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

It combines 200mg of emtricitabine, 245mg of tenofovir disoproxil and 150mg of elvitegravir, along with 150mg cobicistat, in a green film-coated tablet. The tablet has ‘GSI’ on one side and ‘1’ on the other side.

Stribild combines different drugs in one pill. Two of the drugs (emtricitabine and tenofovir disoproxil) are from a class of drugs known as NRTIs (nucleoside/nucleotide reverse transcriptase inhibitors) and one drug (elvitegravir) is an integrase inhibitor. Each drug class works against HIV in a different way. Cobicistat is a drug used only as a boosting agent to increase the effect of elvitegravir.

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 Stribild once a day with food. The tablet should be swallowed whole – don’t chew, crush or split it.

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 Stribild and realise within 18 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 with less than 6 hours left until your next dose, don’t take a double dose, just skip the dose you’ve forgotten and then carry on with your normal routine

If you are sick (vomit) within 1 hour of taking your Stribild tablet, you should take another tablet; if you vomit more than 1 hour after your dose there is no need to repeat the dose.

All medicines have possible side-effects.  It’s a good idea to talk to your 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 Stribild.

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 Stribild include (most common in bold):

• headache, weakness, dizziness, difficulty sleeping, abnormal dreams, fatigue
• feeling sick, vomiting, diarrhoea, decreased appetite, indigestion, feeling bloated, constipation, flatulence
• skin rash, itching, dark skin patches (often starting on the hands or soles of feet)
• changes in some blood test results, including liver and kidney tests, blood sugar and cholesterol.

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 (‘chems’).

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.

If you are taking Stribild it’s important to check with your HIV doctor or pharmacist before taking any medicines from the following groups:

• antibiotics
• antiepileptic medicines
• medication to treat high blood pressure
• medication to treat high cholesterol (e.g. statins)
• antidepressants
• anticoagulants (medication to thin the blood)
• medication to help sleep or for sedation
• metformin (a tablet to treat diabetes)
• antiarrhythmic medication (for irregular heart rhythm)
• oral contraceptives (birth control)
• steroids taken by inhaler or nasal spray – some steroids can build up in the body causing serious side-effects and must not be taken with Stribild; check before using any steroids in this way
• herbal medicines – in particular St John’s Wort should be avoided
• erectile dysfunction agents – some of these can be increased to dangerous levels and a decreased dose may be recommended.

Taking calcium, iron, magnesium or aluminium can stop you from absorbing Stribild properly – all multivitamin and mineral supplements and antacids must be taken at least four hours before or after Stribild.

The patient information leaflet which comes with your Stribild has a full list of medicines which should be avoided.

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.

Stribild is not recommended for women during 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. Stribild should not be used during breastfeeding as at least one of the drugs it contains passes into breast milk.

Stribild is approved for use in children aged 12 years and over, weighing 35kg or more.

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