Truvada (emtricitabine/tenofovir disoproxil fumarate) and Descovy (emtricitabine/tenofovir alafenamide) are brand-name oral tablets. They’re both approved to treat and prevent HIV. Only Truvada is available as a generic.

This article explains the main similarities and differences between Truvada and Descovy. If you’re considering taking one of these drugs, discussing this information with your doctor can help you decide if one of these treatments may be right for you.

Note: For more comprehensive information about these two drugs, you can refer to our Truvada and Descovy articles.

Truvada contains two active ingredients: emtricitabine and tenofovir disoproxil fumarate. Descovy also contains two active ingredients: emtricitabine and tenofovir alafenamide.

Both Truvada and Descovy contain two active ingredients in one oral tablet. The first active ingredient, emtricitabine, is present in both drugs. The second active ingredient, tenofovir, differs slightly in each drug. But both drugs contain a version of tenofovir.

Truvada and Descovy belong to a class of medications known as nucleoside reverse transcriptase inhibitors (NRTIs). NRTIs are antiviral medications used to treat HIV. They block the action of key enzymes to stop HIV from multiplying and growing.

Truvada and Descovy are both approved by the Food and Drug Administration (FDA) to:

HIV treatment

Truvada and Descovy are approved to treat HIV in adults and children of a certain weight.

Doctors can prescribe Truvada to treat HIV in people who weigh at least 17 kilograms (kg), which is about 37 pounds (lb).

Doctors can prescribe Descovy to treat HIV in:

  • people who weigh at least 35 kg (about 77 lb) when used in combination with certain other HIV drugs
  • children who weigh at least 14 kg to less than 35 kg (about 31 lb to less than 77 lb) when used in combination with certain other HIV drugs

Truvada and Descovy are both approved to treat HIV in males and females.*

* Sex and gender exist on spectrums. Use of the terms “male” and “female” in this article refers to sex assigned at birth.

HIV prevention as PrEP

Truvada is approved for use as PrEP in adults and adolescents* who weigh at least 35 kg, which is about 77 lb. Descovy is approved for use as PrEP in adults and adolescents* who weigh 35 kg or more.

If you’re taking Truvada or Descovy for PrEP, you must not have HIV before and while you take the medication.

Truvada is approved for PrEP use in males and females. Descovy isn’t approved for use as PrEP in females at risk of contracting HIV through vaginal sex. The drug hasn’t been tested in this group of people in clinical trials.

Note: For more information about the drugs’ uses, see our articles about Truvada and Descovy.

* The term “adolescent” generally refers to children ages 12 years and older.

How much Truvada and Descovy cost depends on the treatment plan your doctor prescribes, your insurance plan, and your pharmacy. You can visit Optum Perks* for price estimates of Truvada and Descovy.

Both Truvada and Descovy are brand-name drugs. Truvada also comes in a generic form. Descovy isn’t currently available as a generic. Brand-name medications are often more expensive than generics. Talk with your doctor or pharmacist to learn about the generic form of Truvada.

* Optum Perks is a sister site of Medical News Today.

Both Truvada and Descovy are effective for the treatment and prevention of HIV. For HIV treatment, they’re used in combination with other approved antiviral medications.

If you experience bothersome side effects or have other concerns while taking Truvada or Descovy, your doctor may switch you from one medication to the other. There aren’t any special dosing instructions regarding this switch.

However, keep in mind that Truvada and Descovy aren’t interchangeable, so you shouldn’t mix doses. For example, you shouldn’t take one dose of Truvada, then one of Descovy, then one dose of Truvada.

It’s also important to know that both Truvada and Descovy are formulated to be effective for their approved uses. One drug isn’t considered better or more effective than the other. For more information, see the “Effectiveness of Truvada vs. Descovy” section below.

Truvada is available as a generic (emtricitabine/tenofovir disoproxil fumarate). This form likely costs less than Descovy, which is a brand-name drug. Generics are often less expensive than brand-name medications. Talk with your doctor about the best option for you.

Note: You shouldn’t switch medications on your own without first talking with your doctor.

Truvada and Descovy both come as oral tablets. Truvada tablets are larger than Descovy tablets. Both Truvada and Descovy contain two active ingredients per single pill.

Truvada and Descovy have one common active ingredient: emtricitabine. Both drugs also contain the active ingredient tenofovir but in different chemical forms. Truvada contains tenofovir disoproxil fumarate, while Descovy contains tenofovir alafenamide.

