Taking Genvoya correctly is crucial for its effectiveness in treating HIV.
- Once Daily with Food: You should take one Genvoya tablet by mouth once a day, and always with food. Taking it with food helps your body absorb the medicine better. A light meal (around 250 calories) is usually sufficient if you can’t eat a full meal.
- Swallow Whole: Swallow the tablet whole. Do not crush, chew, or split the tablet, as this can affect how the medicine works in your body.
- Consistency is Key: Take your medicine every day, ideally at the same time, to maintain steady drug levels in your body. This helps prevent the virus from multiplying and becoming resistant to the medicine. Setting an alarm on your phone can be a good reminder.
- Missed Dose:
- If you miss a dose and realize it within 18 hours of your usual time, take it with food as soon as possible, then take your next dose at your usual time.
- If you realize it with less than 6 hours left until your next dose, skip the missed dose and just take your next dose at your usual time. Do not take a double dose to make up for a missed one.
- Vomiting: If you vomit within 1 hour of taking Genvoya, you should take another tablet with food. If you vomit more than 1 hour after your dose, you do not need to repeat the dose.
- Do Not Stop Without Doctor’s Advice: Never stop taking Genvoya or change your dose without first talking to your doctor. Stopping HIV treatment, even for a short time, can cause the virus to multiply and potentially become resistant to treatment.
Genvoya contains four different medicines, each working in a specific way to fight HIV:
- Elvitegravir (an Integrase Inhibitor): HIV needs a special enzyme called “integrase” to insert its genetic material into your healthy cells. Elvitegravir blocks this enzyme, preventing HIV from making copies of itself inside your cells.
- Cobicistat (a “Booster”): Cobicistat is not an HIV medicine itself, but it plays a crucial role. It slows down how quickly your body breaks down elvitegravir. This means that elvitegravir stays in your body at higher levels for longer, making it more effective against HIV.
- Emtricitabine (an NRTI): Emtricitabine belongs to a group of drugs called “Nucleoside Reverse Transcriptase Inhibitors” (NRTIs). HIV uses an enzyme called “reverse transcriptase” to convert its genetic material into a form that can infect your cells. Emtricitabine blocks this enzyme.
- Tenofovir Alafenamide (TAF) (another NRTI): TAF is another NRTI. It’s a “prodrug” of tenofovir, meaning it’s converted into the active form of tenofovir inside your body. Like emtricitabine, it also blocks the reverse transcriptase enzyme. TAF is a newer form of tenofovir that tends to be gentler on the kidneys and bones compared to an older form (tenofovir disoproxil fumarate).
By blocking HIV at different stages of its life cycle, these four medicines work together to significantly reduce the amount of virus in your blood and help your immune system become stronger.
Like all medicines, Genvoya can cause side effects, though most are mild and tend to improve over time.
- Common Side Effects:
- Nausea
- Diarrhea
- Headache
- Fatigue (tiredness)
- More Serious (but less common) Side Effects:
- Kidney Problems: While TAF is generally safer for kidneys than TDF, new or worsening kidney problems (including kidney failure) can still occur. Your doctor will monitor your kidney function regularly with blood and urine tests. Symptoms can include swelling, less urination, or dark urine.
- Liver Problems: Although rare, severe liver problems (including lactic acidosis, a buildup of lactic acid in your blood) or an enlarged liver can occur. Symptoms might include yellowing of the skin/eyes (jaundice), dark urine, nausea, vomiting, or stomach pain.
- Worsening of Hepatitis B: If you also have Hepatitis B virus (HBV) and stop taking Genvoya, your HBV infection could suddenly get worse (called an HBV flare-up). Do not stop Genvoya without talking to your doctor, as they may need to monitor your liver or start you on other HBV medicines.
- Immune Reconstitution Inflammatory Syndrome (IRIS): When your immune system starts to recover after starting HIV treatment, it might overreact to old, hidden infections, causing symptoms like fever, swollen lymph nodes, or worsening of previous infections.
- Bone Density Loss: While less common with TAF than TDF, some individuals may experience a decrease in bone mineral density.
- Weight Gain: Some studies have shown that certain HIV medications, including integrase inhibitors like elvitegravir (in Genvoya), may be linked to some weight gain.
- Depression/Mood Changes: Though rare, depression or other mood changes can occur.
- Allergic Reactions: Symptoms like rash, swelling, or trouble breathing are rare but require immediate medical attention.
Always report any new or worsening symptoms to your doctor immediately.
Before starting or while taking Genvoya, there are important warnings and precautions to be aware of.
- Not a Cure for HIV: Genvoya does not cure HIV infection or AIDS. You must continue taking it every day as prescribed to control the virus and stay healthy.
- Risk of HIV Transmission: While effective treatment significantly reduces the risk, it is still possible to pass HIV to others through sexual contact or sharing needles. Continue practicing safer sex and avoiding needle sharing.
