Idvynso (Doravirine/Islatravir) for HIV

Idvynso (doravirine/islatravir) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat human immunodeficiency virus type 1 (HIV-1) infection in adults.

How Idvynso Works and How It’s Taken

Idvynso is a type of human immunodeficiency virus (HIV) medicine called an antiretroviral. It contains two drugs that block an enzyme called reverse transcriptase. HIV needs this enzyme to make copies of itself.

In HIV-1 infection, this helps reduce the amount of virus in the body.

Doctors prescribe Idvynso for adults with HIV-1 whose virus is already under control. This means their viral load is less than 50 copies per milliliter. It is used to replace their current HIV treatment.

Idvynso is only for people who have not experienced treatment failure and who do not have HIV that is resistant to doravirine.

Idvynso is taken as a tablet by mouth once a day. It can be taken with or without food.

Typical Dosing for HIV

The usual dose is one tablet each day. If rifabutin is also taken, the Idvynso dose stays the same. A separate 100-milligram doravirine tablet should be taken about 12 hours after Idvynso during rifabutin treatment.

This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.

Idvynso Side Effects

In clinical trials of adults with HIV-1 who switched to Idvynso while already virologically suppressed, the most common side effects occurred in about 2 percent to 3 percent of people. These include:

Diarrhea
Dizziness
Fatigue (feeling unusually tired)
Abdominal distension (bloating)
Headache
Weight gain

Serious Side Effects and Warnings

Idvynso can cause serious side effects that require immediate medical attention. These include:

Stevens-Johnson syndrome — This is a severe skin reaction that may cause a painful or worsening rash, sores in the mouth or eyes, or fever.
Toxic epidermal necrolysis — This is a severe skin reaction that may cause a painful or worsening rash, sores in the mouth or eyes, or fever.
Drug reaction with eosinophilia and systemic symptoms (DRESS) — This is a severe allergic-type reaction that may cause a rash with swollen lymph nodes, eosinophilia, or organ involvement.
Severe immune thrombocytopenia — This is a serious immune-related platelet disorder. In one clinical trial, a single case occurred 32 days after starting Idvynso and involved subcutaneous hematoma, petechiae, and hematuria.

Get medical help right away if you think you are having a serious reaction.

How To Save on Idvynso

Merck, the manufacturer of Idvynso, offers the Merck Access Program for Idvynso. Eligible people with commercial insurance may receive copay assistance.

The Merck Access Program for Idvynso also provides information about insurance coverage, out-of-pocket costs, and ways to access Idvynso through the program. To learn more, visit the Merck Access Program for Idvynso or call 877-709-4455.

What To Know Before Taking Idvynso

Tell your doctor if you have any allergies to doravirine/islatravir or any ingredients in Idvynso.

Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.

Do not take Idvynso with certain medicines. These include:

Strong CYP3A enzyme inducers
Lamivudine (3TC) or emtricitabine (FTC)

Because Idvynso is a complete HIV treatment, do not take it with other HIV medicines unless your doctor tells you to.

Tell your doctor if you have or have had hepatitis B (HBV) infection. Idvynso does not treat HBV, and your doctor may need to monitor you or give you other treatment.

If you miss a dose of Idvynso, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the next dose at your regular time.

If you are pregnant, planning to become pregnant, or breastfeeding while taking Idvynso, talk with your doctor about the risks and benefits.

There is an Antiretroviral Pregnancy Registry (APR) for people who take Idvynso during pregnancy. To learn more, visit the Antiretroviral Pregnancy Registry or call 800-258-4263.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Idvynso?
In two 48-week studies, Idvynso was studied in adults whose HIV was already under control. After switching to Idvynso, most people kept their virus at very low levels (below 50 copies per milliliter). In one study, 96 percent of people did, and in the other study, 92 percent did.

In one study, 1 percent of people taking Idvynso had higher virus levels after 48 weeks. This happened in 5 percent of people who stayed on their previous HIV treatment.

In the other study, 1 percent of people taking Idvynso and 1 percent of people taking another HIV treatment (bictegravir, emtricitabine, and tenofovir alafenamide) had higher virus levels after 48 weeks.

How long does Idvynso take to work for HIV?
Idvynso is used in people whose HIV is already under control. Because of this, it is not meant to lower the virus quickly, but to keep it at low levels.

In studies, doctors looked at how well Idvynso kept the virus controlled over 48 weeks after people switched to it. The study report does not say exactly how long it takes to “start working.”

What tests or monitoring are needed with Idvynso for HIV?
There is no set schedule of lab tests listed for everyone taking Idvynso. Your doctor will decide what tests you need. People who also have hepatitis B need close monitoring.

This is important if they switch to Idvynso from a treatment that also worked against hepatitis B, or if they are newly diagnosed with hepatitis B. Doctors should also check for drug interactions and watch for side effects during treatment.

If a serious rash or allergic reaction happens, your doctor will closely monitor your condition and may stop the medicine.