Biktarvy is a medication used to treat HIV. It is a combination of three separate antiretroviral drugs in one pill, taken once a day.

It combines 50mg of bictegravir, 200mg of emtricitabine and 25mg of tenofovir alafenamide in a purplish-brown tablet with ‘GSI’ on one side and ‘9883’ on the other side of the tablet.

Biktarvy combines three antiretroviral drugs in one pill. Two of the drugs (emtricitabine and tenofovir alafenamide) are from a class of drugs known as NRTIs (nucleoside/nucleotide reverse transcriptase inhibitors). The third drug, bictegravir, is an HIV integrase inhibitor. Each drug class works against HIV in a different way.

The aim of HIV treatment is to reduce the level of HIV (the ‘viral load’) in your body until it is undetectable – usually less than 50 copies of virus per ml of blood. Taking HIV treatment and having an undetectable viral load protects your immune system and stops HIV being passed on to someone else during sex.

You should take Biktarvy once a day. Biktarvy can be taken with or without food.

HIV treatment works best if you take it every day, ideally at the same time each day. It may help to set an alarm, e.g. on your mobile phone, to remind you. If you forget to take a dose of Biktarvy and realise within 12 hours of the time you usually take it, take it as soon as possible, then take your next dose at your usual time. If you realise more than 12 hours late, don’t take a double dose, just skip the dose you’ve forgotten and then carry on with your normal routine.

If you vomit less than one hour after taking Biktarvy, take another dose. If you vomit more than one hour after taking Biktarvy there is no need to repeat the dose.

All medicines have possible side-effects. It’s a good idea to talk to a doctor, nurse or pharmacist about what to expect before you start taking any medication, and how to manage any side-effects which occur.

A full list of side-effects, including less common side-effects, can be found in the patient information leaflet that comes with Biktarvy.

Side-effects can be described as:

• Common – a side-effect that occurs in at least one in a hundred people (more than 1%) who take this drug.
• Rare – a side-effect that occurs in fewer than one in a hundred people (less than 1%) who take this drug.

Common side-effects of Biktarvy include depression, abnormal dreams, headache, dizziness and tiredness.

Biktarvy is not suitable for people with severely reduced kidney function.

You should always tell your doctor and pharmacist about any other drugs or medication you are taking. That includes anything prescribed by another doctor, medicines you have bought from a high-street chemist, herbal and alternative treatments, and recreational or party drugs.

Some medicines or drugs are not safe if taken together – the interaction could cause increased, dangerous levels, or it could stop one or both of the drugs from working. Other drug interactions are less dangerous but still need to be taken seriously. If levels of one drug are affected, you may need to change the dose you take. This must only be done on the advice of your HIV doctor.

You should not take Biktarvy if you are currently taking the following medicines:

• products that contain St John’s wort (a herbal remedy used for depression and anxiety)
• rifabutin, rifampicin and rifapentine (used to treat some bacterial infections such as tuberculosis)
• carbamazepine, oxcarbazepine, phenobarbital and phenytoin (used to treat epilepsy and prevent seizures)
• ciclosporin (an immunosuppressant)
• sucralfate (a treatment for stomach ulcers and severe gastric reflux).

Biktarvy should be taken at least 2 hours before, or with food 2 hours after, antacids containing magnesium and/or aluminium.

Biktarvy should be taken at least 2 hours before iron supplements or taken with food.

If you are considering having a baby, or think you might be pregnant, talk to your doctor as soon as possible about which combination of anti-HIV medications would be right for you. It is important to take antiretroviral treatment during pregnancy to prevent passing HIV from mother to baby.

Biktarvy is not usually used by women who are pregnant or want to get pregnant as it has not been studied in women who are pregnant. For this reason, the British HIV Association (BHIVA) does not recommend its use in pregnancy.

Women living with HIV are advised not to breastfeed, as HIV can be passed on in breast milk. However, some women do choose to breastfeed. Biktarvy should not be used during breastfeeding as at least one of the drugs it contains passes into breast milk.

Biktarvy is not licensed for use in children.

If you have any concerns about your treatment or other aspects of your health, it’s important to talk about these. For example, if you have any symptom or side-effect which may be from your treatment, or if you are finding it difficult to take your medication every day, one of your healthcare team will be able to help.

Building a relationship with a doctor may take time. You may feel very comfortable talking to your doctor, but some people find it more difficult, particularly when talking about sex, mental health, or symptoms they find embarrassing. It’s also easy to forget things you wanted to talk about.

Preparing for an appointment can be very helpful. Take some time to think about what you are going to say. You might find it helpful to talk to someone else first, or to make some notes and bring them to your appointment. Our online tool Talking points may help you to prepare for your next appointment – visit www.aidsmap.com/talking-points 

For detailed information on this drug, visit the Biktarvy pages in the A-Z of antiretroviral drugs.