Choosing the Best Anti-HIV Medication: Descovy Vs Truvada

Truvada and Descovy are the same drugs having the same drug formulations. But Descovy has TAF – a prodrug of the active substance TDF. The existence of TAF may be a benefit to Descovy but will this outperform Truvada’s high profile of its efficacy and tolerability? Here are the ultimate facts to determine when choosing the best anti-HIV med between the two.

Treatment of HIV is possible with the use of very effective anti-HIV drugs. In fact, there are several medicines that can be used to manage the virus in the body. Some of these drugs are used for both PrEP and HIV/AIDS treatment.

When it comes to which drug is highly effective and tolerable, most decisions are based on clinical results but most importantly on an individual adherence to medication (drug prescription) and tolerability.

Here at HIVPrEP, we detailed the full info comparing Truvada versus Descovy for the best anti-HIV medication. Note that your doctor can prescribe you another med for the same health condition based on your health outcomes and preferred treatment regimen.

📋Descovy Vs Truvada: What Are They Prescribed For?

Truvada contains two medicines – emtricitabine (or FTC) and tenofovir (TDF). These two meds are used in combating HIV as a prevention and treatment. Truvada is approved for HIV/AIDS treatment.

It’s also prescribed as PrEP medication – a strategy of using medication and other safer sex methods by HIV uninfected individuals to stay protected from the virus when they are at a higher risk of being infected.

Furthermore, Truvada is used as hep B treatment [1].

Compared to Truvada, Descovy is a relatively new drug in the field of antiretrovirals containing two medicines – FTC and tenofovir alafenamide (TAF). TAF is a prodrug (or improved version) of TDF designed to be highly effective with a better safety profile than TDF [2].

Descovy is also active against HBV. Although there is an ongoing assessment conducted to determine if Descovy is highly effective and tolerable as PrEP, it has not been approved for PrEP. Nonetheless, there is a possibility that this med will also be used as PrEP. Until approved, do not use it as a virus prevention method.

⚙Does Descovy Work the Same As Truvada?

Both Truvada and Descovy belong to a drug class known as nucleoside reverse transcriptase inhibitors (or commonly NRTIs). These medicines work to block reverse transcriptase which is an HIV enzyme that uses the body CD4 cells or T-cells to multiply in the blood.

Truvada containing FTC + TAF has the same mode of action as Descovy containing FTC + TAF. In this case, the Descovy mechanism of action is better favorable as it mostly concentrates inside the cells of the immune system causing less kidney damage and slight or no bone loss which is common in Truvada. Nonetheless, both drugs are highly tolerable and effective as anti-HIV medicines [3].

🛡Are These Drugs Safe?

Truvada was approved for three main health issues – PrEP, HBV as well as HIV/AIDS treatment. Its profile of high efficacy and tolerability has placed this med as among the top list medication for combating HIV. It’s the only recommended med used as PrEP (although there are generics) and it continues to build its positive profile. Thanks to the formulation of FTC and TDF.

In the same note, Descovy is yet another relatively new but improved version of the Truvada’s active substances. TAF is an improved version of TDF that works the same but with better safety to kidney problem and BMD [4]. TAF is highly effective and safer just like TDF.

FDA approved both drugs as safe in its efficacy and tolerability for treating HIV. We are yet to witness FTC/TAF approval as PrEP since its clinical trials prove to be non-inferior to FTC/TDF.

⚖Difference in Dosage and Administration

Dosage difference in Truvada and Descovy are used especially in regards to patient weight as well as tolerability concerns. Truvada for HIV treatment comes in four dose strength combinations.

Here is a table showing its dose variations based on patient age:

Body Weight (kg) Dosing of FTC/TDF (mg)
17 ≤ 22 100/150 tab
22 ≤ 28 133/200 tab
28 < 35 167/250 tab

For people weighing above 35 kg, a tablet of 200 mg of FTC and 300 mg of TDF is used. This is the same quantity used as PrEP [5].

Descovy is available in the dose strength of 200 mg of FTC and 25 mg of TAF. There is no available dose information for a patient weighing less than 35 kg.

It’s recommended that you take only one tab a day with or without meals as prescribed by your medical specialist and never missing a dose. If you miss a dose, take it as soon as you remember (12 hours or fewer) but not as it approaches the time for the next dose.

To avoid missing a dose, take it at the same time of the day. This makes a habit and easy to remember your dosage.

🤧Side Effects: Which Medication Is Tolerated Better?

Before administering either of the medications, it’s necessary to consult with a doctor to assess your health and determine if a certain drug is well for you. This is based on your health outcome regarding the condition of other illnesses (if they exist).

Both drugs have side effects. Some effects come and fade away with continual medication while others are long-term and may demand medical attention.

The negative effect of Descovy includes nausea and increased cholesterol among others characterized as adverse effects (see below).

