Generic name: cobicistat, darunavir, emtricitabine, and tenofovir [ koe-BIK-i-stat, dar-UE-na-vir, EM-trye-SYE-ta-been, and-ten-OF-oh-vir ]
Drug class: Antiviral combinations

Medically reviewed by Philip Thornton, DipPharm. Last updated on Oct 24, 2023.

What is Symtuza?

Symtuza contains a combination of cobicistat, darunavir, emtricitabine, and tenofovir alafenamide. . Cobicistat reduces the action of enzymes in your liver that break down certain antiviral medicines. This allows the antiviral medicines to be used more safely and effectively at lower doses.

Darunavir, emtricitabine and tenofovir are antiviral medicines that prevent human immunodeficiency virus (HIV) from multiplying in your body. HIV can cause acquired immunodeficiency syndrome (AIDS).

Symtuza is an antiviral medicine used to treat human immunodeficiency virus (HIV), the virus that can cause the acquired immunodeficiency syndrome (AIDS). Symtuza is for use in adults and children weighing at least 88 pounds (40 kilograms). This medicine is not a cure for HIV or AIDS.

Symtuza is sometimes used in people who have never been treated with other HIV medications.

Symtuza is also used to replace other HIV medications in adults with suppressed viral loads. Your doctor will determine which medication is best for you.

Warnings

Tell your doctor about all your other medicines. Some drugs should not be used with Symtuza.

Symtuza can cause serious liver problems. Call your doctor if you have upper stomach pain, loss of appetite, vomiting, dark urine, or yellowing of the skin or eyes.

Stop taking Symtuza and call your doctor right away if you have a severe skin reaction: fever, burning or redness in your eyes, mouth sores, or a skin rash that spreads and causes blistering and peeling.

If you've ever had hepatitis B, it may become active or get worse after you stop using Symtuza. You may need frequent liver function tests for several months.

Related/similar drugs

Biktarvy, Descovy, Truvada, Atripla, Stribild, Complera, Epzicom

Before taking this medicine

Some drugs should not be used with Symtuza. Your treatment plan may change if you also use:

• alfuzosin;

• cisapride;

• colchicine (in people with liver or kidney disease);

• elbasvir and grazoprevir;

• lovastatin or simvastatin;

• pimozide, lurasidone;

• rifampin;

• sildenafil (Revatio, for pulmonary arterial hypertension);

• St. John's wort;

• triazolam or oral midazolam;

• heart medication - dronedarone, ivabradine, ranolazine;

• ergot medicines - dihydroergotamine, ergotamine, methylergonovine; or

• seizure medicine - carbamazepine, phenytoin, phenobarbital.

To make sure Symtuza is safe for you, tell your doctor if you have ever had:

• liver disease (especially cirrhosis, or hepatitis B or C);

• kidney disease;

• diabetes;

• an allergy to sulfa drugs; or

• a bleeding disorder such as hemophilia.

You may develop lactic acidosis, a dangerous build-up of lactic acid in your blood. Ask your doctor about your risk.

Symtuza may not work as well if you take it during pregnancy. Do not start taking Symtuza if you are pregnant, and tell your doctor if you become pregnant.

If you plan to get pregnant, ask your doctor for another antiviral medicine to use during pregnancy. To prevent HIV in a newborn baby, use all medications to control your infection during pregnancy. Your name may be listed on an antiviral pregnancy registry.

If you do not plan to get pregnant, ask your doctor about using a non-hormonal birth control (condom, diaphragm, cervical cap, or contraceptive sponge) to prevent pregnancy. Symtuza can increase certain side effects when taken with hormonal birth control (pills, injections, implants, skin patches, vaginal rings).

Women with HIV should not breastfeed. The virus can pass to your baby in your breast milk.

How should I take Symtuza?

Take Symtuza exactly as prescribed by your doctor. Follow all directions on your prescription label and read all medication guides or instruction sheets.

Take Symtuza with food.

If you cannot swallow a Symtuza tablet whole, you may break the tablet in half. Take both halves right away.

You will need frequent medical tests.

Use all HIV medications as directed. Do not change your dose or stop using a medicine without your doctor's advice. Skipping doses could make your virus resistant to medication. Remain under the care of a doctor.

Store at room temperature away from moisture and heat. Keep the tablets in their original container, along with the packet or canister of moisture-absorbing preservative.

If you've had hepatitis B, it may come back or get worse after you stop using Symtuza. You may need liver function tests while using Symtuza and for several months after you stop.

Dosing information

Usual Adult Dose of Symtuza for HIV Infection:

1 tablet orally once a day

Comments:
-This drug is not recommended during pregnancy due to considerably lower exposures of darunavir and cobicistat during the second and third trimesters.
-This drug should not be started in pregnant women; patients who become pregnant during therapy with this drug should be switched to an alternative regimen.

Use: As a complete regimen for the treatment of HIV-1 infection in patients with no prior antiretroviral treatment history or in patients virologically-suppressed (HIV-1 RNA less than 50 copies/mL) on a stable antiretroviral regimen for at least 6 months who have no known substitutions associated with resistance to darunavir or tenofovir

Usual Pediatric Dose of Symtuza for HIV Infection:

At least 40 kg: 1 tablet orally once a day

Comments:
-This drug is not recommended during pregnancy due to considerably lower exposures of darunavir and cobicistat during the second and third trimesters.
-This drug should not be started in pregnant women; patients who become pregnant during therapy with this drug should be switched to an alternative regimen.

Use: As a complete regimen for the treatment of HIV-1 infection in patients with no prior antiretroviral treatment history or in patients virologically-suppressed (HIV-1 RNA less than 50 copies/mL) on a stable antiretroviral regimen for at least 6 months who have no known substitutions associated with resistance to darunavir or tenofovir

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Get your prescription refilled before you run out of medicine completely.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking Symtuza?

Using Symtuza will not prevent your disease from spreading. Do not have unprotected sex or share razors or toothbrushes. Ask your doctor how to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe.

Symtuza side effects

Get emergency medical help if you have signs of an allergic reaction to Symtuza (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning eyes, skin pain, red or purple skin rash with blistering and peeling).

Call your doctor at once if you have:

• increased thirst, increased urination;

• kidney problems - swelling, urinating less, feeling tired or short of breath;

• lactic acidosis> - unusual muscle pain, trouble breathing, stomach pain, vomiting, irregular heart rate, dizziness, feeling cold, or feeling very weak or tired; or

• liver problems - nausea, upper stomach pain, loss of appetite, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Symtuza can affect your immune system (even weeks or months after you've used Symtuza). Tell your doctor if you have:

• signs of a new infection - fever, night sweats, swollen glands, cold sores, cough, wheezing, diarrhea, weight loss;

• trouble speaking or swallowing, problems with balance or eye movement, weakness or prickly feeling; or

• swelling in your neck or throat (enlarged thyroid), menstrual changes, impotence.

Common Symtuza side effects may include:

• nausea, upset stomach, diarrhea, gas;

• headache, feeling tired; or

• rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect Symtuza?

Sometimes it is not safe to use certain medicines at the same time. Some drugs can affect your blood levels of other drugs you use, which may increase side effects or make the medicines less effective.

Many drugs can interact with cobicistat, darunavir, emtricitabine, and tenofovir, and some drugs should not be used at the same time. Tell your doctor about all other medicines you use. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible interactions are listed here.

Frequently asked questions

• What drugs are contained in the HIV treatment Symtuza?

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Symtuza only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

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