25 mg of tenofovir alafenamide. Descovy Is produce By Gilead sciences, As Truvada.
How should I take Descovy?
Descovy should be taken as one tablet, orally the same time every day. This medication should be taken for at least 7 days before any high-risk sexual activity takes place.
Is Dsescovy safe for PrEP?
Research shows that Descovy Is save for Use as PrEP. However, Descovy Was not researched for vaginal or front hole sex. Therefore, Descovy is approved only for MSM anal sex.
What are the side effects of Descovy?
Descovy side effects have lots in common with traditional PrEP therapy ( TDF-FTC).
Descovy contains emtricitabine and tenofovir alafenamide. Therefore, these medications can cause similar side effects. Below are examples of these side effects.
More common side effects
-
- nausea
- diarrhea
- headache
- fatigue (lack of energy)
Serious side effects
-
- loss of bone density (which can lead to osteoporosis)
- Serious:
- immune reconstitution syndrome (when your immune system strengthens and reduces HIV infection symptoms, but then responds to other infections you may have had and caused unexpected infection symptoms).
- new or worsening kidney damage.
- liver damage
- lactic acidosis (buildup of lactic acid in your body)
- severe allergic reactions
What is the difference between Descovy and Truvada?
The difference between Truvada and Descovy is in the form of tenofovir contained in each product. Descovy contains a newer form of tenofovir called tenofovir alafenamide (TAF) and Truvada contains the original form of tenofovir as tenofovir disoproxil fumarate (TDF). The new form of Tenofovir, Tenofovir alafenamide, is a prodrug. This prodrug was designed in a way so it can enter the HIV infected cells easier than Truvada.
Who should take Descovy?
Descovy is indicated to HIV negative, males that have sex with males. Furthermore, these males should display high-risk sexual activity to be eligible for PrEP (Check our Our STEP 1 in our PrEP guide to further understand what is high-risk sexual activity).
Moreover, they should check they are vaccinated/negative for hepatitis, and if they have normal kidney functions (Check our Our STEP 3 in our PrEP guide to further understand what tests are needed to be performed before taking PrEP).
Who should not take DESCOVY for PrEP?
DESCOVY for PrEP is not for people who are HIV-positive or don’t know their HIV status. Before starting and while taking Descovy for PrEP, you have to be tested for HIV to confirm that you are HIV-negative.
If you think you might have been exposed to HIV before starting or while taking DESCOVY for PrEP, let a healthcare provider know right away. Descovy by itself is not a complete treatment for HIV—in fact, taking Descovy alone to treat HIV can make HIV harder to treat now and in the future.
Do not take Descovy for PrEP if you weigh less than 77 pounds (35 KG).
What side effects does Descovy have compared to Truvada?
As Descovy and Truvada have similar chemical components they share the list of side effects almost identically. However, Descovy has lighter kidney side effects as well as osteoporosis side effects.
Is Descovy a New Medication?
Descovy was introduced as HIV-1 therapy in April 2016. However, in the beginning, it was approved as an HIV treatment for people that are already infected with HIV, in a combination with other medications.
In October 2019, Descovy was approved as a PrEP therapy for HIV by the FDA.
Can Descovy be Used as Truvada for all groups?
No, Derscovy can be used only for Male anal sex. other forms of sex including Vaginal sex or front hole sex have not been approved for use as PrEP.
Why isn’t Descovy approved For Vaginal or heterosexual sex?
Descovy is not approved for Vaginal or front hole sex as no research was performed on this group, thus Descovy is indicated only for Male to Male anal sex.
Can I use Descovy in combination with Truvada?
No, Descovy was approved only for use as a single drug in a daily regimen for anal male sex. Truvada as well is approved to be used as a single regimen and not in combination with other medications. PrEP, unlike other HIV therapies, is a single-drug therapy and was not tested for combinations of medication. We do not recommend you using PrEP in combination with Truvada as it was not tested. Furthermore, both share similar profiles of side effects, thus, using them in combination might exacerbate side effects.
Why does combination therapy work for HIV infection and not for PrEP?
HIV infection happens when the virus invades the patient’s blood cells and establishes itself within them. In this case, according to research a combination of antiviral medication is needed to suppress the progression of the disease, this combination is many times called “cocktail therapy”. Combination therapy was not tested for PrEP.
So why didn’t researchers check combination therapy?
Combination therapy includes usually 3 drugs. The HAART regimens consist of three drugs: 2 NRTIs and a PI/NNRTI/INSTI. Combination therapy is very potent in stopping the progression of HIV into AIDS, however, it has a larger profile of side effects. Another reason is that PrEP is used for prophylactic therapy, the virus didn’t establish itself yet inside the blood cells, thus, a milder form of treatment can help eliminate it.
Can I use Descovy for On-Demand 2:1:1 PrEP regimen?
No, you can’t use Descovy for the On-Demand 2:1:1 PrEP regimen as it was not researched. Although the active products in TDF/FTC (Truvada) are similar to Descovy, the On-Demand regimen only on TDF/FTC, thus, we don’t have any data regarding the effectiveness of this regimen in Descovy.
