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Descovy® vs. Truvada®: What Are The Differences?

If you’ve looked into medications for preventing and treating HIV, you’ve likely seen two names mentioned: Descovy® and Truvada®.

Descovy and Truvada are antiretroviral medications used to treat HIV. They’re approved by the FDA for use as treatments for HIV-1 infection, and as medications for HIV pre-exposure prophylaxis (PrEP), or HIV prevention.

As HIV treatments and PrEP drugs, Descovy and Truvada contain similar active ingredients and work in similar ways to treat and prevent HIV. 

However, there are a few key differences between these medications that you'll want to know before using either for PrEP or HIV treatment.

Below, we’ve explained how medications like Descovy and Truvada work, as well as the biggest differences between the two medications.

We’ve also shared what you need to know to safely and effectively use either medication as part of PrEP, or to treat HIV.

What Is Truvada?

Truvada is a prescription medication that’s used to prevent and treat human immunodeficiency virus (HIV). 

Truvada is made up of two ingredients: emtricitabine and tenofovir disoproxil fumarate. 

Both of these ingredients are antiretroviral agents that work by blocking pathways used by the HIV virus to spread throughout your body.

The FDA approved Truvada in 2004 as a treatment for HIV infection in combination with other drugs. Eight years later, in 2012, the FDA approved Truvada as a PrEP medication for use in people at risk of acquiring HIV through sex or the use of an injection drug.

Truvada was developed and launched by Gilead Sciences, Inc. In 2017, the FDA approved a generic version of the medication containing the same active ingredients for use in the United States.

What Is Descovy?

Descovy is a prescription medication that’s used to prevent and treat HIV infection. It contains the active ingredients emtricitabine and tenofovir alafenamide.

Like Truvada, Descovy is produced by Gilead Sciences, Inc. It’s a newer medication that was first approved by the FDA in 2016 as a treatment for HIV infection, then was later approved in 2019 as a medication for PrEP. 

Descovy vs. Truvada: Major Differences

Truvada and Descovy are similar medications. Both are effective at treating and preventing HIV infection. 

However, there are a few key differences that are important to consider if you need to use either medication to treat or prevent HIV.

The main difference between Truvada and Descovy is the form of the active ingredient tenofovir that’s used in each medication.

Truvada contains the active ingredient ​​tenofovir disoproxil fumarate, or TDF. ​​Tenofovir disoproxil fumarate belongs to a class of medications called nucleoside reverse transcriptase inhibitors, or NRTIs. It works by reducing the amount of HIV in your blood.

Tenofovir disoproxil fumarate doesn’t cure HIV. However, when it’s used with other forms antiretroviral therapy, it can reduce your risk of acquiring HIV or developing acquired immunodeficiency syndrome (AIDS).

Truvada is safe and effective for most people. It’s shown to be effective for gay and bisexual cisgender men, cisgender women, transgender women, transgender men, heterosexuals and people who use injectable drugs.

Due to its ingredient profile, Truvada should not be taken by people with osteoporosis or people with kidney health issues or a family history of kidney disease.

Descovy contains a newer form of the ingredient tenofovir, called tenofovir alafenamide. This is a prodrug that converts to tenofovir inside the body. 

As a newer medication for PrEP and HIV infection, Descovy is just as effective at stopping HIV infection and treating HIV as Truvada. 

However, it’s currently only shown to be effective for gay and bisexual cis men and trans women.

Descovy is also a  safer option for people with kidney issues, a history of kidney disease or bone health issues such as osteoporosis.

Which Medication Is More Effective?

Truvada and Descovy are similar medications. Both drugs are effective at preventing infection and treating HIV, with research noting that Truvada and Descovy have similar safety profiles, efficacy and tolerability. 

Although it contains a newer form of tenofovir, there’s no scientific evidence that Descory offers greater protection against HIV infection than Truvada.

Descovy and Truvada Side Effects

Overall, Descovy and Truvada both have low rates of side effects. You may experience initial side effects such as nausea, vomiting and diarrhea when you first start using either medication for PrEP. These side effects usually improve over the course of a few months.

In clinical trials of Descovy and Truvada, PrEP users (people without HIV infection) reported the following side effects:

  • Diarrhea was reported by 5% of Descovy users and 6% of Truvada users.
  • Nausea was reported by 4% of Descovy users and 5% of Truvada users.
  • Headache was reported by 2% of Descovy users and 2% of Truvada users.
  • Fatigue was reported by 2% of Descovy users and 3% of Truvada users.
  • Gastrointestinal or abdominal pain was reported by 2% of Descovy users and 3% of Truvada users.

Overall, rates of most side effects are very similar between the two medications. Other potential side effects of Descovy and Truvada include depression, anxiety, heartburn, changes in weight, difficulty sleeping and pain, tingling or a burning sensation that affects your hands or feet.

Descovy may cause a small degree of weight gain, as well as a mild increase in LDL cholesterol and triglycerides. 

Truvada may cause a small degree of weight loss, as well as a mild decrease in HDL, LDL and other lipid components.

It’s important to tell your healthcare provider if you develop any severe or persistent side effects after using PrEP options.

Descovy and Truvada may cause a decrease in bone mineral density. If you have or have ever had a bone health problem, such as osteoporosis, bone fracture or bone density issues, it’s important to tell your healthcare provider before using either medication for PrEP or to treat HIV infection.

Before treatment and while using Descovy or Truvada, your healthcare provider may carry out a blood test to check your liver function, renal function, general health and response to treatment.

Descovy vs. Truvada: Costs and Insurance Coverage

Without health insurance, Descovy and Truvada both cost approximately $2,000 per month. You may be able to receive PrEP medication at a discounted rate or for free if you:

  • Have health insurance. PrEP medications are covered by most health insurance plans and Medicaid programs.

  • Qualify for free PrEP medications. Programs such as Ready, Set, PrEP provide free HIV-prevention medications to people without adequate health insurance coverage.

  • Are eligible for Gilead's Advancing Access® program. This program offers co-pay support for people without adequate health insurance coverage.

  • Live in a state with a PrEP assistance program. Several states provide assistance programs to improve access to PrEP medications such as Descovy and Truvada.

Recently, a generic version of Truvada sold by Teva Pharmaceuticals has come onto the market in the United States. This medication contains the same ingredients as Truvada, but is available at a reduced monthly cost.

Descovy vs Truvada

Descovy and Truvada are both effective at preventing and treating HIV. Your healthcare provider may prescribe these medications for PrEP, or in combination with other medications to treat HIV infection if you’ve tested positive for HIV.

If you have kidney or bone health problems such as osteoporosis, your healthcare provider may prescribe Descovy instead of Truvada.

Regardless of which medication you’re prescribed, it’s important to take your medication exactly as prescribed. 

When it comes to PrEP, consistent daily use is the key to reducing your risk and keeping yourself protected from HIV. 

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.