What Is Genvoya Used For?
Genvoya is a complete regimen approved by the US Food and Drug Administration (FDA) to treat HIV-1 infection in adults and children who weight at least 35 kilograms (77 pounds). While there is no cure for HIV or AIDS, antiretroviral therapies (ART), such as Genvoya, can improve your immune system and prevent the virus from multiplying. ART can reduce the amount of virus in the blood (viral load) into undetectable levels, which can also lower the likelihood of transmitting HIV to another person. Gilead Sciences combine four different HIV meds, elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide, in creating Genvoya. One tablet of Genvoya is considered a complete pill; it should not be combined with other antiretroviral agents, unless specified by your health care provider.
How it works
Each of the active ingredients in Genvoya has specific actions that limit the ability of the virus to multiply. The main function of emtricitabine and tenofovir alafenamide is to block the activity of reverse transcriptase, an enzyme necessary for HIV to create copies of itself and attack CD4 T-cells. These two drugs belong to the group nucleotide/nucleoside reverse transcriptase inhibitors or NRTIs. Elvitegravir is another enzyme-altering drug belonging to the group of integrase strand transfer inhibitors or INSTIs. It blocks the action of the enzyme integrase, preventing viral duplication. Cobicistat, a pharmacokinetic enhancer, is added to boost the effects of the other drugs and keep them longer in the body.
Advantage over other antiretroviral regimens
Genvoya contains four potent drugs in one pill and is available in tablet form. It is now easier to take the medication because you only need to take one tablet a day compared to older combination pills, which requires intake of two or more pills several times a day. Also, previously approved combination regimens containing tenofovir uses the form tenofovir disoproxil fumarate (TDF), while Genvoya is designed with a newer prodrug call tenofovir alafenamide (TAF). Clinical trials conducted to test Genvoya’s safety and efficacy suggest that with TAF, there seems to be less kidney toxicity and decrease in bone density. This is particularly helpful for patients with moderate kidney impairment and bone density issues. TAF also stays within cells that are affected by HIV and not in the bloodstream. This translates to fewer side effects and complications.
Things to know before taking Genvoya
Good Candidates for Treatment
Genvoya is recommended for people without hepatitis B coinfection. While it is said to be beneficial for patients with moderate renal impairment, it is not the drug of choice for those with severe renal and hepatic problems. You are a good candidate for the treatment if you are an HIV-infected patient aged 12 years and above, weighing at least 35 kilograms. If you are someone who has not received HIV treatment in the past or would like to replace your current ARV regimen:
- you must be on that regimen for at least 6 months;
- have never failed treatment;
- and have a viral load of less than 50 copies/ml.
Warnings and Contraindications
- This drug may cause lactic acid buildup in the bloodstream or lactic acidosis.
- Genvoya may cause severe liver problems or worsen existing liver impairment. It is associated with the occurrence of liver enlargement (hepatomegaly) and fatty liver (steatosis).
- Genvoya may cause existing hepatitis B infection to get worse.
- People with kidney dysfunction may experience worsening of symptoms or progression of the disease.
- You should not take Genvoya if you have a history of allergic reactions to any component of the medication.
- Avoid breastfeeding your baby if you have HIV or taking Genvoya. One of the drug components of this medication can pass to your baby through your breast milk. There are no studies confirming if the other 3 drugs can pass via breast milk.
How to take Genvoya
Take this HIV regimen according to your doctor’s advice. Do not change or miss a dose without consulting your doctor. The recommended dose for Genvoya is one tablet a day with food.
There are over 800 drugs that are known to interact with Genvoya, of which 334 cause major drug interactions. Common medications that may interact with Genvoya include:
- Antacids with aluminum and magnesium hydroxide (take at least two hours before or after Genvoya)
- Drugs for abnormal heart beat such as digoxin, amiodarone, quinidine, and systemic lidocaine
- Antibacterial drugs clarithromycin and telithromycin
- Anticonvulsants like oxcarbazepine and ethosuximide
- Certain antidepressants: SSRIs and TCAs
- Immune suppressants
- Pain relievers such as naproxen and ibuprofen