Descovy side effects and how to avoid them

Descovy side effects include weight gain, diarrhea, and nausea

By Georgia C. Yalanis, MD | Jan. 9, 2022 Medically reviewed by Anne Jacobson, MD, MPH

Descovy is the brand name for emtricitabine/tenofovir alafenamide or F/TAF. It’s an antiretroviral drug (ART) used in the treatment and prevention of human immunodeficiency virus-1 (HIV-1). Descovy is in the class of medications called nucleotide and nucleoside reverse transcriptase inhibitor (NRTI) combinations. NRTIs block the activity of the HIV enzyme, reverse transcriptase, which prevents HIV from replicating.

In an HIV-negative person, Descovy is used as pre-exposure prophylaxis, sometimes called PrEP. PrEP is taken by people who are at higher risk for HIV to reduce the risk of transmission.

Descovy is not an over-the-counter medication. It is a prescription drug associated with some potentially serious side effects. In this article, we will discuss side effects, warnings, and potential drug interactions users should be aware of.

Common side effects of Descovy

Descovy is associated with the following common side effects. If any of these side effects become worrisome, notify your healthcare provider.

Gastrointestinal effects: Diarrhea, nausea, vomiting, abdominal pain, gas
General feelings of malaise: Headache, dizziness, fatigue, tiredness, weakness, lack of energy
Psychiatric symptoms: Depression
Sleep disturbances: Insomnia, abnormal dreams
Metabolic derangements: Kidney problems, abnormal blood tests, weight gain, high blood sugar, glucose in the urine, blood in the urine
Musculoskeletal issues: Muscle pain, joint pain, loss of bone density, tingling or “pins and needles” sensations, numbness or burning pain in the hands or feet
Upper respiratory effects: Stuffy nose, cough
Immune system and blood cell abnormalities: Neutropenia (low white blood cells), anemia (pediatric patients)
Dermatologic toxicity: Darkening of the skin on the soles of the feet and palms of the hands), rash

Weight gain

There is a growing body of evidence suggesting that some antiretroviral regimens may cause weight gain and obesity in individuals with HIV. Studies suggest these effects are stronger in women, in Black individuals, in people who have a lower CD4 count and a higher viral load, and in those who do not inject drugs.

The exact mechanism for this is still unclear. It’s possible that some medications affect the metabolism of fat cells or disturb the balance of bacteria in the gut. Certain combinations of medications used for HIV treatment may also increase the risk of weight gain.

Not all medications exhibit the same risk for weight gain. For example, tenofovir alafenamide is associated with more weight gain when compared to tenofovir disoproxil fumarate, abacavir, or zidovudine. Other reports have shown that weight gain is greater on regimens of dolutegravir/abacavir/FTC and darunavir/TDF/TC.

Weight gain as a side effect of HIV drugs is emerging as an area that needs more study.

Diarrhea and nausea

Diarrhea and nausea were two of the most commonly reported side effects associated with Descovy use. According to the original clinical trials supplied by the Food and Drug Administration, 10% of individuals with active HIV infection experienced nausea while taking Descovy. Similarly, 5% of HIV-1 negative individuals given Descovy for PrEP reported diarrhea as an adverse reaction.

Serious side effects of Descovy

HIV medications like Descovy may be associated with some rare but serious side effects. If any of the following adverse reactions are experienced while taking Descovy, it is important to seek medical advice right away. Adverse reactions can also be reported directly to Gilead Sciences by calling 1-800-GILEAD-5 or the FDA by calling 1-800-FDA-1088.

Lactic acidosis
Angioedema (swelling under the skin and mucous membranes of the eyes, face, and lips)
Exacerbation or worsening of Hepatitis B
Immune reconstitution syndrome
Pancreatitis
Kidney toxicity, which may cause kidney failure
New-onset autoimmune disorders
Neutropenia (low white blood cells)
Severe liver problems

Rash

Rash is a common side effect that can be associated with many medications. Some chemotherapy or antiretroviral regimens are associated with serious skin reactions in certain individuals. These reactions are extremely rare, only reported in a few case reports, and symptoms include pain, tingling, burning, and redness or darkening of the skin on the soles of the feet or palms of the hands. This rare condition is sometimes called plantar palmar erythrodysesthesia or hand-foot syndrome. Notify a healthcare professional if a worrisome rash, allergic reaction, or irritation to the hands or feet is experienced while taking this mediation.

How long do Descovy side effects last?

Some side effects of Descovy, like feeling tired, are self-limiting and usually resolve after a few days to weeks of taking the medication. Other side effects, like weight gain or sleep problems, may reach their peak after a few months. Still other side effects, like toxicity to the pancreas, kidneys, liver, or skin, may begin after someone has been taking the medication for a while. Because some side effects may be fatal, any new serious symptoms should receive immediate medical attention.

