If you have HIV, your doctor might suggest Biktarvy as a treatment option. It’s a prescription drug used to treat HIV-1 (the most common form of HIV) in adults and some children.

Specifically, this drug is used:

  • if you haven’t taken any antiretroviral medications (a kind of HIV drug) before, or
  • to change your current HIV treatment in certain circumstances

Biktarvy is a complete HIV treatment, which means you don’t need to take other HIV medications with it. It contains three active ingredients: bictegravir, emtricitabine, and tenofovir alafenamide. (An active ingredient is what makes a drug work.)

Biktarvy comes as a tablet you swallow. It’s used as a long-term treatment for HIV.

For more information about Biktarvy, including details about its uses, see this in-depth article.

Like other drugs, Biktarvy can cause mild to serious side effects (also called adverse effects). Keep reading to learn more.

Some people may experience mild to serious side effects during treatment with Biktarvy. Listed below are some examples of the drug’s commonly reported side effects. But these are not all the possible side effects of Biktarvy.

Some common side effects include:

  • nausea
  • diarrhea
  • headache
  • fatigue (low energy)

These are just a few of the more common side effects reported by people in studies of Biktarvy.

Biktarvy may cause some mild side effects.

Examples that have been reported with this drug include:

* To learn more about this side effect, see the “Side effects explained” section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop taking Biktarvy unless your doctor recommends it.

Biktarvy may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Biktarvy, visit MedWatch.

Biktarvy may cause serious side effects, but they’re usually less common than mild ones.

Serious side effects that have been reported with Biktarvy include:

* To learn more, see the “Side effects explained” section below.
† Biktarvy has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.
‡ An allergic reaction is possible after using Biktarvy. But this side effect wasn’t reported in studies.

Serious side effects with Biktarvy may be more likely if you have certain health conditions. See the “Warnings for Biktarvy” section below for more information.

If you develop serious side effects while taking Biktarvy, call your doctor right away. If they seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Get answers below to some frequently asked questions about Biktarvy’s side effects.

Does Biktarvy cause weight gain?

It’s possible. In a review of Biktarvy studies, it was found that certain people experienced weight gain when starting treatment. This was more common in the first 2 years of treatment with antiretroviral therapy in people who hadn’t had HIV treatment in the past.

One of the active ingredients* in Biktarvy is bictegravir, which is an integrase inhibitor. Studies have shown that some integrase inhibitors may cause weight gain in certain situations.

If you experience weight gain with Biktarvy, talk with your doctor. They’ll be able to suggest ways to manage your weight while taking this drug.

* An active ingredient is what makes a drug work.

Are there any long-term side effects of Biktarvy?

Yes. Biktarvy may cause long-term side effects, but they’re not common.

Long-term side effects include:

* To learn more, see the “Side effects explained” section below.
† Biktarvy has a boxed warning for this side effect. This is the most serious warning from the Food and Drug Administration (FDA). To learn more, see the “Side effects explained” section below.

Long-term side effects may begin during treatment with Biktarvy. And in some cases, they may continue after treatment ends.

If you have ongoing side effects while taking Biktarvy, talk with your doctor. They’ll determine whether you need to stop taking it and switch to a different HIV medication instead.

Do not stop taking Biktarvy without first talking with your doctor. Suddenly stopping this drug can cause serious side effects if you have certain conditions. (See “Side effects explained” below for more information.)

Your doctor will monitor you for worsening of certain conditions if you stop taking Biktarvy.

Does Biktarvy cause neuropathy?

No. Neuropathy (nerve damage) wasn’t reported in studies of the drug. Some symptoms of neuropathy include:

  • tingling in the hands or feet
  • trouble walking (balance or coordination problems)
  • muscle cramps
  • painful burning sensations in your hands or feet

If you experience symptoms of neuropathy, talk with your doctor. They’ll discuss possible causes with you and suggest ways to help manage your symptoms.

Will I have hair loss from Biktarvy?

No, this wasn’t a side effect reported in studies of the drug.

But Biktarvy contains the active ingredients* emtricitabine and tenofovir alafenamide. These belong to a group of drugs called nucleoside reverse transcriptase inhibitors (NRTIs). And there have been reports of hair loss with NRTIs.

If you have hair loss while taking Biktarvy, talk with your doctor. They’ll suggest ways to help manage this side effect.

* An active ingredient is what makes a drug work.

Learn more about some of the side effects Biktarvy may cause.

Risk of worsening hepatitis B

Biktarvy has a boxed warning for the risk of worsening hepatitis B. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

Biktarvy may lead to a worsening of hepatitis B in some people. You have an increased risk of worsening hepatitis B infection if you also have HIV and stop taking Biktarvy.

If you have both conditions, your doctor will monitor your liver function for several months if you stop taking Biktarvy. This is to make sure the hepatitis B infection isn’t becoming worse. If it is, you may need treatment for it.

For more details on this serious side effect, see the prescribing information or talk with your doctor or pharmacist.

What might help

Your doctor will check whether you have hepatitis B infection before you begin treatment with Biktarvy. Do not stop taking Biktarvy if you have both HIV and hepatitis B. This could increase your risk of serious liver damage from worsening hepatitis B.

If you have both infections and need to stop taking Biktarvy, your doctor will monitor your liver function for several months after you stop treatment. This is to make sure the hepatitis B infection isn’t worsening.

You may need treatment for hepatitis B infection if your condition worsens after you stop Biktarvy.

Skin rash

Biktarvy may cause a skin rash in some people. But this wasn’t very common in the drug’s studies.

