Symtuza is a fixed-dose combination tablet containing darunavir, cobicistat, tenofovir alafenamide and emtricitabine.

Darunavir is a protease inhibitor also marketed as Prezista and in combination with cobicistat as Rezolsta. Cobicistat is a drug used as a boosting agent to increase the effect of darunavir. Tenofovir alafenamide and emtricitabine are from a class of drugs known as NRTIs (nucleoside/nucleotide reverse transcriptase inhibitors). They are also marketed as the combination tablet Descovy and included in the combination tablets Odefsey, Genvoya and Biktarvy.

These drugs reduce the amount of HIV in the body, prevent the development of AIDS-defining illnesses and prevent HIV being passed on during sex when the viral load is undetectable.

Symtuza was approved in the United States in July 2018 and in the European Union in September 2017 for the treatment of HIV infection. Symtuza was approved on the basis of results from the EMERALD study. (Orkin)

Symtuza is taken as one yellow tablet once daily with food. Each tablet combines 800mg darunavir, 200mg emtricitabine and 10mg tenofovir alafenamide, along with 150mg cobicistat.

Common side-effects of Symtuza include headache, diarrhoea, nausea (feeling sick), tiredness (fatigue), rash, allergic reaction (hypersensitivity), facial swelling, itching, loss of appetite, abnormal dreams, vomiting, abdominal pain, bloating, indigestion, flatulence, diabetes, raised lipid or liver or pancreatic enzyme or creatinine levels, dizziness, aching joints or muscles, feeling weak.

You must not take Symtuza with any of the following medicines:

  • alfuzosin (treatment for prostate enlargement)
  • amiodarone (treatment for angina and cardiac arrhythmia)
  • avanafil (for erectile dysfunction)
  • carbamazepine, phenobarbital, phenytoin (epilepsy and seizures)
  • colchicine (if you have kidney/liver problems)
  • dihydroergotamine or ergotamine (migraine)
  • dronedarone, quinidine (cardiac arrhythmia)
  • ergometrine or methylergonovine (after childbirth)
  • lovastatin, simvastatin (lipid lowering)
  • lurasidone, pimozide, quetiapine, sertindole (antipsychotic)
  • midazolam (seizures)
  • ranolazine (angina)
  • rifampicin (tuberculosis)
  • sildenafil (when used for pulmonary arterial hypertension)
  • St John’s wort (anti-depressant)
  • ticagrelor (blood thinner)
  • triazolam (sedative).

Symtuza is not recommended for women who want to get pregnant, or who are pregnant, but it may be considered as an option.

For further information about Symtuza’s component drugs, including efficacy, side-effects and resistance, see darunavir, tenofovir and emtricitabine.