Biktarvy vs. Genvoya: Comparing HIV Treatments

Do Biktarvy and Genvoya have generic versions?

Both Biktarvy and Genvoya are combination drugs that contain multiple active ingredients. Some of the active ingredients in both medications are available separately as generic drugs. For example, emtricitabine is available as a generic capsule.

A generic drug is an exact copy of the active ingredients in a brand-name medication. (An active ingredient is what makes a drug work.)

As you’ll see in the list below, Biktarvy and Genvoya are available only in brand-name versions.

• Biktarvy:
  • Available as a generic: no
  • Active ingredients: bictegravir, emtricitabine, and tenofovir alafenamide
• Genvoya:
  • Available as a generic: no
  • Active ingredients: elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide

What are Biktarvy and Genvoya used for?

Biktarvy and Genvoya are both prescribed for adults and some children living with HIV. See the table below for details on who can take each drug. Children’s dosages are based on body weight and are listed in kilograms (kg). One kilogram is approximately 2.2 pounds (lb).

To learn more about taking Biktarvy or Genvoya to treat HIV, talk with your doctor.

Biktarvy or Genvoya and children

Doctors can prescribe Genvoya for children who weigh at least 25 kg. And they can prescribe Biktarvy for children who weigh at least 14 kg.

For more information about the use of either drug in children, talk with your child’s doctor.

How do the dosing and administration of Biktarvy and Genvoya compare?

Here’s an overview of the dosage and how you’ll take Biktarvy and Genvoya for HIV. Strengths are listed in milligrams (mg).

Biktarvy is also used to treat HIV in children who weigh less than 25 kilograms (kg), but this use isn’t addressed below. To learn more about Biktarvy’s dosage for children of all body weights, see this Biktarvy dosage article.

Dosage for HIV (for adults and children weighing at least 25 kg)

* Biktarvy and Genvoya are combination drugs. They both contain the active ingredients emtricitabine and tenofovir alafenamide. (An active ingredient is what makes a drug work.)
† These are the active ingredients that are unique to each drug.

What are the side effects of Biktarvy and Genvoya?

Biktarvy and Genvoya may cause side effects ranging from mild to serious.

For more information about possible side effects, see the side effect articles on Biktarvy and Genvoya.

Mild side effects

Biktarvy and Genvoya may cause mild side effects. The table below lists examples of mild side effects that have been reported with these drugs.

This table may not include all mild side effects of these drugs. For more information on the mild side effects of the two drugs, see Biktarvy’s prescribing information and Genvoya’s prescribing information.

Serious side effects

In addition to the mild side effects described above, serious side effects may occur in people using Biktarvy or Genvoya. See the table below for a list of side effects that have been reported with these drugs.

To learn about your specific risk for serious side effects from Biktarvy or Genvoya, talk with your doctor or pharmacist.

* Biktarvy and Genvoya have a boxed warning for this side effect. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “What are the warnings of Biktarvy and Genvoya?” section.
† An allergic reaction is possible after taking Biktarvy or Genvoya. But this side effect wasn’t reported in studies.

How effective are Biktarvy and Genvoya?

You may wonder which drug — Biktarvy or Genvoya — is more effective for your condition.

Biktarvy and Genvoya are both prescribed to treat HIV. Studies of Biktarvy and Genvoya have shown that both drugs are effective for this use. In addition, the National Institute of Health Office of AIDS Research Advisory Council includes both drugs in its treatment recommendations for HIV.

It’s important to note that your results from Biktarvy or Genvoya may differ from those seen in studies. Talk with your doctor about whether one of these drugs is right for you.

If you’d like to read more about how each drug performed in studies, see the prescribing information for Biktarvy and Genvoya.

Cost and savings

Whether you have health insurance or not, cost may be a factor when you’re considering these drugs. Keep in mind that what you’ll pay for either drug will depend on your treatment plan, health insurance, the pharmacy you use, and other factors.

Learn more about Biktarvy cost and savings and Genvoya cost and savings.

What are the warnings for Biktarvy and Genvoya?

Biktarvy and Genvoya may not be right for you if you have certain medical conditions or other factors that affect your health. These may be called warnings.

