Symtuza (Darunavir/Cobicistat/Emtricitabine/Tenofovir Alafenamide) for HIV

What Members Say Top Tips Side Effects Copay Help FAQs

Symtuza (darunavir/cobicistat/emtricitabine/tenofovir alafenamide) 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 and children who weigh at least 40 kilograms.

What Members Say

MHT logo These insights are based on 145 comments about Symtuza from myHIVteam members. These are the experiences of a small number of people and are not meant to be medical advice.

Benefits:

Once-daily dosing in one pill feels simpler than multi-pill regimens.
Viral load often drops quickly, sometimes reaching undetectable within months.
Some switch to Symtuza to combine darunavir-based treatment into one tablet.

Considerations:

Diarrhea and loose stools are frequent concerns, especially after certain foods.
Nausea, stomach upset, and indigestion can start soon after beginning treatment.
Kidney and liver monitoring are important during treatment.

How Symtuza Works and How It’s Taken

Symtuza combines four medicines in one tablet: darunavir, cobicistat, emtricitabine, and tenofovir alafenamide.

These medicines work in different ways. Darunavir blocks an HIV-1 protein called protease, which helps stop the virus from making mature virus particles. Emtricitabine and tenofovir alafenamide block reverse transcriptase, an enzyme HIV-1 needs to copy itself. Cobicistat helps increase the amount of darunavir in the body. In HIV-1 infection, this helps reduce the amount of virus in the body.

Doctors prescribe Symtuza as a complete treatment for HIV-1 infection in adults and children who weigh at least 40 kilograms. It may be used in:

People who have never taken antiretroviral treatment before
People whose HIV-1 RNA is less than 50 copies per milliliter, who have been on a stable antiretroviral treatment for at least six months, and who have no known substitutions associated with resistance to darunavir or tenofovir

HIV-1 is the virus that causes acquired immune deficiency syndrome (AIDS).

Symtuza is taken by mouth once daily with food. If you cannot swallow the tablet whole, it may be split into two pieces with a tablet-cutter. Both pieces should be taken right away after splitting.

Typical Dosing for HIV

Each Symtuza tablet contains four medicines:

800 milligrams of darunavir
150 milligrams of cobicistat
200 milligrams of emtricitabine
10 milligrams of tenofovir alafenamide

The recommended dose of Symtuza is one tablet taken by mouth once daily with food for adults and children who weigh at least 40 kilograms.

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

Top Advice From Members on Symtuza

MHT logo These insights are based on 145 comments about Symtuza from myHIVteam members.

Members who use Symtuza often say that experiences can vary a lot, especially when it comes to side effects and how quickly lab results improve. Across the community, members most often encourage others to stay in close contact with their HIV care team, pay attention to stomach-related side effects, and keep up with regular dosing and follow-up blood work.

1

Keep track of food triggers if Symtuza upsets your stomach.
“It causes diarrhea if I eat any kind of greasy food. Almost like clockwork, about one hour after I eat anything greasy I’m running for the bathroom. Once I discovered which foods to avoid, it became much easier to be on it.”
2

Take Symtuza consistently and do not miss doses.
“I started on Symtuza and was undetectable in two months, and I have been ever since. That’s been a year ago now. Not missing any dose is the key.”
3

Check for drug interactions with every new medicine or supplement.
“I show my doctor everything I take, and thank God I do because supplements I was taking awhile back had ingredients that were not good with my Symtuza!”

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Symtuza Side Effects

In clinical studies of Symtuza, the most common side effects occurred in about 2 percent to 9 percent of people. These include:

Diarrhea
Rash
Nausea
Fatigue
Headache
Stomach discomfort
Flatulence (gas)

Serious Side Effects and Warnings

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

Worsening hepatitis B after stopping Symtuza — Hepatitis B can flare up and cause serious liver problems in people who have both HIV-1 and hepatitis B.
Liver problems, including drug-induced hepatitis — Liver inflammation can be severe.
Severe skin reactions — Serious rashes, including Stevens-Johnson syndrome, toxic epidermal necrolysis, and DRESS, can occur.
Immune reconstitution syndrome — Immune system changes can trigger inflammation as your body starts fighting infections.
New or worsening kidney problems — These problems can include kidney failure and Fanconi syndrome, a serious kidney tubule problem.
Lactic acidosis with severe liver enlargement and fatty liver — A serious buildup of lactic acid in the blood with liver injury can occur.
Diabetes and high blood sugar — New or worsening diabetes and high blood sugar can occur.
Changes in body fat distribution — Fat may build up or decrease in different parts of the body.
Increased bleeding in people with hemophilia — More bleeding than usual can occur, including into joints or under the skin.

