Descovy vs. Truvada: What's the Difference? | Mira Health
Descovy vs. Truvada: What's the Difference?
The difference between Descovy and Truvada is that Descovy contains a newer form of tenofovir while Truvada contains the original form of tenofovir. Compared to Descovy, Truvada has been shown to have more adverse effects on kidney function and bone density.
Alexis Bryan
Alexis Bryan MPH, is a recent graduate of Columbia’s Mailman School of Public Health. She is passionate about increasing access to care to improve health outcomes. Outside of work, she loves to travel, read, and pay too much attention to her plants.
Descovy and Truvada are commonly prescribed drugs used to treat human immunodeficiency virus (HIV) infection and pre-exposure prophylaxis (PrEP). Both are two-drug, antiviral combinations containing emtricitabine and tenofovir. The difference between Descovy and Truvada is that Descovy contains a newer form of tenofovir while Truvada contains the original form of tenofovir. Compared to Descovy, Truvada has been shown to have more adverse effects on kidney function and bone density.
Differences Between Descovy and Truvada
Dr. Daniel Boyer, M.D., practicing doctor at the Farr Institute, notes, “The only difference between descovy and Truvada is that descovy contains newer forms of tenofovir called tenofovir alafenamide while Truvada contains the original form of tenofovir called tenofovir disoproxil fumarate.” Descovy and Truvada are both manufactured by Gilead Sciences Inc. The table below summarizes some general information regarding the two brand-name drugs.
| #### Descovy | #### Truvada | |
|---|---|---|
| FDA Approval | April 4, 2016 | August 2, 2004 |
| Generic Name | Emtricitabine and tenofovir alafenamide (TAF) | Emtricitabine and tenofovir disoproxil fumarate (TDF) |
| How it’s Supplied | Tablets - Emtricitabine 200 mg / TAF 25 mg |
Tablets - Emtricitabine 200 mg / TDF 300 mg - Emtricitabine 167 mg / TDF 250 mg - Emtricitabine 133 mg / TDF 200 mg - Emtricitabine 100 mg / TDF 150 mg |
| Recommended Dosage | For HIV-1 Infection - One tablet taken once daily with or without food in patients with body weight at least 25 kg For Pre-Exposure Prophylaxis (PrEP) - One tablet taken once daily with or without food |
For HIV-1 Infection - In adults and pediatric patients weighing at least 35 kg: One tablet taken once daily with or without food - In pediatric patients weighing at least 17 kg: One low-strength tablet (based on body weight) taken once daily with or without food For Pre-Exposure Prophylaxis (PrEP) - One tablet taken once daily with or without food |
| Covered by Insurance | Likely | Yes |
| Covered by assistance programs for medication and medical care costs | Yes | Yes |
Descovy vs. Truvada: Cost
| Descovy | Truvada | |
|---|---|---|
| Cost | 200 mg-25 mg tablet - $67.51 per tablet - Around $2,025 for a supply of 30 tablets without insurance |
100 mg-150 mg tablet - $64.43 per tablet - Around $1,933 for a supply of 30 tablets without insurance |
Descovy vs. Truvada: Usage & Reactions
| Descovy | Truvada | |
|---|---|---|
| Indications and Usage | For HIV-1 Infection - In adults and pediatric patients weighing at least 25 kg (in combination with other antiretroviral agents) For Pre-Exposure Prophylaxis (PrEP) - In at-risk adult and adolescent men and transgender women weighing at least 35 kg |
For HIV-1 Infection - In adults and pediatric patients weighing at least 17 kg (in combination with other antiretroviral agents) For Pre-Exposure Prophylaxis (PrEP) - In at-risk adults and adolescents weighing at least 35 kg (in combination with safer sex practices) |
| Most Common Adverse Reactions | - Nausea - Diarrhea |
- Diarrhea - Nausea - Fatigue - Headache - Dizziness - Depression - Insomnia - Abnormal dreams - Rash - Abdominal pain - Weight decrease |
| Known Drug Interactions | Major: - Acyclovir - Ibuprofen Moderate: - Metformin - Prezcobix (cobicistat/darunavir) |
Major: - Acyclovir - Ibuprofen Moderate: - Metformin - Norvir (ritonavir) - Prezista (darunavir) - Reyataz (atazanavir) |
Is Descovy or Truvada more effective?
Descovy is a newer drug marketed as safer and more effective mainly because the drug persists in HIV-infected cells with fewer adverse events related to renal and bone density outcomes. On the contrary, there is more data on Truvada since it has been around longer. At this time, research shows similar tolerability, safety, and effectiveness between both forms of Tenofovir.
The Discover Trial is actively evaluating the safety and effectiveness of Descovy vs. Truvada for PrEP. There are several considerations to know what drug is right for you, including effectiveness, regimen, and which drug has been proven effective for given available clinical data. Below is a comparison table for Descovy and Truvada when used for PrEP.
Descovy vs. Truvada for PrEP
| #### Descovy | #### Truvada | |
| Effectiveness for PrEP | >99% effective | >99% effective |
| Regimen | - Daily use - Descovy for PrEP 2-1-1 is being studied, there is inadequate clinical data to support this regimen now |
- Daily use - PrEP 2-1-1 |
| Shown to be effective for | - Gay & bisexual cis men - Trans women |
Everyone, including: - Gay & bisexual cis men - Trans women - Trans men - Heterosexuals - Cis women - People who inject drugs |
Special Health Considerations
| #### Descovy | #### Truvada | |
| Bone Health | Safer to take for people with osteoporosis | People with osteoporosis should avoid |
| Kidney Health | Safer to take for people with kidney issues or a strong family history of kidney disease, though monitoring still recommended | People with kidney issues or a strong family history of kidney disease should avoid |
| Metabolic Health | May cause a small degree of weight gain | May cause a small degree of weight loss |
| Cholesterol | May cause small increases in LDL cholesterol and triglycerides | May cause small decreases in HDL, LDL and total cholesterol |
Descovy and Truvada Frequently Asked Questions (FAQs)
Determining the best drug for your situation is a difficult endeavor. In addition to working with your prescribing physician, it is important to do your own research to be an informed patient. Below we answer questions related to Descovy and Truvada.
How do Descovy and Truvada Work?
Dr. Boyer explains, “HIV Antivirals function by stopping the virus from further multiplication, thus reducing the HIV amount in the body. It acts by only suppressing the virus, but not completely eliminating it.” To replicate, HIV needs to create DNA from RNA using nucleotides. This process involves uses reverse transcriptase (RT) enzymes. NRTIs, like Descocy and Truvada, block RT enzymes to prevent HIV from replicating.
What is PrEP 2-1-1?
A “2-1-1” schedule is a recommended dosing guidance for taking pre-exposure prophylaxis (PrEP) to prevent HIV. Individuals take two tablets 2 to 24 hours before sex, one tablet 24 hours after the first dose, and another tablet 24 hours later.
What is Tenofovir?
Tenofovir works to decrease the amount of HIV and hepatitis B virus (HBV) in the blood. It does not cure HIV or HBV, but it reduces the chance of developing acquired immunodeficiency syndrome (AIDS). Tenofovir also reduces the risk of transmitting the to other people. Tenofovir is in a class of medications called nucleoside reverse transcriptase inhibitors (NRTIs).
Bottom Line
Descovy and Truvada are both approved for HIV treatment and PrEP. Both are two-drug antiviral combinations containing different forms of tenofovir. So far, it is thought that both drugs have similar effectiveness, but Descovy might be safer for some people.