What is Symtuza?

Symtuza is a medication used to treat HIV. It is a combination of antiretroviral drugs in one pill, taken once a day.

It combines 800mg darunavir, 200mg emtricitabine and 10mg tenofovir alafenamide, along with 150mg cobicistat, in a yellow tablet. The tablet has ‘JG’ on one side and ‘8121’ on the other side.

How does Symtuza work?

Symtuza combines different drugs in one pill. Two of the drugs (emtricitabine and tenofovir alafenamide) are from a class of drugs known as NRTIs (nucleoside/nucleotide reverse transcriptase inhibitors) and one drug (darunavir) is a protease inhibitor. Each drug class works against HIV in a different way. Cobicistat is a drug used as a boosting agent to increase the effect of darunavir.

The aim of HIV treatment is to reduce the level of HIV (the ‘viral load’) in your body until it is undetectable – usually less than 50 copies of virus per ml of blood. Taking HIV treatment and having an undetectable viral load protects your immune system and stops HIV being passed on to someone else during sex.

How do I take Symtuza?

You should take Symtuza once a day with food – you should take it within half an hour of having a meal or snack.  The tablet should be swallowed whole – don’t chew, crush or split it.

HIV treatment works best if you take it every day, ideally at the same time each day. It may help to set an alarm, e.g. on your mobile phone, to remind you. If you forget to take a dose of Symtuza and realise within 12 hours of the time you usually take it, take it as soon as possible, with food, then take your next dose at your usual time. If you realise with less than 12 hours left until your next dose, don’t take a double dose, just skip the dose you’ve forgotten and then carry on with your normal routine.

What are the possible side effects of Symtuza?

All medicines have possible side effects. It’s a good idea to talk to your doctor, nurse or pharmacist about what to expect before you start taking any medication, and how to manage any side effects which occur.


antiretroviral (ARV)

A substance that acts against retroviruses such as HIV. There are several classes of antiretrovirals, which are defined by what step of viral replication they target: nucleoside reverse transcriptase inhibitors; non-nucleoside reverse transcriptase inhibitors; protease inhibitors; entry inhibitors; integrase (strand transfer) inhibitors.

undetectable viral load

A level of viral load that is too low to be picked up by the particular viral load test being used or below an agreed threshold (such as 50 copies/ml or 200 copies/ml). An undetectable viral load is the first goal of antiretroviral therapy.

drug interaction

A risky combination of drugs, when drug A interferes with the functioning of drug B. Blood levels of the drug may be lowered or raised, potentially interfering with effectiveness or making side-effects worse. Also known as a drug-drug interaction.

viral load

Measurement of the amount of virus in a blood sample, reported as number of HIV RNA copies per milliliter of blood plasma. Viral load is an important indicator of HIV progression and of how well treatment is working. 



A chemical messenger which stimulates or suppresses cell and tissue activity. Hormones control most bodily functions, from simple basic needs like hunger to complex systems like reproduction, and even the emotions and mood.

A full list of side effects, including less common side effects, can be found in the patient information leaflet that comes with Symtuza.

Side effects can be described as:

Common – a side effect that occurs in at least one in a hundred people (more than 1%) who take this drug.

Rare – a side effect that occurs in fewer than one in a hundred people (less than 1%) who take this drug.

Common side effects of Symtuza include (most common in bold):

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.

People with HIV may gain weight after starting treatment. Combinations containing darunavir have been shown to lead to modest weight gain.

Does Symtuza interact with other drugs?

You should always tell your doctor and pharmacist about any other drugs or medication you are taking. That includes anything prescribed by another doctor, medicines you have bought from a high-street chemist, herbal and alternative treatments, and recreational or party drugs (‘chems’).

Some medicines or drugs are not safe if taken together – the interaction could cause increased, dangerous levels, or it could stop one or both of the drugs from working. Other drug interactions are less dangerous but still need to be taken seriously. If levels of one drug are affected, you may need to change the dose you take. This must only be done on the advice of your HIV doctor.

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

  • alfuzosin
  • amiodarone
  • avanafil
  • carbamazepine
  • colchicine (if you have kidney/liver problems)
  • dihydroergotamine
  • dronedarone
  • ergotamine
  • ergometrine
  • lovastatin
  • lurasidone
  • methylergonovine
  • midazolam
  • phenobarbital
  • phenytoin
  • pimozide
  • quetiapine
  • quinidine
  • ranolazine
  • rifampicin
  • sertindole
  • sildenafil (used for pulmonary arterial hypertension)
  • simvastatin
  • St John’s wort
  • ticagrelor
  • triazolam

There are a number of other drugs which can be affected by Symtuza, so your doctor or pharmacist may prescribe a different dose. This includes some commonly prescribed drugs such as hormonal contraceptives and hormone replacement therapy, erectile dysfunction drugs, psychiatric drugs, and drugs used to treat opioid dependence, asthma, infections and pain.

The patient information leaflet which comes with your Symtuza has a fuller list of medicines which should be avoided, but it is very important to tell your doctor about any medicines you are taking.

Can I take Symtuza in pregnancy?

If you are considering having a baby, or think you might be pregnant, talk to your doctor as soon as possible about which combination of anti-HIV medications would be right for you. It is important to take antiretroviral treatment during pregnancy to prevent passing HIV from mother to baby.

Symtuza is not recommended for women during pregnancy.

Women living with HIV are advised not to breastfeed, as HIV can be passed on in breast milk. However, some women do choose to breastfeed. Symtuza should not be used during breastfeeding as at least one of the drugs it contains passes into breast milk.

Can children take Symtuza?

Symtuza can be taken by children aged 12 years and over, weighing 40kg or more.

Talking to your doctor

If you have any concerns about your treatment or other aspects of your health, it’s important to talk about these. For example, if you have any symptom or side effect which may be from your treatment, or if you are finding it difficult to take your medication every day, one of your healthcare team will be able to help.

Building a relationship with a doctor may take time. You may feel very comfortable talking to your doctor, but some people find it more difficult, particularly when talking about sex, mental health, or symptoms they find embarrassing. It’s also easy to forget things you wanted to talk about.

Preparing for an appointment can be very helpful. Take some time to think about what you are going to say. You might find it helpful to talk to someone else first, or to make some notes and bring them to your appointment.

For detailed information on this drug, visit the Symtuza page in the A-Z of antiretroviral medications.

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