Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide) is a prescription drug used to treat HIV. This drug can interact with other medications and some supplements. For example, Biktarvy can interact with certain antibiotics and antacids.
Biktarvy comes as a tablet that you swallow. It’s used in certain adults and children to treat HIV-1, which is the most common type of HIV.
An interaction can occur because one substance causes another substance to have a different effect than expected. Interactions can also occur if you have certain health conditions.
Keep reading to learn about Biktarvy’s possible interactions.
Certain health conditions or other factors could raise your risk of harm if you take Biktarvy. In such cases, your doctor may not prescribe Biktarvy for you. These are known as contraindications. The following text describes Biktarvy’s contraindications.
If you take rifampin: Rifampin (Rifadin, Rimactane) is an antibiotic used to treat tuberculosis. Your doctor will likely not prescribe Biktarvy for you while you’re taking rifampin.
Taking Biktarvy with rifampin could make Biktarvy less effective. This is because rifampin may speed up the breakdown of Biktarvy in your body. This can lead to lower levels of Biktarvy in your body, making the drug less effective.
Before starting Biktarvy treatment, tell your doctor if you take rifampin. They can recommend a treatment other than Biktarvy for your condition.
If you take dofetilide: Dofetilide (Tikosyn) is a drug used to treat an irregular heart rhythm. If you take dofetilide, your doctor likely won’t prescribe Biktarvy for you.
Taking Biktarvy with dofetilide could raise your risk of side effects from dofetilide. This is because Biktarvy may keep your body from breaking down dofetilide as it should. This can lead to high levels of dofetilide in your system, which raises your risk of side effects from the drug.
Before you take Biktarvy, tell your doctor if you take dofetilide. They can recommend a treatment other than Biktarvy for your condition.
Before you start taking Biktarvy, talk with your doctor if any of these factors apply to you. Your doctor can determine whether Biktarvy is safe for you to take.
There’s no known interaction between Biktarvy and alcohol.
If you drink alcohol, talk with your doctor about how much alcohol may be safe to consume while taking Biktarvy.
Before you start taking Biktarvy, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions. (To learn whether Biktarvy interacts with supplements, herbs, and vitamins, see the “Are there other interactions with Biktarvy?” section.)
If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.
The following table lists drugs that may interact with Biktarvy. Keep in mind that this table does not include all drugs that may interact with Biktarvy.
| Drug group or drug name | Drug examples | What can happen |
|---|---|---|
| dofetilide (Tikosyn) | — | can increase the risk of side effects from dofetilide |
| metformin (Fortamet, Glumetza) | — | can increase the risk of side effects from metformin |
| sucralfate (Carafate) | — | can make Biktarvy less effective |
| certain antibiotics | • rifampin (Rifadin, Rimactane) • rifabutin (Mycobutin) • rifapentine (Priftin) | can make Biktarvy less effective or can increase the risk of side effects from Biktarvy and certain antibiotics |
| certain antivirals | • acyclovir (Sitavig) • valacyclovir (Valtrex) • valganciclovir (Valcyte) | can increase the risk of side effects from Biktarvy and certain antivirals |
| certain seizure drugs | • phenytoin (Dilantin, Phenytek) • phenobarbital (Sezaby) • carbamazepine (Carbatrol, Epitol, others) • oxcarbazepine (Oxtellar XR, Trileptal) | can make Biktarvy less effective |
| nonsteroidal anti-inflammatory drugs (NSAIDs) | • ibuprofen (Advil, Motrin) • naproxen (Aleve, Naprelan, others) • meloxicam • celecoxib (Celebrex) | can increase the risk of side effects of Biktarvy and NSAIDs |
| antacids | • calcium carbonate (TUMS) • aluminum hydroxide/magnesium carbonate (Gaviscon) • calcium carbonate/magnesium hydroxide (Rolaids) | can make Biktarvy less effective |
For more information about Biktarvy and its interactions with rifampin and dofetilide, see the “What medications should not be taken with Biktarvy?” section. For more information about Biktarvy and antacids, certain antibiotics, and NSAIDs, see the “Drug interactions explained” section next.
Learn more about certain drug interactions that can occur with Biktarvy.
Interaction with antacids
Antacids are used to treat symptoms of conditions such as heartburn and indigestion.
Examples of antacids include:
- calcium carbonate (TUMS)
- aluminum hydroxide/magnesium carbonate (Gaviscon)
- calcium carbonate/magnesium hydroxide (Rolaids)
What could happen
Taking Biktarvy with antacids could make Biktarvy less effective. This is because antacids commonly contain calcium, magnesium, or aluminum, which could prevent your body from absorbing Biktarvy properly. This could lead to lower levels of the drug in your system, which may make Biktarvy less effective.
What you can do
You can take Biktarvy with antacids that contain calcium. But if you do, you’ll take Biktarvy and the antacid with food. Taking these drugs with food should help prevent calcium from affecting how your body absorbs Biktarvy.
You’ll take Biktarvy at least 2 hours before or 6 hours after an antacid that contains magnesium or aluminum. This can help prevent magnesium and aluminum from affecting how your body absorbs Biktarvy.
Before taking any antacids with Biktarvy, talk with your doctor or pharmacist. They can let you know whether an antacid contains calcium, magnesium, or aluminum.
Interaction with certain antibiotics
Antibiotics are used to treat infections caused by bacteria.
Examples of antibiotics that interact with Biktarvy include:
- rifabutin (Mycobutin)
- rifapentine (Priftin)
- gentamicin
- rifampin (Rifadin, Rimactane)
Examples of antibiotics that you may be able to take during Biktarvy treatment include amoxicillin (Amoxil), doxycycline (Monodox, Vibramycin), and sulfamethoxazole/trimethoprim (Bactrim).
