What is Genvoya (Elvitegravir/Cobicistat/Emtricitabine/Tenofovir Alafenamide)?
Genvoya medication is a combination formulation of the Integrase Strand Transfer Inhibitor (INSTI) drug elvitegravir (150mg), the Nucleoside Reverse Transcriptase Inhibitor (NRTI) emtricitabine (200mg), the Nucleotide Reverse Transcriptase Inhibitor (NRTI) tenofovir alafenamide (10mg), and the pharmacokinetic enhancer cobicistat (150mg). Cobicistat has no inherent antiretroviral activity of its own. Genvoya drug is a complete HIV treatment formulation, and use with other antiretroviral medications is therefore not advised.
Dosage & Administration
Genvoya is indicated for the treatment of HIV-1 infection in certain adults and children weighing 25 kg or more. No dosage adjustments are required in mild or moderate liver dysfunction (Child-Pugh Class A and B), but the drug should not be used in patients with severe liver impairment. HIV medication Genvoya can be used in patients with a creatinine clearance >= 30 mL/min, but has not been studied in patients with renal dysfunction below that level. The drug is dosed as one tablet by mouth per day with food in all eligible patients.
Genvoya is contraindicated in patients with hypersensitivity to any of its components, and in patients on any of the medications or herbals listed in the product monograph.
Genvoya Side Effects
Genvoya contains a new form of tenofovir designed to reduce side effects.
Common side effects are:
- immune reconstitution syndrome,
- reduced bone mineral density,
- redistribution of body fat.
Rare cases of suicidal ideation and suicidal behavior have been reported in patients taking Genvoya tablets. A complete list of potential adverse effects is provided in the product monograph.
Emtricitabine and tenofovir have been associated with serious, even fatal, cases of lactic acidosis or hepatomegaly with steatosis. This risk is elevated in obesity, liver dysfunction, female gender, and prolonged nucleoside exposure. Screening and monitoring guidelines are detailed in the product monograph.
Patients should be screened for renal dysfunction prior to starting treatment with Genvoya HIV med.
All patients who test positive for HIV infection should be screened for comorbid HBV and HCV infection. Co-infected patients should be started on an antiretroviral regimen targeting co-infected viruses, regardless of CD4 counts or viral loads. Current HIV treatment guidelines outline drug regimens and prescribing considerations. The safety and efficacy of treatment with Genvoya pills have not been established in patients with HIV and HBV co-infection.
Genvoya is associated with a large number of drug-drug interactions and is contraindicated for concurrent use with many medications and herbals that are strong inducers of CYP3A. A complete list is provided in the product monograph.
Pregnancy & Lactation
Highly active retroviral combination treatment should be used in all pregnant women, regardless of viral load and CD4 count. However, Genvoya is not recommended for use in pregnant women. Current guidelines should be consulted when treating women in pregnancy. Some elements of the drug are excreted in breast milk. The CDC recommends that all HIV positive women, treated or untreated, avoid breastfeeding to prevent vertical transmission of the virus.
Genvoya overdose should be treated by close observation and standard supportive care should be provided. Some elements of this drug are dialyzable.
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