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

How To Save on Symtuza

Johnson & Johnson, the manufacturer of Symtuza, offers the J&J withMe Savings Program. Eligible people with commercial insurance may pay as little as $0 per prescription fill.

The J&J withMe Savings Program also offers help understanding insurance coverage, enrolling in savings and treatment support, and managing program benefits.

To learn more, visit the J&J withMe Savings Program website or call 866-836-0114.

What To Know Before Taking Symtuza

Before starting Symtuza, your doctor will check or test for:

Hepatitis B virus infection
Kidney function, including serum creatinine and estimated creatinine clearance
Glucose and protein in your urine
Serum phosphorus if you have chronic kidney disease

Before taking Symtuza, tell your doctor if you:

Have liver problems, including hepatitis B or hepatitis C
Have kidney problems
Are allergic to sulfa, also called a sulfonamide
Have diabetes
Have hemophilia
Are pregnant or plan to become pregnant
Are breastfeeding or plan to breastfeed

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

Do not take Symtuza with certain medicines because serious problems can happen or Symtuza may not work as well. These include:

Alfuzosin
Carbamazepine
Phenobarbital
Phenytoin
Rifampin
Dronedarone
Ivabradine
Ranolazine
Lurasidone
Pimozide
Dihydroergotamine, ergotamine, or methylergonovine
St. John’s wort
Elbasvir/grazoprevir
Lomitapide
Lovastatin
Simvastatin
Naloxegol
Sildenafil (when used to treat pulmonary arterial hypertension)
Midazolam (when taken by mouth)
Triazolam

Do not take colchicine with Symtuza if you have kidney or liver problems.

Do not miss doses or let your supply of Symtuza run out. The amount of virus in your blood may increase, and the virus may become harder to treat.

Symtuza should not be started during pregnancy and is not recommended during pregnancy. If you become pregnant while taking Symtuza, tell your doctor. Your doctor will prescribe a different treatment.

A pregnancy registry tracks pregnancy outcomes in people exposed to Symtuza. Healthcare providers can register pregnancies by visiting the Antiretroviral Pregnancy Registry or calling 800-258-4263.

Do not breastfeed while taking Symtuza. You should not breastfeed if you have HIV-1 because HIV-1 can pass to your baby through breast milk. Emtricitabine, one of the medicines in Symtuza, can pass into breast milk. It is not known if the other medicines in Symtuza pass into breast milk.

Community FAQs

These answers are fact-checked by our editorial staff.

How effective is Symtuza for HIV?

In adults taking HIV treatment for the first time, 91 percent of people taking Symtuza had an HIV-1 RNA level below 50 copies per milliliter at 48 weeks. Their CD4-positive cell counts, a measure of immune system health, increased by an average of 189 cells per cubic millimeter. Virologic failure occurred in 4 percent of people taking Symtuza.

In adults who were already virologically suppressed and switched to Symtuza, 95 percent had an HIV-1 RNA level below 50 copies per milliliter at 48 weeks. Virologic failure occurred in 1 percent.

How long does Symtuza take to work for HIV?

The clinical studies measured results at 48 weeks, but they do not give an exact timeline for how quickly each person’s HIV-1 RNA level will improve. How fast Symtuza works can vary from person to person.

Can Symtuza be used with other medicines for HIV?

No. Symtuza is a complete HIV-1 treatment, so taking it with other antiretroviral medicines for HIV-1 is not recommended.

Symtuza can also interact with many other medicines. Some should not be taken with Symtuza at all, while others may need dose changes or closer monitoring. Tell your healthcare provider about all medicines and supplements you take.