How much does Descovy cost in the US?
What is the difference in the price between Descovy and Truvada?
In the US this is quite similar, the prices range from 1200-2000$ a month depending on the insurance program, however, many insurance companies won’t approve Descovy as its a new therapy and will offer Truvada. In other countries, the Truvada generic form is available, thus the differences can be bigger.
Let’s take Canada as an example:
The price of a one-month supply of a generic formulation of Truvada is about $250, Canadian per person. In contrast, a month’s supply of Descovy is about $1000–$1200 Canadian per person.
Does Research Prove that Descovy is efficient?
In a large randomized, placebo-controlled clinical trial sponsored by Gilead Sciences, called the Discover trial, HIV-negative participants were randomly assigned to receive one of the following pills taken once daily:
- Truvada
- Descovy
Participants did not know which formulation they received for the first 96 weeks. After this time, the study was unblinded and all participants were offered Descovy.
Most participants are gay or bisexual men and about 1% are transgender women.
The study is still ongoing; however, interim results have been released.
Overall, cases of HIV infection that occurred were distributed as follows:
- Truvada – 15 cases.
- Descovy – seven cases.
Why did the participants get infected with HIV in the study?
The infected people in the Truvada group (15): 10 didn’t take the medication as they should and 1 got infected at the beginning of the study, thus maybe they had sex before reaching optimal levels of the medication. 4 infections have not been explained however, the difference between infections was not statistically significant.
The infected people in the Truvada group (7): Six infections were associated with less-than-ideal levels of tenofovir in the blood; this suggests that these participants were not taking Descovy every day. Another infection is believed to have happened at the beginning of the study, thus maybe they had sex before reaching optimal levels of the medication.
Should All PrEP Users on Truvada Switch to Descovy?
No, Truvada or TDF/FTC is a well-researched drug that is approved for PrEP for more than 8 years. On the other hand, Descovy or TAF/FTC is a newly introduced drug for PrEP and only one serious study was performed by its Producer Gilead sciences, that showed it to be, not inferior to Truvada. Gilead is pushing Descovy as its a newly patented medication, the Descovy patent will last until 2026 while Truvada’s patent will be expiring this year. Furthermore, Descovy is not approved for vaginal /front hole sex or as PrEP for drug injection addicts as it was not tested, unlike Truvada.
Is Descovy safer than Truvada for PrEP?
We don’t have enough data supporting this. Although you can find many lawsuits and complications of Truvada, this is majorly due to the long time people are using the medication for PrEP. Descovy is a new medication and we are not sure about its side effect profile. Some indication point of a lower of kidney side effects, however, these numbers need to be approved by research.
I have Renal Impairment is Descovy Better for me than Truvada?
Research shows that Descovy has a slightly better renal side effect profile, however, Descovy has a higher rate of hyperlipidemia and weight gain compared to Truvada.
To Summarize, Descovy is a newly introduced therapy for PrEP. The research performed on MSM and woman transgender has been promising. However, much more research is needed to be able to map the whole picture regarding Devoy.
Summary Comparision
| TRUVADA | DESCOVY |
|---|---|
| Effectiveness | Effectiveness |
| >99% effective | >99% effective |
| Regimen | Regimen |
| Daily use & PrEP 2-1-1 | Daily use (Although Descovy for PrEP 2-1-1 is being studied, there is inadequate clinical data to support this regimen now) |
| Shown to be effective for | Shown to be effective for |
Everyone, including:
|
Only:
(No clinical data to support use in people who may be exposed to HIV through injection drug use or vaginal sex) |
| Safety: general | Safety: general |
| Both medicines have very low rates of side effects overall. Some people experience “start-up” symptoms including diarrhea, nausea, and vomiting, which usually resolve in the first three months of PrEP use. | Both medicines have very low rates of side effects overall. Some people experience “start-up” symptoms including diarrhea, nausea, and vomiting, which usually resolve in the first three months of PrEP use. |
| Bone health | Bone health |
| People with osteoporosis should avoid | Safer to take for people with osteoporosis |
| Kidney health | Kidney health |
| People with kidney issues or a strong family history of kidney disease should avoid | Safer to take for people with kidney issues or a strong family history of kidney disease, though monitoring still recommended |
| Weight loss/gain | Weight loss/gain |
| May cause a small degree of weight loss1 | May cause a small degree of weight gain |
| Cholesterol | Cholesterol |
| May cause small decreases in HDL, LDL and total cholesterol1 | May cause small increases in LDL cholesterol and triglycerides2,3 |
| Cost | Cost |
| Same cost ($1,845/month without insurance) Generic version may be available in 2020 |
Same cost ($1,845/month without insurance) |
| Insurance | Insurance |
| Covered by insurance | Likely covered by insurance |
| Assistance programs | Assistance programs |
| Covered by assistance programs for medication and medical care costs | Covered by assistance programs for medication and medical care costs |
| Pill size | Pill size |
| Larger pill than Descovy | Smaller pill than Truvada |