Appendix C: Antiretroviral Medications That Can Be Switched Temporarily If Unable to Access Certain Formulations
Clinicians are encouraged to consult an HIV specialist with additional questions about regimen switches, if needed. Many drugs that are used to treat HIV have significant interactions with other drugs that are used to treat HIV or other conditions. Before making changes to an HIV drug regimen or prescribing any new medicine to a person on antiretroviral therapy, evaluate the new medication for drug–drug interactions with concomitant medications. Some antiretroviral drugs may require dosage adjustment in people with renal insufficiency (see Appendix B, Table 12 in the Adult and Adolescent Antiretroviral Guidelines for more information).
| Brand (Generic Names) | Replace With – Brand (Generic1) Names |
|---|---|
| Efavirenz + tenofovir DF + emtricitabine (generic single tablet regimen) | Generic efavirenz + Truvada (tenofovir DF + emtricitabine2) or Generic efavirenz + Descovy (tenofovir alafenamide + emtricitabine) or Generic (efavirenz + tenofovir DF + lamivudine) single-tablet regimen |
| Biktarvy (bictegravir + tenofovir alafenamide + emtricitabine) | Tivicay (dolutegravir) + Descovy (tenofovir alafenamide + emtricitabine) or Tivicay (dolutegravir) + Truvada (tenofovir DF + emtricitabine2) |
| Cabenuva (cabotegravir + rilpivirine) (IM formulation) | Vocabria (PO cabotegravir) + Edurant (PO rilpivirine) or Note: Vocabria is not commercially available and must be accessed directly from the manufacturer. Tivicay (dolutegravir) + Edurant (PO rilpivirine) |
| Cimduo (tenofovir DF + lamivudine) | Truvada (tenofovir DF + emtricitabine2) or Descovy (tenofovir alafenamide + emtricitabine) |
| Complera (rilpivirine + tenofovir DF + emtricitabine) | Edurant (rilpivirine) + Truvada (tenofovir DF + emtricitabine2) or Edurant (rilpivirine) + Descovy (tenofovir alafenamide + emtricitabine) or Odefsey (rilpivirine + tenofovir alafenamide + emtricitabine) |
| Descovy (tenofovir alafenamide + emtricitabine) | Vemlidy (tenofovir alafenamide) + Emtriva (emtricitabine) or Truvada (tenofovir DF + emtricitabine2) or Cimduo (tenofovir DF + lamivudine) or Viread (tenofovir DF) + Emtriva (emtricitabine) or Viread (tenofovir DF) + Epivir (lamivudine) 300 mg |
| Abacavir + lamivudine (generic single tablet regimen) | Generic abacavir + Epivir (lamivudine) (as individual tablets) or Abacavir + lamivudine (as individual generic tablets) or Generic abacavir + Emtriva (emtricitabine) (as individual tablets) |
| Evotaz (atazanavir + cobicistat) | Reyataz (atazanavir) + Tybost (cobicistat) or Reyataz (atazanavir) + Norvir (ritonavir) 100 mg |
| Genvoya (elvitegravir + cobicistat + tenofovir alafenamide + emtricitabine) | Stribild (elvitegravir + cobicistat + tenofovir DF + emtricitabine) (only if CrCl >70 mL/min; Consult an HIV expert if CrCl <70 mL/min), or Biktarvy (bictegravir + tenofovir alafenamide + emtricitabine) or Tivicay (dolutegravir) + Descovy (tenofovir alafenamide + emtricitabine) |
| Isentress HD (raltegravir once-daily formulation—two 600-mg tablets per day) | Isentress (raltegravir) 400 mg twice daily or Tivicay (dolutegravir) If the person is on Isentress HD + Descovy, they can switch to Biktarvy (bictegravir + tenofovir alafenamide + emtricitabine). |
