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Stribild

Generic name: cobicistat, elvitegravir, emtricitabine, and tenofovir (koe BIK i stat, EL vi TEG ra vir, EM trye SYE ta been, and ten OF oh vir)
Brand name: Stribild
Drug class: Antiviral combinations

Medically reviewed by Philip Thornton, DipPharm. Last updated on Nov 8, 2021.

What is Stribild?

Stribild is a tablet containing a combination of cobicistat, elvitegravir, emtricitabine, and tenofovir. 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.

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

Stribild is a combination medicine used to treat HIV in adults and children who are at least 12 years old and who weigh at least 55 pounds (25 kilograms).

Stribild is not a cure for HIV or AIDS.

Warnings

Stribild can harm your liver. Call your doctor at once if you have: upper stomach pain, loss of appetite, dark urine, clay-colored stools, or yellowing of your skin or eyes.

Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact, and some drugs should not be used together.

Do not stop using Stribild without your doctor's advice. Get your prescription refilled before you run out of medicine completely.

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

Many drugs can interact with cobicistat, elvitegravir, emtricitabine, and tenofovir and some should not be used at the same time. Tell your doctor about all the medicines you use.

Before taking this medicine

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

Stribild is a complete combination treatment and should not be used with other antiviral medications, especially those that contain adefovir, cobicistat, elvitegravir, emtricitabine, lamivudine, ritonavir, or tenofovir: Atripla, Biktarvy, Cimduo, Combivir, Complera, Descovy, Epivir, Epzicom, Evotaz, Hepsera, Kaletra, Norvir, Odefsey, Prezcobix, Symfi, Symtuza, Technivie, Triumeq, Trizivir, Tybost, Viekira, and others.

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

  • hepatitis B or other liver problems; or

  • kidney disease.

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

Stribild may not work as well if you take it during pregnancy. Do not start taking the medicine if you are pregnant. Tell your doctor right away 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. Stribild 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 Stribild?

Take Stribild exactly as prescribed by your doctor. This medicine is usually taken once per day. Follow all directions on your prescription label and read all medication guides or instruction sheets.

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 in the original container at room temperature, away from moisture and heat. Keep the bottle tightly closed when not in use.

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

Dosing information

Usual Adult Dose for HIV Infection:

1 tablet orally once a day with food

Comments:
-This drug is not recommended during pregnancy due to considerably lower exposures of cobicistat and elvitegravir 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 antiretroviral treatment history or to replace the current antiretroviral regimen in patients virologically-suppressed (HIV-1 RNA less than 50 copies/mL) on a stable antiretroviral regimen for at least 6 months with no history of treatment failure and no known substitutions associated with resistance to the individual components of this drug

Usual Pediatric Dose for HIV Infection:

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 Stribild?

Avoid taking an antacid within 2 hours before or 2 hours after you take Stribild. Some antacids can make it harder for your body to absorb cobicistat, elvitegravir, emtricitabine, and tenofovir.

Using Stribild 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.

Side Effects

Get emergency medical help if you have signs of an allergic reaction to Stribild: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • 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).

Antiviral medicine can affect your immune system (even weeks or months after you've used Stribild). 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 Stribild side effects may include:

  • nausea; or

  • diarrhea.

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 Stribild?

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, elvitegravir, 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.

Popular FAQ

Weight gain is not listed as a side effect in the product information for Stribild, but a large study suggests that some of the newer HIV treatments, including those containing integrase strand inhibitors such as elvitegravir (found in Stribild), can be linked with significant weight gain. Over 96 weeks, elvitegravir was associated with a mean weight gain of 2.72 kg [6 lbs] (95% CI, 2.45–3 kg). Continue reading

Stribild works quickly to drop levels of HIV-1 in the blood; however, it may take several months for viral loads to become undetectable (defined in clinical studies using Stribild as an HIV-1 RNA of <50 copies/mL). Most Stribild studies were a minimum of 48 weeks duration and these showed that 94% of people with HIV-1 taking Stribild achieved undetectable viral loads. Continue reading

Stribild interacts with a large number of medications, including antacids, anticonvulsants, antidepressants, antifungals, antipsychotics, benzodiazepines, colchicine, corticosteroids, direct oral anticoagulants, ergot derivatives, heart medications, hormonal contraceptives, immunosuppressants, lipid-modifying agents, narcotic analgesics, PDE-5 inhibitors, salmeterol, and other antivirals. Continue reading

Yes, Stribild tablets can be crushed or cut to ease administration to people who have difficulty swallowing the tablets.  The effects of crushing Stribild and then combining the crushed tablet with liquid nutrition were investigated in 24 volunteers. There was no difference in most pharmacokinetic parameters, such as area under the curve between the people receiving crushed Stribild and those receiving a whole tablet with breakfast. A difference in the maximum concentration of Stribild was noted between the two groups, but this was considered not clinically relevant. People with swallowing difficulties or needing liquid feeding can safely use crushed and suspended Stribild tablets. Continue reading

No, Stribild is not approved for pre-exposure prophylaxis (PrEP). Stribild is used to treat (not prevent) HIV infection.
Continue reading

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Further information

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

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