Bictegravir/Emtricitabine/Tenofovir Alafenamide

What it treats

Treatment of HIV-1 infection in adults and pediatric patients (weighing at least 14 kg) who have no prior antiretroviral treatment history, or to replace a stable current regimen. Biktarvy is FOR TREATMENT ONLY, it is not FDA-approved for PrEP (HIV prevention in HIV-negative people). Truvada and Descovy are the PrEP-approved options in this class.

Typical dosing

One tablet (50 mg bictegravir/200 mg emtricitabine/25 mg tenofovir alafenamide) by mouth once daily, with or without food. Take at the same time each day for consistent viral suppression.

Monitoring

Kidney function (creatinine/eGFR) before starting and periodically during treatment, tenofovir alafenamide is gentler on kidneys and bone than the older tenofovir disoproxil (TDF), but monitoring still applies. HIV viral load and CD4 count per your HIV care team's schedule. Screen for hepatitis B before starting, stopping Biktarvy in a patient with untreated hepatitis B can cause a dangerous flare.

Side effects

Common: diarrhea, nausea, headache. Serious (rare): lactic acidosis and severe liver problems (boxed-warning class effect for nucleoside analogs), immune reconstitution syndrome shortly after starting treatment, worsening of hepatitis B if present and untreated, kidney problems.

Interactions to know

Do not take with dofetilide (dangerous interaction with bictegravir). Certain anticonvulsants, rifampin, and St. John's wort can reduce effectiveness. Antacids/supplements containing polyvalent cations (calcium, iron, magnesium, aluminum) can reduce absorption, timing matters; ask your pharmacist.

Cost assistance programs

Gilead Advancing Access (manufacturer program) offers copay assistance for eligible commercially insured patients, many pay as little as $0 per month, and separate assistance pathways for uninsured/underinsured patients. Enroll or check eligibility at https://www.gileadadvancingaccess.com/. BetterBuyRx has no financial relationship with Gilead; we link to this because it is the official, free enrollment path.

Pregnancy & breastfeeding

Data on Biktarvy in pregnancy are more limited than for some other regimens; the HHS Perinatal HIV Guidelines should be consulted with your HIV care team, who will weigh viral suppression benefits against limited pregnancy-specific data. Do not stop or switch HIV treatment during pregnancy without your care team's guidance, untreated HIV poses a bigger risk to both parent and baby than most regimen choices.

Additional notes

Resistance considerations: as with any HIV regimen, missed doses increase the risk of resistance developing, strict daily adherence matters. Not recommended for patients with resistance to any component. Bone density: tenofovir alafenamide (in Biktarvy/Descovy) has a more favorable bone and kidney safety profile than the older tenofovir disoproxil fumarate (in Truvada), relevant if switching between regimens.

Frequently asked questions

How much does Bictegravir/Emtricitabine/Tenofovir Alafenamide cost without insurance?

We compare cash prices for Bictegravir/Emtricitabine/Tenofovir Alafenamide live across verified pharmacies on the drug page, the current lowest price is shown there. Cash prices are unregulated and vary by pharmacy, so compare before you fill and confirm the price at the counter.

Can I use the free BetterBuyRx discount card for Bictegravir/Emtricitabine/Tenofovir Alafenamide?

Yes. The free BetterBuyRx discount card is compared live on the drug page and, when a partner network prices Bictegravir/Emtricitabine/Tenofovir Alafenamide, shows the card price with its BIN, PCN, Group, and Member ID. It can't be combined with insurance.

Why does the price of Bictegravir/Emtricitabine/Tenofovir Alafenamide vary so much between pharmacies?

U.S. cash prescription prices are unregulated, each pharmacy sets its own markup, and discount programs and mail-order sources widen the spread further (this is common across the HIV integrase inhibitor combination (INSTI + 2 NRTIs) class). That's why comparing verified prices before you fill can save money.