| Juluca (dolutegravir + rilpivirine) | Tivicay (dolutegravir) + Edurant (rilpivirine) |
| Odefsey (rilpivirine + tenofovir alafenamide + emtricitabine) | Edurant (rilpivirine) + Descovy (tenofovir alafenamide + emtricitabine) or Edurant (rilpivirine) + Truvada (tenofovir DF + emtricitabine2) or Complera (rilpivirine + tenofovir DF + emtricitabine) |
| Prezcobix (darunavir + cobicistat) | Prezista (darunavir) + Tybost (cobicistat) or Prezista (darunavir) + Norvir (ritonavir) 100 mg |
| Stribild (elvitegravir + cobicistat + tenofovir DF + emtricitabine) | Genvoya (elvitegravir + cobicistat + tenofovir alafenamide + emtricitabine) or Biktarvy (bictegravir + tenofovir alafenamide + emtricitabine) or Tivicay (dolutegravir) + Descovy (tenofovir alafenamide + emtricitabine) |
| Symfi (efavirenz + tenofovir DF + lamivudine) | Generic (efavirenz + tenofovir DF + emtricitabine) single-tablet regimen or Generic efavirenz + Truvada (tenofovir DF + emtricitabine2) or Generic efavirenz + Descovy (tenofovir alafenamide + emtricitabine) |
| Symtuza (darunavir + cobicistat + tenofovir alafenamide + emtricitabine) | Prezcobix (darunavir + cobicistat) + Descovy (tenofovir alafenamide + emtricitabine) or Prezista (darunavir) + Tybost (cobicistat) + Descovy (tenofovir alafenamide + emtricitabine) or Prezista (darunavir) + Norvir (ritonavir) 100 mg + Descovy (tenofovir alafenamide + emtricitabine) |
| Triumeq (dolutegravir + abacavir + lamivudine) | Tivicay (dolutegravir) + Epzicom (abacavir + lamivudine3) or Tivicay (dolutegravir) + generic abacavir + Epivir (lamivudine) |
1 Generic versions of stand-alone abacavir, atazanavir, efavirenz, emtricitabine, lamivudine, darunavir, ritonavir, and tenofovir DF are commercially available. 2 Generic fixed-dose combinations of tenofovir DF/emtricitabine are commercially available. 3 Generic fixed-dose combinations of abacavir/lamivudine are commercially available. | |
| Key: CrCl = creatinine clearance; DF = disoproxil fumarate; HD = high dose; IM = intramuscular; PO = oral | |
| Brand (Generic Names) | Replace With – Brand (Generic1) Names |
|---|---|
| Atripla (efavirenz + tenofovir DF + emtricitabine) | Generic (efavirenz + tenofovir DF + emtricitabine) single-tablet regimen or Sustiva (efavirenz) + Truvada (tenofovir DF + emtricitabine2) or |
| Biktarvy (bictegravir + tenofovir alafenamide + emtricitabine) | Tivicay (dolutegravir) + Descovy (tenofovir alafenamide + emtricitabine) or Tivicay (dolutegravir) + Truvada (tenofovir DF + emtricitabine2) |
| Cabenuva (cabotegravir + rilpivirine) (IM formulation) | Vocabria (PO cabotegravir) + Edurant (PO rilpivirine) or Note: Vocabria is not commercially available and must be accessed directly from the manufacturer. Tivicay (dolutegravir) + Edurant (PO rilpivirine) |
| Cimduo (tenofovir DF + lamivudine) | Truvada (tenofovir DF + emtricitabine2) or Descovy (tenofovir alafenamide + emtricitabine) |
| Complera (rilpivirine + tenofovir DF + emtricitabine) | Edurant (rilpivirine) + Truvada (tenofovir DF + emtricitabine2) or Edurant (rilpivirine) + Descovy (tenofovir alafenamide + emtricitabine) or Odefsey (rilpivirine + tenofovir alafenamide + emtricitabine) |
