What is Descovy (Emtricitabine/Emtricitabine/Tenofovir alafenamide)?
Descovy is a combination formulation of the Nucleoside and Nucleotide Reverse Transcriptase Inhibitor (NRTI) drugs emtricitabine (200mg) and tenofovir alafenamide (10mg). It is used for the treatment of HIV infection in patients without Hepatitis B virus (HBV) or Hepatitis C virus (HCV) co-infection. Please note that the drug contains tenofovir alafenamide, a newer formulation of the NRTI tenofovir disoproxil fumarate, and differs in various aspects. Tenofovir alafenamide, the version present in Descovy, has a reduced side effect profile.
Dosing & Administration
Descovy HIV medication is indicated for the treatment of HIV infection in adults and children weighing at least 25 kg, in combination with other antiretroviral medications. The dose is one tablet once daily with or without food. The medication comes in a film-coated oral tablet.
No dosage adjustments are required in patients with mild to moderate liver dysfunction. No dosage adjustments are required in renal dysfunction, but Descovy should not be used if the creatinine clearance is less than 30 mL/min. Dosage instructions are detailed in the product monograph.
Descovy is contraindicated in patients with hypersensitivity to the drug.
Descovy Side Effects
Descovy is associated with reduced bone mineral density (BMD), and with hepatotoxicity (see precautions).
Other potential side effects include:
- immune reactivation syndrome,
- body fat redistribution,
- increased cholesterol.
A complete list of potential adverse effects is provided in the product monograph.
Descovy is not indicated for the treatment of HBV infection, and should not be used in HIV patients who are co-infected with HBV of HCV due to increased risk of hepatotoxicity.
All patients who test positive for an HIV infection should be screened for a comorbid HBV infection. Co-infected patients should be started on an antiretroviral regimen targeting both viruses, regardless of CD4 counts or HBV viral loads. Current HIV treatment guidelines outline drug regimens and prescribing considerations.
Current HIV treatment guidelines recommend testing HIV-positive patients for Hepatitis C virus (HCV), and regular ongoing testing for those at high risk. If HIV/HCV co-infection is identified, consideration should be given to treating both infections concurrently.
Descovy therapy should be suspended in any patient who develops lactic acidosis or hepatomegaly. Screening and monitoring recommendations are detailed in the product monograph.
This drug has been associated with reduced BMD, so BMD monitoring should be considered in certain patients, as detailed in the product monograph.
Descovy is associated with a large number of drug-drug and herbal interactions. These are listed in the product monograph.
Pregnancy & Lactation
Highly active retroviral combination treatment should be used in all pregnant women. Effects of Descovy in pregnancy are unknown, so current guidelines should be consulted prior to using this medicine in pregnant women. Descovy excretion in breast milk is unknown. The CDC recommends that all HIV positive women, treated or untreated, avoid breastfeeding to prevent vertical transmission of the virus.
The drug overdose should be treated by standard supportive measures and close observation. Both active ingredients of Descovy are partially dialyzed.
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