Truvada has the following notable effects:

  • diarrhea;
  • flu or bronchitis;
  • fatigue;
  • depression;
  • nausea;
  • stuffy nose;
  • headache;
  • dizziness;
  • rash;
  • insomnia;
  • common cold;
  • vomiting.

Adverse effects include:

  • adverse acute exacerbations of hep B;
  • the buildup of lactic acidosis/adverse hepatomegaly with steatosis;
  • worse or new onset of renal impairment;
  • immune reconstitution syndrome;
  • bone effects of TDF.

Truvada’s active substances slightly decreased cell proliferation without affecting mitochondrial parameters (or less mitochondrial toxicity). Bone effects are common in Truvada medication [6]. As with a fixed dose of FTC/TAF, there is no change in BMD or bone effects.

Furthermore, kidney issues (although it may exist) are not a serious effect when medicating with Descovy. This gives Descovy an advantage over Truvada.

🔁How Do Descovy & Truvada Interact with Other Substances?

Drug interactions exist in the pharmaceutical realms. That’s why it’s very important to let a medical specialist examine your health before initiating any anti-HIV meds.

Common drug interactions of Truvada and Descovy include:

  • didanosine medication. Close monitoring should be taken. Administering with Truvada or Descovy may lead to didanosine-related reaction;
  • it can interact with HIV-1 Protease Inhibitors causing increase concentrations of tenofovir;
  • should not be used together with hep C antiviral agents especially Epclusa or Harvoni;
  • any med affecting renal function;
  • meds for hepatotoxicity;
  • any med that affects the same body conditions, especially kidney and liver.

There are other meds not mentioned in this list. Your medical specialist should assess all the meds you are using. Bet it OTC, recreational drugs, herbal remedies or prescription meds. Do not take any other medicine without first consulting with a medical specialist.

🏭Who Makes These Medications?

Both drugs are designed and marketed by Gilead Sciences. Gilead is one of the global leaders in the design and manufacturing of antiretroviral meds among others.

Truvada was introduced into the market in 2004 after approval from the FDA. It was later recommended for use a PrEP in 2012 after an assessment form the same body (the FDA). This medication is based on two active substances – TDF/FTC.

The same company manufactures Descovy (based on FTC/TAF) and it passed approval test in 2016 after proving to be highly effective as Truvada but with less kidney toxicity and bone loss. This indication proves that Descovy can be the safest replacement or alternative to Truvada especially for persons with severe kidney problems and BMD.

💵Price Comparison

Truvada is widely sold globally as the only approved PrEP brand drug. As an anti-HIV treatment, there are other approved brand meds.

Truvada cost is extremely higher and its pricing varies from pharmacies [7].

Descovy, on the other hand, is quite expensive as Truvada. In fact, it comes under the same pricing as depicted from the table below:

Truvada (100 mg – 150 mg) for 30 tabs $1843.75
Descovy (200 mg – 25 mg) for 30 tabs $1843.75

These prices are on average and can change. All the Truvada dose strength cost the same price per tab.

There are copays, coupons, patient assistance programs as well as insurance that you can join to lower the cost of these drugs. Based on eligibility, you can pay as little as 0 dollars in copays or in insurances.

👉How to Choose the Right Drug?

Based on efficacy and tolerability the two drugs are highly effective and tolerable and are among the list of the top drugs recommended for use in their respective regiments.

Both meds work well in preventing the replication of HIV in the blood giving a patient an improved immune system. This makes an individual stronger in fighting other opportunistic infections.

Descovy is a new anti-HIV MED having very impressive performance especially safety to the kidneys and BMD. Thanks to the improvement of TDF formulated under the name TAF.

Choosing the right drug depends mainly on your health condition and tolerability to medication. Descovy just as Truvada is non-inferior. The most important consideration is to let your doctor assess your health and prescribed the right drug for you. Descovy is tolerated well if you have problems with kidneys and BMD.

📚References:

  1. Emtricitabine / Tenofovir Disoproxil Fumarate. Aidsinfo.nih.gov.
  2. Tenofovir Alafenamide. Aidsinfo.nih.gov.
  3. Truvada vs. Descovy for HIV prevention. Catie.ca. Retrieved June 2019.
  4. Descovy PrEP Works Equally Well, May Be Safer for Kidneys and Bones. By Liz Highleyman. Poz.com. Retrieved March 8, 2019.
  5. Truvada Dosage. Drugs.com. Retrieved May 18, 2018.
  6. Relative Mitochondrial Toxicity of Tenofovir Alafenamide (TAF) vs. Tenofovir Disoproxil Fumarate (TDF) (UCLACAREMITO). Theodoros Kelesidis, MD, PhD, University of California, Los Angeles. ClinicalTrials.gov. Retrieved April 16, 2019.
  7. Truvada Prices, Coupons and Patient Assistance Programs. Drugs.com.
Logan Morris

Expert in pharmaceutical practice and antiviral medicine, founder of HIVPrEP. Main goal is to popularize HIV topics and create awareness for global masses on how to prevent the disease and how to use HIV medication safely.

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Logan Morris

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