| Descovy (tenofovir alafenamide + emtricitabine) | Vemlidy (tenofovir alafenamide) + Emtriva (emtricitabine) or Truvada (tenofovir DF + emtricitabine2) or Cimduo (tenofovir DF + lamivudine) or Viread (tenofovir DF) + Emtriva (emtricitabine) or Viread (tenofovir DF) + Epivir (lamivudine) 300 mg |
| Epzicom (abacavir + lamivudine) | Generic (abacavir + lamivudine3) or Ziagen (abacavir) + Epivir (lamivudine) |
| Evotaz (atazanavir + cobicistat) | Reyataz (atazanavir) + Tybost (cobicistat) or Reyataz (atazanavir) + Norvir (ritonavir) 100 mg |
| Genvoya (elvitegravir + cobicistat + tenofovir alafenamide + emtricitabine) | Stribild (elvitegravir + cobicistat + tenofovir DF + emtricitabine) (only if CrCl >70 mL/min; Consult an HIV expert if CrCl <70 mL/min), or Biktarvy (bictegravir + tenofovir alafenamide + emtricitabine) or Tivicay (dolutegravir) + Descovy (tenofovir alafenamide + emtricitabine) |
| Isentress HD (raltegravir once-daily formulation—two 600-mg tablets per day) | Isentress (raltegravir) 400 mg twice daily or Tivicay (dolutegravir) If the person is on Isentress HD + Descovy, they can switch to Biktarvy (bictegravir + tenofovir alafenamide + emtricitabine). |
| Juluca (dolutegravir + rilpivirine) | Tivicay (dolutegravir) + Edurant (rilpivirine) |
| Odefsey (rilpivirine + tenofovir alafenamide + emtricitabine) | Edurant (rilpivirine) + Descovy (tenofovir alafenamide + emtricitabine) or Edurant (rilpivirine) + Truvada (tenofovir DF + emtricitabine2) or Complera (rilpivirine + tenofovir DF + emtricitabine) |
| Prezcobix (darunavir + cobicistat) | Prezista (darunavir) + Tybost (cobicistat) or Prezista (darunavir) + Norvir (ritonavir) 100 mg |
| Stribild (elvitegravir + cobicistat + tenofovir DF + emtricitabine) | Genvoya (elvitegravir + cobicistat + tenofovir alafenamide + emtricitabine) or Biktarvy (bictegravir + tenofovir alafenamide + emtricitabine) or Tivicay (dolutegravir) + Descovy (tenofovir alafenamide + emtricitabine) |
| Symfi (efavirenz + tenofovir DF + lamivudine) | Atripla (efavirenz + tenofovir DF + emtricitabine) or Generic (efavirenz + tenofovir DF + emtricitabine) single-tablet regimen or Sustiva (efavirenz) + Truvada (tenofovir DF + emtricitabine2) or Sustiva (efavirenz) + Descovy (tenofovir alafenamide + emtricitabine) |
| Symtuza (darunavir + cobicistat + tenofovir alafenamide + emtricitabine) | Prezcobix (darunavir + cobicistat) + Descovy (tenofovir alafenamide + emtricitabine) or Prezista (darunavir) + Tybost (cobicistat) + Descovy (tenofovir alafenamide + emtricitabine) or Prezista (darunavir) + Norvir (ritonavir) 100 mg + Descovy (tenofovir alafenamide + emtricitabine) |
| Triumeq (dolutegravir + abacavir + lamivudine) | Tivicay (dolutegravir) + Epzicom (abacavir + lamivudine3) or Tivicay (dolutegravir) + Ziagen (abacavir) + Epivir (lamivudine) |
1 Generic versions of stand-alone abacavir, atazanavir, efavirenz, emtricitabine, lamivudine, darunavir, ritonavir, and tenofovir DF are commercially available. 2 Generic fixed-dose combinations of tenofovir DF/emtricitabine are commercially available. 3 Generic fixed-dose combinations of abacavir/lamivudine are commercially available. | |
| Key: CrCl = creatinine clearance; DF = disoproxil fumarate; HD = high dose; IM = intramuscular; PO = oral | |
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