What should you do if you FORGET a are bothersome, please discuss this with BICTEGRAVIR/ dose? your doctor or pharmacist. EMTRICITABINE/ TENOFOVIR If you miss a dose of Biktarvy and it is less Rare but serious adverse effects that have than 18 hours from when you normally take been observed are damage to the liver, ALAFENAMIDE it, take the dose immediately. If it is more especially in patients with long-term hepatitis than 18 hours from when you normally take B or C. This can manifest as jaundice (skin Other NAMES: Biktarvy is a purplish Biktarvy , do not take the dose and wait or eyes turn yellow), dark urine and stools brown tablet that is a combination of until your next scheduled dose. Do not take and loss of appetite. bictegravir 50 mg, emtricitabine 200 mg and 2 doses of Biktarvy at the same time, and tenofovir alafenamide 25mg in each tablet. do not take more than 1 dose in the same If you have hepatitis B and are taking day. Biktarvy, do not stop taking the medication without consulting your WHY is this drug prescribed? Why should you not forget to take this doctor first. Stopping Biktarvy may drug? worsen the hepatitis B infection. This tablet contains bictegravir, an integrase stand transfer inhibitor (INSTI) AND If you miss doses of this drug, the amount of tenofovir alafenamide and emtricitabine, two HIV virus in your blood (known as the viral It is important that you keep your doctor antiretroviral (anti-HIV) reverse transcriptase load) will start increasing again and your appointments and come for your inhibitors (“nukes”). It is a convenient single immune system will be further damaged. A laboratory tests so that your progress tablet treatment option for HIV infection in few missed doses can be enough for the can be followed. adults. By using Biktarvy consistently, your three components: bictegravir, tenofovir immune system should improve (increase in alafenamide and emtricitabine, to stop being What other PRECAUTIONS should you CD4+ count) and you will be better protected active,a phenomenon known as resistance. follow while using this drug? against infections. When this happens, other antiretrovirals that work in a similar way may also become You must make sure that you are taking the Biktarvy does not cure AIDS or inactive. Therefore, missing doses of this right dose. If you take higher doses than what completely kill the HIV virus, but helps to drug can decrease treatment options for is prescribed, you may increase the chance prevent further damage by slowing down the the future. Please do not stop this drug of having side effects. If you take lower doses production of new viruses. without talking to your doctor first. of than what is prescribed, the HIV virus may become resistant to Biktarvy . What ADVERSE EFFECTS can this drug HOW should this drug be taken? cause? What should you do about them? Certain drugs can increase or decrease the effect of bictegravir, tenofovir alafenamide Generally, the dose is 1 tablet once a day, Most common adverse effects reported with and emtricitabine. Drugs that interact with with or without food. Biktarvy are mild, and include nausea, Biktarvy and may alter its effect include: diarrhea, fatigue, headache, trouble sleeping Anticonvulsants: Take Biktarvy 2 hours before or after and abnormal dreams. Carbamazepine (Tegretol, Carbatrol, antacids or mineral supplements; Epitol), oxcarbazepine (Trileptal), alternatively, Biktarvy may be taken Less common side effects include phenobarbital and phenytoin (Dilantin) together with mineral supplements with indigestion, bloating, depression, rash and Antimycobacterials: food. thoughts of suicide. If these effects occur and Rifampin (Rifadin, Rofact), Rifabutin
(Mycobutin), Rifapentine (Priftin) Please inform your doctor if you are pregnant. Your doctor can recommend the Antacids or mineral supplements Aluminium hydroxide, magnesium appropriate treatment to help to reduce the hydroxide or calcium carbonate. Take risk of passing the HIV virus on to your baby.
Biktarvy 2 hours before or after Breastfeeding is NOT recommended if you antacids or mineral supplements; have HIV as you can transmit the virus to alternatively, Biktarvy may be taken your baby through your breast milk. BICTEGRAVIR together with mineral supplements with food. How should this drug be STORED? + Antifungals: Ketoconazole (Nizoral), Itraconazole Biktarvy tablets should be stored in a cool EMTRICITABINE (Sporanox) dry place (below 30C), protected from light and well out of the reach of children. Ensure Antiretrovirals: + that the drug has not expired by checking the Atazanavir (Reyataz, Evotaz) expiry date (“EXP”) shown on the outside of TENOFOVIR
the package. Do not store in your bathroom
or kitchen, as heat and moisture may cause ALAFENAMIDE Drugs that should not be taken with the drug to be less active. Biktarvy are:
Other medications containing If you have any questions or concerns (BIKTARVY) tenofovir (Atripla, Complera, about this drug or if you are experiencing Descovy, Genvoya, Odefsey, adverse effects, please discuss them with Stribild, Truvada, Viread) your pharmacist, doctor or nurse. Other medications containing emtricitabine or lamivudine Write questions or concerns down to MEDICATION (Atripla, Complera, Emtriva, ensure they are addressed. Descovy, Genvoya, Stribild, Odefsey, Truvada, 3TC, The following pharmacist is available to FACT SHEET Combivir, Heptovir, Kivexa, answer questions: Triumeq, Trizivir) Pharmacist: ______Inform your doctor and pharmacist of all prescribed and non-prescribed drugs Telephone: ______(including vitamins and minerals) you are taking. As well, you should inform them of Reference: Product Monograph Biktarvy(bictegravir/ tenofovir alafenamide/emtricitabine). Gilead Canada Inc, natural products you are taking. Some Mississauga, ON, 2018. products such as St. John’s wort influence Prepared by Zubeir Khan (PharmD student 2019). the effect of Biktarvy and should not be taken together. If you wish to start a new Additional medication fact sheets and updates may be found drug or natural product, please consult with at: https://hivclinic.ca your pharmacist before doing so.