Biktarvy is a complete, single-tablet HIV treatment taken once daily.

It combines three antiretroviral medicines into one tablet: bictegravir (an integrase strand transfer inhibitor), emtricitabine, and tenofovir alafenamide (both nucleoside reverse transcriptase inhibitors).

Together, these three medicines work in different ways to block HIV from copying itself in the body. Biktarvy is used to treat HIV-1 infection in adults and adolescents weighing at least 25kg.

How it works:

HIV needs certain enzymes to replicate inside your body.

Biktarvy blocks two of these: integrase (which HIV uses to insert its genetic material into your cells) and reverse transcriptase (which HIV uses to copy its genetic code).

By blocking both, Biktarvy keeps the amount of HIV in your blood (your viral load) very low.

Biktarvy does not cure HIV. It keeps the virus suppressed so your immune system can stay healthy and you can live a full life.

Your dose:

One tablet taken once daily. Always take it exactly as prescribed by your doctor.

How to take it:

• Take Biktarvy at the same time every day
• It can be taken with or without food
• Swallow the tablet whole. Do not crush or chew it
• If you take antacids containing aluminium or magnesium, take Biktarvy at least 2 hours before or 6 hours after the antacid

Before you start:

• Tell your doctor about all other medicines, vitamins, and supplements you take. Some medicines can interact with Biktarvy
• Let your doctor know if you have any kidney or liver problems, including hepatitis B or C
• Tell your doctor if you are pregnant or planning to become pregnant

Ongoing check-ups:

You will need regular blood tests to monitor your viral load, CD4 count, kidney function, and liver health. These help your doctor confirm that Biktarvy is working and that you are tolerating it well.

• If you remember within 18 hours of your usual dose time: take it as soon as you can, then continue your regular schedule
• If more than 18 hours have passed: skip the missed dose and take your next one at the usual time
• Never take two tablets at once

Consistency is very important with HIV treatment.

Missing doses can allow the virus to replicate and may lead to resistance. If you are struggling to remember, talk to your doctor or pharmacist about strategies to help.

If you think you have taken more than prescribed, call 000 or go to your nearest emergency department straight away. Bring your medicine packet with you.

• Store below 30°C
• Keep in the original bottle. The bottle contains a desiccant to control moisture. Do not remove it
• Keep the bottle tightly closed
• Keep out of reach of children and pets

Biktarvy is generally well tolerated.

Common side effects include:

• Diarrhoea, nausea, or headache: Usually mild and often improve after the first few weeks
• Fatigue: Some people feel more tired, particularly at the start of treatment
• Vivid dreams or trouble sleeping: Reported by some people, particularly in the early weeks
• Weight changes and changes in body fat: Changes in how the body distributes fat can occur over time with HIV medicines
• Kidney changes: Tenofovir alafenamide is gentler on the kidneys than older tenofovir formulations, but kidney function is still monitored
• Liver changes: Your liver enzymes may rise. Let your doctor know if you notice yellowing of the skin or eyes

If you have hepatitis B and stop taking Biktarvy, your hepatitis B may worsen suddenly.

Do not stop taking it without speaking to your doctor first.

Biktarvy can interact with several medicines. Tell your doctor and pharmacist everything you are taking.

Key interactions include:

• Rifampicin and rifabutin: Used for tuberculosis, these significantly reduce Biktarvy's effectiveness
• St John's Wort: This herbal supplement reduces Biktarvy's levels in the blood. Avoid it
• Antacids and supplements containing aluminium, magnesium, calcium, or iron: Take these at least 2 hours before or 6 hours after Biktarvy
• Other antiretroviral medicines: Biktarvy should not be taken with other HIV medicines unless specifically directed by your doctor

Never start, stop, or change any medicine without speaking to your doctor first.

Will Biktarvy protect my partner from HIV?

When your viral load is undetectable on treatment, you cannot transmit HIV to sexual partners. This is known as U=U (Undetectable = Untransmittable). Staying on treatment consistently is key to achieving and maintaining an undetectable viral load.

Can I drink alcohol while taking Biktarvy?

There is no direct interaction between Biktarvy and alcohol. However, alcohol can affect your overall health and your ability to take medicines consistently. Speak to your doctor if you have concerns.

Do I have to take Biktarvy forever?

Currently, HIV treatment is lifelong. Stopping treatment allows the virus to replicate again. However, HIV medicines continue to improve, and your doctor will review your treatment regularly to make sure you are on the best option available to you.

Ace provides accurate and independent information medically reviewed on prescription medications. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.