The strengths of Truvada are:

  • 100 milligrams (mg) emtricitabine/150 mg tenofovir disoproxil fumarate
  • 133 mg emtricitabine/200 mg tenofovir disoproxil fumarate
  • 167 mg emtricitabine/250 mg tenofovir disoproxil fumarate
  • 200 mg emtricitabine/300 mg tenofovir disoproxil fumarate

Descovy is available in two strengths:

  • 120 mg emtricitabine/15 mg tenofovir alafenamide
  • 200 mg emtricitabine/25 mg tenofovir alafenamide

You typically take Truvada and Descovy once daily. The dosage of either drug that your doctor prescribes for you will depend on your:

  • age
  • health conditions, such as kidney disease
  • weight

If you have kidney disease, liver disease, or another health condition that might increase your risk for side effects, your doctor may adjust your dosage.

Note: For more information about dosage, see our dosage articles about Truvada and Descovy.

Truvada and Descovy have similar ingredients, so these drugs can cause some of the same side effects. However, because they’re not exactly alike, there are also some different side effects. Some of these side effects are mentioned below. For more information about the side effects of these two drugs, see Truvada’s prescribing information and Descovy’s prescribing information.

Mild side effects

The following lists address a few common mild side effects of Truvada and Descovy, as well as some that both drugs share.

These side effects are usually temporary, lasting a few days or weeks. But if the side effects last longer than that, bother you, or become severe, be sure to talk with your doctor or pharmacist.

Serious side effects

The following lists address some serious side effects of Truvada and Descovy, as well as some that both drugs share.

If you have serious side effects while using Truvada or Descovy, call your doctor immediately. If the side effects feel life threatening or you believe you’re having a medical emergency, call 911 or your local emergency number right away.

Note: For more information about mild and serious side effects, see our side effects articles about Truvada and Descovy.

* There were no reported allergic reactions in the clinical trials of Truvada and Descovy. However, allergic reaction is a possibility with any medication. To learn about the symptoms, see this article.
† Truvada and Descovy have a boxed warning for the worsening of hepatitis B infection. A boxed warning is a more serious warning from the Food and Drug Administration (FDA). For details, see the “Warnings of Truvada and Descovy” section below.

A review of studies comparing Truvada with Descovy found that both drugs are effective in treating and preventing HIV. One study found that tenofovir alafenamide, an active ingredient in Descovy, caused fewer bone- and kidney-related problems than tenofovir disoproxil fumarate, an active ingredient in Truvada.

According to HIV treatment guidelines, experts consider Truvada and Descovy to be first-choice options when a person begins HIV treatment when used with another antiviral drug. An example of another antiviral drug is dolutegravir (Tivicay).

The Centers for Disease Control and Prevention (CDC) recommends both Truvada and Descovy as preexposure prophylaxis (PrEP) treatments. If your doctor prescribes either Truvada or Descovy, you will likely take the medication daily. These drugs may not be effective if you don’t take them every day.

Ask your doctor about the best treatment plan for you based on your medical history.

Truvada and Descovy may not be right for you if you have certain medical conditions or other factors that affect your health. This article refers to these as warnings. The two drugs share some of the same warnings, but they also have different ones. Some of these warnings are mentioned below.

Before you start using Truvada or Descovy, be sure to talk with your doctor to see if these warnings apply to you.

Boxed warnings for both Truvada and Descovy

Truvada and Descovy have boxed warnings. A boxed warning is the most serious warning from the Food and Drug Administration (FDA). The warning alerts doctors and patients about drug effects that may be dangerous.

Your doctor will do blood tests to monitor you before you start Truvada or Descovy and while you’re taking it.

  • Worsening of hepatitis B infection: If you have a hepatitis B infection and stop taking Truvada or Descovy, the infection could worsen. To help prevent this, you’ll typically have blood tests before, while, and after you use Truvada or Descovy. This allows your doctor to monitor your liver function. If necessary, they can treat the infection.
  • Resistance to treatment: To use either Truvada or Descovy for preexposure prophylaxis (PrEP), you must not have HIV before and while you take the medication. Your doctor will test to check whether you have HIV before you start taking Truvada or Descovy and at least every 3 months during use. If you do have HIV, you may develop viral resistance, which means that the drug may not work to prevent HIV.

Other warnings

In addition to boxed warnings, Truvada and Descovy have other warnings.

If any of the following medical conditions or other health factors are relevant to you, talk with your doctor before using Truvada or Descovy.

Note: For more information about these two drugs, view our Truvada and Descovy articles.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.