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Why do you take Genvoya with food?

Medically reviewed by Leigh Ann Anderson, PharmD Last updated on May 15, 2020.

Official Answer

by Drugs.com

Key Points

  • Genvoya contains four medicines: elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide. You should take Genvoya with food to help increase the absorption of elvitegravir into your body. Elvitegravir is an HIV-1 integrase strand transfer inhibitor, and is one of the drugs that is contained in Genvoya.
  • Taking Genvoya with food may also help to lower the chance of nausea.
  • Genvoya is an oral tablet taken once daily to treat human immunodeficiency virus (HIV) in adults and children. HIV-1 is the virus that causes AIDS (Acquired Immune Deficiency Syndrome).
  • Genvoya is considered a complete treatment regimen in one pill for HIV. You do not need to use other HIV medicines with Genvoya.

Take Genvoya on a regular dosing schedule with food. Avoid skipping any doses as this can result in the development of resistance which can worsen HIV.

What kind of food should I eat with Genvoya?

The manufacturer does not specify the type of food you should eat with Genvoya. Food interaction studies have shown that the effects of a high fat meal (~800 kcal, 50% fat), relative to fasting increased drug levels by over 80% compared to over 30% with a light meal (~373 kcal, 20% fat), relative to fasting. There is no recommendation that you have to eat a high fat meal with Genvoya.

Plus, you don’t always have to eat a full meal with Genvoya, either. Just a snack, such as a bowl of cereal with milk, toast with peanut butter, or yogurt could be sufficient. The most important thing is that you eat something when you take your Genvoya.

Will food help with side effects from Genvoya?

The most common side effect of Genvoya is nausea (upset stomach), and has been reported in about 11% (11 out of 100) of patients. Genvoya can also cause diarrhea (7%), so taking the medicine with food may help to reduce these side effects.

Most people can tolerate Genvoya well and stay on treatment. In clinical studies, only 1% of patients (1 out of every 100) stopped Genvoya treatment due to any severity. 

How do I take Genvoya?

Genvoya is an oral tablet taken once a day with food. It’s a complete treatment regimen for HIV and you do not have to take it with other HIV medications.

It’s important not to change your dose, stop your medicine, or skip any doses without checking with your doctor first. The HIV virus in your blood may increase and develop resistance to treatment if you stop treatment, even for a short time.

Always get your refills on time and keep your scheduled doctor appointments.

Genvoya can lead to many different drug interactions. One common interaction may be with indigestion medicine (antacids).

  • You should take indigestion (antacids) that contain aluminum hydroxide, magnesium hydroxide or calcium carbonate at least 2 hours before or 2 hours after you take Genvoya. 
  • Taking these types of antacids with Genvoya may decrease absorption and blood levels of elvitegravir, one of the medicines in Genvoya.
  • Tell your doctor and pharmacist about all the medicines you take, including over-the-counter medicines, vitamins, herbals, and dietary supplements.

Be sure to tell your doctor if you have kidney or liver disease. Genvoya carries a Boxed Warning of a build-up of lactic acid in the blood and the possibility for severe liver problems. If you have kidney or liver impairment you may not be able to use Genvoya. 

What is the advantage of Genvoya?

Today, there are many treatment options for HIV, known as antiretroviral therapy (ART) medications. Most new approvals combine several of the needed medicines into one convenient pill. Genvoya is a complete treatment regimen that contains four medications for HIV treatment and is taken only once a day. No more taking handfuls of pills every few hours. 

Combination treatments:

  • make it easier to stay on course
  • fight drug resistance
  • help prevent treatment failures
  • are often given once-a-day.

Experts recommend starting HIV treatment as soon as you are diagnosed, regardless of your T-cell count (which is an indicator of how healthy the immune system is). Starting treatment early may:

  • slow the progression of HIV
  • lower your risk of infectious complications
  • improve your quality of life
  • lead to undetectable viral loads
  • prolong life expectancy to near normal.

Why does Genvoya contain tenofovir alafenamide (TAF)?

Genvoya contains tenofovir alafenamide (TAF), a newer version of the original tenofovir disoproxil fumarate (TDF). TAF is an HIV-1 nucleoside analog reverse transcriptase inhibitor (NRTI) that works by blocking the action of reverse transcriptase. It inhibits viral replication of the HIV virus.

TAF is known as a "prodrug" of tenofovir and is inactive when taken. However, after it enters the body, it’s changed to an active form in the cell (not in the blood like TDF). 

TAF enters the HIV-infected cell more easily than TDF. Because of this, you will have lower levels of medicine in the blood, but higher levels in cells where HIV-1 makes copies of itself. TAF can be given at roughly 1/10th the dose of TDF.

Researchers state kidney toxicity and decreased bone mineral density may be less of a concern with TAF (based on observed laboratory measures), due to lower required doses and drug levels in the blood. However, TDF is associated with lower lipid levels (such as cholesterol) compared to TAF. 

When deciding which tenofovir agent to select, talk to your doctor about safety, cost, insurance coverage, and ease of access of these drugs in your community.

Bottom Line

  • You should take Genvoya with food because it helps to increase the absorption and blood levels of the drug in your body.
  • Genvoya can also cause nausea and diarrhea in some patients, so taking your medicine with food may help to lower these side effects.
  • Genvoya is a complete treatment regimen for people living with HIV. It contains four medications (elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide) and only needs to be taken one time per day.

This is not all the information you need to know about Genvoya for safe and effective use. Review the full Genvoya information here, and speak to your health care provider if you have questions or concerns.

References
  • Genvoya [package insert]. Gilead Sciences. Feb. 2019. Accessed May 13, 2020 at https://www.gilead.com/~/media/files/pdfs/medicines/hiv/genvoya/genvoya_pi.pdf
  • Cattaneo D, Baldelli S, Minisci D, et al. When food can make the difference: The case of elvitegravir-based co-formulation. Int J Pharm. 2016;512(1):301‐304. doi:10.1016/j.ijpharm.2016.08.063
  • Stribild [package insert]. Gilead Sciences. Jan. 2019. Accessed May 13, 2020 at https://www.gilead.com/~/media/Files/pdfs/medicines/hiv/stribild/stribild_pi.pdf

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