Question explored with the scientific record
Conversation so far
- 1 Can I change from truvada to descovy on pep with raltegravir?
- 2 What dosage of descovy
Answered on this page ↓
What dosage of descovy
The short version: Descovy for HIV prevention is one tablet once a day, but the dose that matters for PEP is the same 200/25 mg tablet, and nothing here tested it as PEP.
Descovy is emtricitabine 200 mg plus tenofovir alafenamide 25 mg, and that is the dose the pharmacology studies used: the adherence study dosed healthy volunteers with the 25/200 mg tablet [2], and the renal safety trial used the same 200/25 mg combination, dropping to 10 mg only when a boosting drug was also given [3]. That last point is the one that touches your regimen. Raltegravir is not a booster, so the standard 25 mg stands.
The honest gap: no record here gives a PEP dosing schedule for Descovy, and the only PEP study with a TAF backbone used a completely different drug combination, elvitegravir/cobicistat/FTC/TAF, which is a single pill, not Descovy plus raltegravir [1]. The raltegravir PEP study used the older tenofovir, TDF, not TAF [4]. So the dose is well established; the use of it in your specific combination is not.
| Regimen in the records | TAF dose | Setting |
|---|---|---|
| Descovy (FTC/TAF) | 25 mg daily | adherence study, healthy volunteers [2] |
| FTC/TAF with a booster | 10 mg daily | renal safety trial [3] |
| EVG/c/FTC/TAF | fixed combination | PEP after sex [1] |
My call: take the standard 200/25 mg Descovy tablet once daily, and confirm the 28-day course and timing with whoever prescribed the raltegravir, because the exact pairing is not in these records. Confidence: moderate on the dose, low on the PEP-specific pairing.
Sources used 4
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Prophylaxis by doravirine-lamivudine-tenofovir disoproxil fumarate or elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide after sexual exposure to HIV
This retrospective observational study evaluates the completion rates and safety profiles of doravirine-lamivudine-tenofovir disoproxil fumarate (DOR/3TC/TDF) compared to elvitegravir-cobicistat-emtricitabine-tenofovir alafenamide (EVG/c/FTC/TAF) as post-exposure prophylaxis (PE…
DOI: 10.1186/s12879-023-08544-x -
Intracellular Tenofovir-Diphosphate and Emtricitabine-Triphosphate in Dried Blood Spots Following Tenofovir Alafenamide: The TAF-DBS Study
In a randomized crossover study of healthy volunteers, DBS TFV-DP and FTC-TP concentrations reflected TAF/FTC dosing frequency, distinguished 33%, 67%, and 100% adherence, approached steady state by week 10, and showed dose proportionality with slope greater than 1.
DOI: 10.1097/qai.0000000000002354 -
Early safety of tenofovir alafenamide in patients with a history of tubulopathy on tenofovir disoproxil fumarate: a randomized controlled clinical trial
In adults with HIV and previous TDF-associated proximal renal tubulopathy, 12 weeks of F/TAF produced no significant change in RBPCR or other renal and bone biomarkers compared with continuing tenofovir-sparing ART, and no PRT occurred.
DOI: 10.1111/hiv.12819 -
Raltegravir‐emtricitabine‐tenofovir as HIV nonoccupational post‐exposure prophylaxis in men who have sex with men: safety, tolerability and adherence
In a nonrandomized cohort of HIV-negative MSM, raltegravir-emtricitabine-tenofovir NPEP was well tolerated (92% completion, 89% adherence), with no HIV seroconversions, but grade 4 creatine kinase elevations occurred in 5 of 91 recipients.
DOI: 10.1111/hiv.12075