The two drugs share the same warnings, but they also have different ones. Some of these warnings are mentioned below. Before you start using Biktarvy or Genvoya, be sure to talk with your doctor to see if these warnings apply to you.

Boxed warning: Risk of worsening hepatitis B

Biktarvy and Genvoya both have boxed warnings for the risk of worsening hepatitis B infection after stopping treatment. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). It alerts doctors and patients about drug effects that may be dangerous.

Some people living with both HIV and chronic hepatitis B who have taken emtricitabine, tenofovir disoproxil fumarate, or both have experienced sudden worsening of hepatitis B when they stopped treatment. Worsening of hepatitis B may also happen if treatment with Biktarvy or Genvoya is stopped.

Worsening hepatitis B can lead to decompensated cirrhosis (symptoms from liver disease) and liver failure.

Because of this risk, before you start taking Biktarvy or Genvoya, your doctor will order a blood test to screen for the hepatitis B virus (HBV).

If you test positive, you’ll need to take certain precautions after starting Biktarvy or Genvoya. These include not stopping treatment without talking with your doctor first and not missing doses of the medication.

If you’re HBV-positive and you and your doctor decide you should stop your treatment, your doctor will closely monitor you for signs of hepatitis B infection. If needed, they’ll prescribe treatments for hepatitis B.

To learn more about the risk of worsening hepatitis B infection when stopping Biktarvy or Genvoya, talk with your doctor.

Other warnings

In addition to the boxed warning, Biktarvy and Genvoya have other warnings.

Before using Biktarvy or Genvoya, talk with your doctor if any of the following conditions or health factors apply to you:

• a previous allergic reaction to either drug or any of its ingredients
• you are pregnant or planning to become pregnant
• you are breastfeeding or planning to breastfeed
• you have ever received a diagnosis of a psychological disorder, such as depression, or had suicidal thoughts or behaviors
• kidney or liver problems

To learn more about these drugs, see the in-depth articles on Biktarvy and Genvoya.

Can I switch between Biktarvy and Genvoya?

The short answer: It’s possible.

Details: In certain situations, your doctor may recommend switching between Biktarvy and Genvoya. For example, if you experience certain side effects, they might suggest you switch drugs.

Before switching from Genvoya to Biktarvy, your doctor will check a few things.

First, they’ll make sure you‘ve been on a stable treatment regimen and have an undetectable viral load. They’ll also confirm that the virus hasn’t developed resistance to treatments in the past. (With resistance, the virus no longer responds to a drug that previously treated it effectively.) And finally, they’ll try to determine whether the virus might already be resistant to any of the active ingredients in the drug you’re thinking about switching to. (An active ingredient is what makes a drug work.)

If your current treatment is working for you, your doctor likely won’t have you switch drugs. But if you’re having bothersome side effects or feel that your current treatment isn’t working well, talk with your doctor. Ask whether switching between Biktarvy and Genvoya is right for you.

Reminder: You should not switch drugs or stop your current treatment unless your doctor recommends it. Doing so can increase the risk of viral resistance.

Takeaway

Biktarvy and Genvoya are both daily, all-in-one prescription pills used to treat HIV. While they work in similar ways to keep the virus under control, they have a few key differences:

• Ingredients: Both drugs share two of the same virus-fighting medications (emtricitabine and tenofovir alafenamide). However, Biktarvy uses a newer main drug called bictegravir, while Genvoya uses elvitegravir.
• The “booster” difference: Genvoya requires an additional ingredient — a “booster” to help the medication stay in your body long enough to work. Biktarvy is strong enough to work on its own without a booster, which means it usually has fewer interactions with other medications.
• Food requirements: You must take Genvoya with food to ensure proper absorption. Biktarvy can be taken with or without food.
• Who can take it: Both medications can be prescribed to adults and children, but the exact dose depends heavily on body weight.

Important Safety Note: Neither Biktarvy nor Genvoya is a cure for HIV. Both carry a serious warning that stopping the medication suddenly can cause a hepatitis B infection to worsen dangerously if a patient has both viruses. Always talk with a doctor before making any changes to your HIV treatment.