Descovy contraindications and warnings

Abuse and dependence

Descovy is not habit-forming or addictive. While there are no withdrawal symptoms associated with stopping Descovy, this medication should not be stopped without talking to a healthcare provider. Stopping treatment for HIV may result in a worsening of Hepatitis B, an increase in HIV, a weakened immune system, and progression of HIV into AIDS.

Overdose

The maximum dose of this medication is 1 tablet per day. Each tablet is 200 mg emtricitabine with 25 mg tenofovir alafenamide. Taking too much of this medication could be fatal. This medication should only be taken by the individual it was prescribed for. If this medication is taken by someone for whom it was not prescribed, or if too much medication has been taken, seek medical attention or contact the poison control centers at 1-800-222-1222.

Restrictions

There are some times when Descovy should not be prescribed or should be used only with caution.

Descovy for PrEP

Descovy should not be used for HIV prevention in individuals who are not confirmed to be HIV-negative. People taking Descovy for PrEP should be confirmed HIV-negative immediately before starting the medication and at least every three months during use. Drug-resistant HIV-1 variants have emerged when Descovy was used for PrEP in people with undetected infections. Do not start Descovy for HIV-1 PrEP if signs or symptoms of acute infection are present or if HIV status is unknown.

Individuals with HBV infection

Severe and acute exacerbations of Hepatitis B virus infection have been reported in individuals who are infected with the Hepatitis B virus and have stopped taking medications containing emtricitabine (FTC) and/or tenofovir disoproxil fumarate (TDF). Liver function must be carefully monitored in these individuals and if needed, started on anti-hepatitis B therapy.

Pregnancy

Descovy is prescribed to women who are pregnant or may become pregnant to decrease the risk of HIV transmission during pregnancy. Providers should offer routine PrEP follow-up and HIV testing every three months.

Breastfeeding mothers

The Centers for Disease Control and Prevention (CDC) recommend that mothers with HIV-1 infection should not breastfeed due to the potential for HIV transmission from the mother to the infant in breast milk.

Emtricitabine has been shown to be present in human breast milk. Tenofovir has been shown to be present in the milk of lactating animals. While present, it is not known if the components of Descovy affect the production of milk or the breastfed child in any way. Women who are not infected with HIV may breastfeed and take Descovy as PrEP.

Pediatric use

The safety and efficacy of this medication has only been established in children and adolescents weighing more than 25 kg (55 lbs). Use of Descovy in pediatric patients between the ages of 6 and 18 weighing at least 25 kg is supported by clinical trials.

Descovy interactions

Descovy is contraindicated for use with the following medications:

Carbamazepine
Cidofovir
Phenobarbital
Phenytoin
Rifampin
St. John’s wort

Other medications may require caution or adjustments in dose. Tell your healthcare provider about all medications you are taking. Drinking excess alcohol with this medication may result in severe liver problems.

How to avoid Descovy side effects

1. Follow medical advice while taking this medication

This medication should be taken daily, at a time when it is easy to remember. Take only the dose prescribed by a healthcare professional. Do not take more medication and do not take less. If there are any missing doses, take the next dose as soon as you remember and notify your healthcare provider.

2. This medication should only be taken by the individual it was prescribed for

Descovy is associated with some possible side effects that may be fatal. It is important that this medication is not shared or given to individuals for whom it was not prescribed.

3. Do not stop taking this medication without seeking medical advice

You should not stop taking this medication unless you with your healthcare provider have decided that is the right decision. There are some instances where abrupt discontinuation of ART is necessary. This should be determined by a healthcare professional experienced with these medications.

4. Tell a healthcare provider about all medications, medical conditions, and allergies before taking Descovy

This includes all medications and supplements, any medical conditions, or any allergic reactions to medications in the past. It is important to share any history of depression or suicidal thoughts, as people have completed suicide while taking this medication.

5. Have a strong support system in place

This medication is associated with an increased risk of depression, suicidal ideation, and completion of suicide. Having a strong emotional support network and access to mental health treatment is important when taking this medication.

6. Store this medication correctly and out of the reach of children

Descovy should be stored at room temperature (68 to 77 degrees Fahrenheit). This medication should be stored away from children’s medications and out of the reach of children.

7. Swallow the tablet whole

Do not crush, break, or chew the tablet. This medication may be taken with or without food.

8. Pregnancy and breastfeeding

Women with HIV-1 infection should not breastfeed. Women who are taking Descovy as PrEP may breastfeed. Descovy is prescribed to women who are pregnant or may become pregnant to decrease the risk of transmitting HIV during pregnancy.

9. Monitor your weight

This medication is associated with unwanted weight gain for some people. Checking your weight regularly and maintaining a healthy diet and exercise plan can help.

10. Seek medical care immediately if you experience any type of allergic reaction to this medication

Allergic responses should be reported and treated as soon as possible. Any type of serious adverse effect or potential overdose should receive medical attention immediately.