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Does Symtuza cause weight gain?

Medically reviewed by Kristianne Hannemann, PharmD. Last updated on Aug 29, 2025.

Official Answer by Drugs.com

Symtuza may lead to mild weight gain as a side effect. In two clinical studies over 96 weeks, patients taking Symtuza gained about 2 kg (4.4 lbs). The exact reason why some antiretroviral medications cause weight gain is not fully understood.

How Symtuza Compares: Weight Gain With Other HIV Treatments

A large real-world study compared people starting Symtuza (darunavir/cobicistat/emtricitabine/tenofovir alafenamide) to those starting bictegravir-based regimens. It found that bictegravir regimens are associated with greater average weight gain than Symtuza over 9–12 months. For example, the mean difference at 9 months was 2.5 kg higher in the bictegravir group, with female patients at higher risk for gaining more than 5% in body weight.

Individual Risk Factors: Who Is Most Affected?

Not everyone experiences weight gain with HIV medications like Symtuza. The likelihood increases for female patients and those with a lower starting BMI. In one study, women were nearly six times more likely than men to gain 5% or more in body weight within a year. Older age and a higher baseline BMI were protective against significant weight gain.

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Managing Weight While on Symtuza

The effects of weight gain from HIV treatment like Symtuza aren’t fully known. To lower your risk of gaining weight:

Most patients do not need to stop Symtuza because of weight gain. For those concerned about changes in weight, regular monitoring, healthy nutrition, and physical activity are recommended. If weight changes are rapid or concerning, consult a healthcare provider to consider possible adjustments to treatment or supportive interventions.

What Is Symtuza Approved For?

Symtuza is an FDA-approved combination antiretroviral regimen containing darunavir, cobicistat, emtricitabine, and tenofovir alafenamide. It is used for the treatment of HIV-1 infection in:

Approved in 2018, Symtuza offers a complete, once-daily treatment option for eligible patients.

References
  1. Emond, B., Rossi, C., Côté-Sergent, A., Dunn, K., Lefebvre, P., Lafeuille, M. H., & Donga, P. (2021). Weight Change and Predictors of Weight Change Among Patients Initiated on Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide or Bictegravir/Emtricitabine/Tenofovir Alafenamide: A Real-World Retrospective Study. Journal of health economics and outcomes research, 8(1), 88–98. https://doi.org/10.36469/001c.24535
  2. Huhn, G. D., et. al. (2021). Week 96 subgroup analyses of the phase 3, randomized AMBER and EMERALD trials evaluating the efficacy and safety of the once daily darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) single-tablet regimen in antiretroviral treatment (ART)-naïve and -experienced, virologically-suppressed adults living with HIV-1. In: HIV Research and Clinical Practice. DOI: https://doi.org/10.1080/25787489.2020.1844520
  3. Ruderman, S. A., et. al. (2021). Brief Report: Weight Gain Following ART Initiation in ART-Naïve People Living With HIV in the Current Treatment Era. In: Journal of Acquired Immune Deficiency Syndrome. DOI: https://doi.org/10.1097/QAI.0000000000002556
  4. Symtuza [package insert]. (2023). Janssen Products LP. Accessed 06/28/2024 at https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=85a17d00-6b7c-41ea-a6b3-5ad924820dab

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