Is Biktarvy a protease inhibitor?
No, Biktarvy is not a protease inhibitor. It is a combination integrase inhibitor and reverse transcriptase inhibitor used in the treatment of people living with HIV.
Biktarvy contains three antiretroviral medicines, bictegravir, emtricitabine, and tenofovir alafenamide. You may see the name Biktarvy abbreviated as BIC / FTC / TAF.
Bictegravir is classified as an integrase strand transfer inhibitor (INSTI), or sometimes just called an integrase inhibitor. Emtricitabine / tenofovir alafenamide is classified as a nucleoside/nucleotide reverse transcriptase inhibitor (NRTI).
In studies looking at Biktary for HIV treatment, most patients were able to reach an undetectable level of virus in their blood with Biktarvy (fewer than 50 copies of HIV per milliliter of blood).
How does Biktarvy work?
The HIV virus uses three different enzymes to convert RNA, the genetic material that allows the virus to multiply, into DNA. The three enzymes that are targeted by HIV antiretroviral medicines include reverse transcriptase, integrase, and protease. Biktarvy specifically blocks (inhibits) integrase and reverse transcriptase.
Integrase inhibitors like bictegravir work by blocking integrase, an enzyme needed for HIV replication. HIV uses integrase to insert its viral DNA into the human CD4 cell (a T cell, or white blood cell). CD4 cells are important to help fight infections, but their numbers decrease in patients with HIV. HIV cannot make copies (replicate) when integrase is blocked by an integrase inhibitor.
Nucleoside / nucleotide reverse transcriptase inhibitors (NRTIs) like emtricitabine / tenofovir alafenamide work by blocking reverse transcriptase, an enzyme needed for HIV replication. HIV uses reverse transcriptase to convert RNA into DNA in the CD4 cell. When reverse transcriptase is blocked by the NRTI medicine, the virus cannot make copies of itself because it does not have the DNA to do it.
Biktarvy is approved by the FDA as a complete regimen for the treatment of HIV-1 infection in adults and pediatric patients weighing at least 14 kg:
- with no antiretroviral treatment history or
- with an antiretroviral treatment history and not virologically suppressed, with no known or suspected substitutions associated with resistance to the integrase strand inhibitor class, emtricitabine, or tenofovir, or
- to replace the current antiretroviral regimen in those who are virologically suppressed (HIV-1 RNA less than 50 copies per mL) on a stable antiretroviral regimen with no known or suspected substitutions associated with resistance to bictegravir or tenofovir.
Biktarvy is used to treat (not prevent) HIV infection in at-risk people and is not used as pre-exposure prophylaxis (PrEP) medication. Descovy (emtricitabine / tenofovir alafenamide fumarate) and Truvada (emtricitabine / tenofovir disoproxil fumarate) are common FDA-approved medications used for PrEP that also contain emtricitabine and tenofovir.
Related information: HIV Treatment Options: An Overview
This is not all the information you need to know about Biktarvy (bictegravir, emtricitabine, and tenofovir alafenamide) for safe and effective use and does not take the place of your doctor's directions about your treatment. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.
Related questions
- Which medicines should not be taken with Biktarvy?
- What if I miss a dose of Biktarvy?
- Does Biktarvy cause weight gain?
References
- Biktarvy [package insert]. Foster City, CA. Gilead. 07/2025. Accessed Aug 19, 2025 at https://www.gilead.com/~/media/files/pdfs/medicines/hiv/biktarvy/biktarvy_pi.pdf
- Sax P, et l. Patient education: Initial treatment of HIV (Beyond the Basics). Up to Date. Accessed August 9, 2021 at https://www.uptodate.com/contents/initial-treatment-of-hiv-beyond-the-basics
Read next
Do you have to take Biktarvy forever?
Biktarvy antiretroviral therapy (ART) is taken indefinitely for HIV-1 infection as it is a complete regimen for long-term treatment. Stopping ART can increase blood levels of the HIV virus, lead to resistance, increase your risk for HIV infections and complications and increase the chance that you may transmit the infection to others.
Continue reading
Can I drink alcohol while taking Biktarvy?
There is not a specific warning in the product label against alcohol (ethanol) consumption with Biktarvy, a medication used for HIV treatment. But drinking too much alcohol can damage your liver. Ask your doctor if it is safe and how much alcohol you can drink while taking Biktarvy.
Continue reading
Is Biktarvy covered by insurance?
Most commercial and government health insurance plans in the U.S. cover some portion of the cost for Biktarvy. Typically a person taking Biktarvy pays between $0 and $5 per month. A co-pay card program for Biktarvy offers up to $7,200 in cost-sharing assistance per year with no monthly limit.
Continue readingSee also:
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