- Hepatitis B Virus (HBV) Testing: Before starting Genvoya, your doctor will test you for HBV infection. If you have HBV, stopping Genvoya could cause your HBV to worsen severely, so specific management is needed.
- Kidney and Liver Monitoring: Your doctor will regularly check your kidney function (with blood and urine tests) and liver health during treatment, as these organs can be affected. Genvoya is not recommended for people with severe kidney or liver problems (unless on chronic hemodialysis for kidney issues).
- Pregnancy: Genvoya is generally not recommended during pregnancy because the levels of some of its components can drop significantly during the second and third trimesters, which could make the treatment less effective for the mother and potentially harm the baby. If you become pregnant while on Genvoya, tell your doctor immediately, as they will likely switch you to an alternative HIV regimen.
- Breastfeeding: HIV-infected mothers should not breastfeed because HIV can be passed through breast milk.
- Drug Interactions: Due to the complex interactions (as mentioned in Section 3), always ensure your doctor and pharmacist have a complete list of all your medications and supplements.
- New or Worsening Symptoms: If you develop new or worsening symptoms (especially severe pain, swelling, yellowing skin, dark urine, or unusual tiredness), contact your doctor right away.
Genvoya can interact with many other medicines because cobicistat (one of its components) can affect how other drugs are processed by your body.
- Always Tell Your Doctor and Pharmacist: It is extremely important to tell your doctor and pharmacist about ALL medicines you are taking or plan to take. This includes prescription and over-the-counter drugs, herbal products (like St. John’s Wort), and vitamins/supplements.
- Medicines to Avoid or Use with Caution:
- Certain heart medicines: Some antiarrhythmics (for irregular heartbeat) and certain blood pressure medicines (like some calcium channel blockers) can have their levels increased, leading to potentially dangerous side effects.
- Erectile dysfunction drugs (PDE5 inhibitors): Levels of drugs like sildenafil or tadalafil can become very high, increasing side effects. Dosing adjustments are often needed, or some may need to be avoided.
- Statins (for cholesterol): Genvoya can increase statin levels, raising the risk of muscle pain or a serious muscle condition called rhabdomyolysis.
- Antidepressants and antipsychotics: Doses of some of these medicines may need to be adjusted, or certain ones may need to be avoided.
- Benzodiazepines (for anxiety/sleep): Levels of some benzodiazepines can be increased, leading to more side effects.
- Anti-seizure medications: Some anti-seizure drugs should not be taken with Genvoya.
- Antacids, iron, calcium, magnesium: These can stop Genvoya from being properly absorbed. Take them at least 2 hours before or 4 hours after your Genvoya dose.
- Grapefruit products: Avoid grapefruit juice or grapefruit products, as they can affect Genvoya levels.
- Other HIV Medicines: Genvoya is a complete regimen. You generally should not take it with other HIV medicines as it can lead to too much of the same type of medicine, causing more side effects or kidney damage.
Genvoya is a fixed-dose combination medication, meaning all four medicines are in one tablet, and the dosage is straightforward.
- One Tablet Daily: The recommended dosage for adults and pediatric patients weighing at least 25 kg (about 55 pounds) is one tablet taken orally once daily with food.
- With Food: It is essential to take Genvoya with food to ensure proper absorption of the medicine.
- Consistent Timing: Try to take it around the same time each day to maintain steady levels of the medication in your body.
- No Adjustments for Mild-to-Moderate Kidney/Liver Issues: For individuals with mild-to-moderate kidney or liver problems, the standard dosage is typically used.
- Hemodialysis Patients: For adults with severe kidney problems (creatinine clearance below 15 mL/minute) who are receiving chronic hemodialysis, Genvoya should be taken after completion of a hemodialysis treatment on dialysis days.
- Strict Adherence: Missing doses can lead to the virus multiplying and potentially developing resistance to the medication. It’s vital to take every dose as prescribed.
Genvoya is a prescription-only medication.
- Doctor’s Evaluation and Prescription: You must receive a valid prescription from a licensed healthcare provider, typically a doctor experienced in managing HIV infection.
- Specific Criteria: Your doctor will assess whether Genvoya is appropriate for you. This includes checking your HIV viral load, CD4 cell count, and testing for any existing resistance to the drugs in Genvoya. They will also perform tests for Hepatitis B infection and assess your kidney and liver function before and during treatment.
- Specialist Oversight: Treatment with HIV medications often involves oversight by an infectious disease specialist or an HIV specialist.
- Ongoing Monitoring: Regular doctor visits and blood tests are essential to monitor the effectiveness of Genvoya, check for side effects, and ensure the virus remains suppressed.
- Not for Self-Medication: Due to the complexity of HIV treatment and potential drug interactions, Genvoya should never be self-prescribed or shared with others.