What might help

If you develop a rash while taking Biktarvy, tell your doctor. If it’s a mild rash, they may recommend an antihistamine such as Benadryl (diphenhydramine). They may also recommend hydrocortisone cream, which you apply to the affected areas of your skin.

But if you have a severe rash, this may be a sign of an allergic reaction to Biktarvy. You should call 911 or go to an emergency medical center immediately if you have this or other symptoms of a severe allergic reaction. These include trouble breathing and swelling under your skin or in your mouth or throat. (See “Allergic reaction” below for more information.)

New or worsening kidney problems

Biktarvy can cause new or worsening kidney problems, including kidney failure in some people. Taking certain other drugs that also affect your kidneys may increase your risk of kidney problems from Biktarvy. Tell your doctor about all the medications you take and whether you have a history of kidney disease.

Symptoms of kidney problems include issues with urination, such as:

What might help

Your doctor will check your kidney function before you start Biktarvy and will monitor it throughout your treatment. If you develop signs of kidney problems, they’ll determine whether this drug is right for you based on the severity of your symptoms. In some cases, they’ll have you stop Biktarvy and will recommend an alternative that’s safer for you.

Lactic acidosis

Biktarvy may cause a serious reaction known as lactic acidosis. This is when your body has too much lactic acid and can’t get rid of it. This can be life threatening in certain cases.

Symptoms of lactic acidosis include:

What might help

Tell your doctor if you have liver or kidney problems. These organs remove Biktarvy from your body. If they’re not functioning properly, lactic acid can build up in your system. This can increase your risk of developing lactic acidosis.

Your doctor will monitor your liver and kidney function before you start Biktarvy and during your treatment. But if you experience symptoms of lactic acidosis, call 911 or your local emergency number immediately.

Allergic reaction

Like most drugs, Biktarvy can cause an allergic reaction in some people. In studies of the drug, some people developed a rash, which may be a sign of an allergic reaction. But this wasn’t a common side effect of Biktarvy.

Symptoms of an allergic reaction can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor. They may recommend an over-the-counter medication to help manage your symptoms. These include:

  • Benadryl (diphenhydramine)
  • hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Biktarvy, they’ll decide whether you should continue taking it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Biktarvy, they’ll likely switch you to a different HIV treatment.

Keeping track of side effects

During your Biktarvy treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Biktarvy affects you. They can then use this information to adjust your treatment plan if needed.

Below are several warnings about Biktarvy. This drug may not be suitable for you in certain situations. Your doctor will determine whether it’s the right treatment option for you based on your health.

Boxed warning: Risk of worsening hepatitis B

Biktarvy has a boxed warning for the risk of worsening hepatitis B. A boxed warning is the most serious warning from the Food and Drug Administration (FDA).

If you have both HIV and hepatitis B, taking Biktarvy may worsen the hepatitis B if Biktarvy is stopped.

To learn more, see the “Side effects explained” section above.

Other warnings

Biktarvy may not be right for you if you have certain medical conditions. These are known as drug-condition interactions. Other factors may also affect whether Biktarvy is the right treatment option for you. Talk with your doctor about your health history before starting this drug. Factors to consider include those described below.

Allergic reaction. If you’ve had an allergic reaction to Biktarvy or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other medications that might be better options.

Liver problems. Biktarvy may cause liver problems. Tell your doctor if you’ve had hepatitis or have a history of liver disease. They’ll monitor your liver function before you start Biktarvy and throughout your treatment with the drug. If you have hepatitis B, your doctor will continue monitoring your liver function for several months after you stop taking Biktarvy.

Kidney problems. Biktarvy can cause new or worsening kidney problems. Tell your doctor if you have a history of kidney problems. They’ll monitor your kidney function before you start Biktarvy and throughout your treatment with this drug.

Depression or certain mental health conditions. Biktarvy may not be right for you if you have certain mental health conditions. If you have a history of depression or suicidal thoughts or behaviors, be sure to tell your doctor. They’ll likely discuss other treatment options that might be a better fit for you. And if you experience new or worsening mental health conditions while taking Biktarvy, tell your doctor right away.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

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Alcohol and Biktarvy

Drinking alcohol while taking Biktarvy may increase your risk of certain side effects. These include:

If you drink alcohol and plan to drink it while taking Biktarvy, ask your doctor what amount, if any, is safe.

Pregnancy and breastfeeding while taking Biktarvy

It’s not known if Biktarvy is safe to take during pregnancy. Your doctor can discuss possible risks with you. They can also sign you up for the Biktarvy pregnancy registry, which allows healthcare professionals to collect information about the drug’s safety during pregnancy.

Biktarvy passes into breast milk, so you should not take it while breastfeeding. The Centers for Disease Control and Prevention (CDC) recommend that people with HIV avoid breastfeeding. This is because breastfeeding increases the risk of transmitting HIV infection to a baby.

Talk with your doctor about the healthiest options for feeding your child.

Biktarvy is a prescription drug used to treat HIV. It can cause mild to serious side effects. Reactions to this drug can vary depending on your age, other medical conditions you may have, and other medications you take.

If you have questions about side effects from Biktarvy, ask your doctor for more information. Here are some questions to get you started:

  • Is my risk of side effects from Biktarvy higher when I first start treatment?
  • At what point should I call my doctor about any side effects I experience?
  • Will taking Biktarvy with a vitamin increase my risk of side effects?

To learn more about Biktarvy, see these articles:

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline 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.