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PrEP

Side-by-side comparison: Truvada and Descovy for PrEP

There are now two medications approved by the U.S. Food and Drug Administration (FDA) for PrEP: Truvada and Descovy. If you have questions about which medication might be right for you, take a look at the similarities and differences between the two medications, below.

It’s important to note that although Descovy is a newer medication, it’s not necessarily “better” or “safer” than Truvada. Truvada has been available for many more years than Descovy, and we have substantially more data to support its use when compared to Descovy.

Truvada Descovy
Effectiveness Effectiveness
>99% effective >99% effective
Regimen Regimen
Daily use & PrEP 2-1-1 Daily use (Although Descovy for PrEP 2-1-1 is being studied, there is inadequate clinical data to support this regimen now)
Shown to be effective for Shown to be effective for
Everyone, including:

  • Gay & bisexual cis men
  • Trans women
  • Trans men
  • Heterosexuals
  • Cis women
  • People who inject drugs
Only:

  • Gay & bisexual cis men
  • Trans women

(No clinical data to support use in people who may be exposed to HIV through injection drug use or vaginal sex)

Safety: general Safety: general
Both medicines have very low rates of side effects overall. Some people experience “start-up” symptoms including diarrhea, nausea and vomiting, which usually resolve in the first three months of PrEP use. Both medicines have very low rates of side effects overall. Some people experience “start-up” symptoms including diarrhea, nausea and vomiting, which usually resolve in the first three months of PrEP use.
Bone health Bone health
People with osteoporosis should avoid Safer to take for people with osteoporosis
Kidney health Kidney health
People with kidney issues or a strong family history of kidney disease should avoid Safer to take for people with kidney issues or a strong family history of kidney disease, though monitoring still recommended
Weight loss/gain Weight loss/gain
May cause a small degree of weight loss1 May cause a small degree of weight gain2
Cholesterol Cholesterol
May cause small decreases in HDL, LDL and total cholesterol1 May cause small increases in LDL cholesterol and triglycerides2,3
Cost Cost
Same cost ($1,845/month without insurance)
Generic version may be available in 2020
Same cost ($1,845/month without insurance)
Insurance Insurance
Covered by insurance Likely covered by insurance
Assistance programs Assistance programs
Covered by assistance programs for medication and medical care costs Covered by assistance programs for medication and medical care costs
Pill size Pill size
Larger pill than Descovy Smaller pill than Truvada

Medical review by Janessa Broussard, NP, November 2019. 

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