To learn more about Biktarvy’s interaction with rifampin, see the “What medications should not be taken with Biktarvy?” section.
What could happen
How an antibiotic interacts with Biktarvy may vary. For example, taking Biktarvy with gentamicin can raise your risk of side effects from either drug. This is because gentamicin can prevent your body from clearing Biktarvy properly. And Biktarvy can also prevent your body from clearing gentamicin properly.
As a result, either drug could build up in your system, which raises your risk of side effects from Biktarvy and gentamicin.
Taking Biktarvy with rifabutin or rifapentine could make Biktarvy less effective. This is because either antibiotic may speed up the breakdown of Biktarvy in your body. This can lead to lower levels of Biktarvy in your system, making the drug less effective.
What you can do
If you get a bacterial infection during your Biktarvy treatment, tell the doctor treating your infection that you’re taking Biktarvy. They’ll likely avoid prescribing certain antibiotics with Biktarvy. They can recommend an antibiotic that doesn’t interact with this drug.
In some cases, your doctor may still prescribe an antibiotic that interacts with Biktarvy. If so, they’ll monitor you closely for the effects of the interaction. For example, they may watch for side effects or to make sure the drug is working to treat your condition.
Interaction with NSAIDs
NSAIDs are used to treat pain, fever, and swelling.
Examples of NSAIDs include:
What could happen
Taking Biktarvy with an NSAID can raise your risk of side effects from either drug. This is because Biktarvy can keep your body from clearing NSAIDs properly. Likewise, NSAIDs can prevent your body from clearing Biktarvy properly.
This means that either drug could build up in your system. Having higher levels of these drugs in your body could raise your risk of side effects from Biktarvy and the NSAID.
What you can do
Before starting Biktarvy, tell your doctor if you take any NSAIDs. They can tell you whether it’s safe to take Biktarvy with an NSAID.
Certain NSAIDs are available over the counter (OTC). If you’d like to take an OTC NSAID or other pain reliever with Biktarvy, talk with your doctor or pharmacist first. They can recommend a treatment that doesn’t interact with Biktarvy, such as acetaminophen (Tylenol).
Biktarvy may have other interactions. They could occur with supplements, foods, vaccines, or even lab tests. See the following text for details. Note that the following information does not include all other possible interactions with Biktarvy.
Does Biktarvy interact with vitamins and supplements?
Before you start taking Biktarvy, talk with your doctor and pharmacist about any supplements, herbs, and vitamins you take. Sharing this information with them may help you avoid possible interactions.
If you have questions about interactions that may affect you, talk with your doctor or pharmacist.
Biktarvy interactions with herbs
It may not be safe to take Biktarvy with the herbal supplement St. John’s wort, which is used to ease symptoms of conditions such as depression.
Taking Biktarvy with St. John’s wort could lower the level of Biktarvy in your system. This may make Biktarvy less effective.
Be sure to talk with your doctor or pharmacist before taking any herbal supplements with Biktarvy.
Biktarvy interactions with vitamins and minerals
Here’s some information on Biktarvy, vitamins, and minerals.
Vitamins
There are currently no reports of Biktarvy interacting with vitamins. But vitamins may contain the minerals calcium, iron, and magnesium. And these minerals are known to interact with Biktarvy. For details, see the “Minerals” section.
Before taking any vitamins with Biktarvy, talk with your doctor or pharmacist. They can determine whether a vitamin product contains any calcium, iron, or magnesium.
Minerals
Mineral supplements such as calcium, iron, and magnesium may interact with Biktarvy. Taking the drug with calcium, iron, or magnesium could prevent your body from absorbing Biktarvy properly. This could make the drug less effective.
You can take Biktarvy with calcium or iron supplements. In this case, you’ll take Biktarvy and the supplement with food. Doing so should help prevent calcium or iron from affecting how your body absorbs the drug.
You’ll take Biktarvy at least 2 hours before or 6 hours after a magnesium supplement. This should help prevent magnesium from affecting how your body absorbs Biktarvy.
Biktarvy’s food interactions
Biktarvy may interact with grapefruit or grapefruit juice. Taking the drug with grapefruit could raise the level of Biktarvy in your system. Having a high level of the drug in your body could raise your risk of side effects with Biktarvy.
If you consume grapefruit products, talk with your doctor before taking Biktarvy.
Does Biktarvy interact with vaccines?
There are currently no reports of Biktarvy interacting with vaccines. If you have questions about receiving specific vaccines during Biktarvy treatment, talk with your doctor or pharmacist.
Does Biktarvy interact with lab tests?
There are currently no reports of Biktarvy interacting with lab tests. If you have questions about getting certain lab tests while taking Biktarvy, talk with your doctor or pharmacist.
Does Biktarvy interact with cannabis or CBD?There are currently no reports Biktarvy interacting with cannabis (commonly called marijuana) or cannabis products such as cannabidiol (CBD). But as with any drug or supplement, talk with your doctor before using cannabis with Biktarvy.
Note: Cannabis is illegal at a federal level but is legal in many states to varying degrees.
Certain medical conditions or other health factors may raise the risk of interactions with Biktarvy. Before taking Biktarvy, talk with your doctor about your health history. They’ll determine whether Biktarvy is right for you.
Health conditions or other factors that might interact with Biktarvy include:
Hepatitis B: Biktarvy has a boxed warning about the risk of worsening hepatitis B. This is a serious warning from the Food and Drug Administration (FDA). A boxed warning alerts doctors and patients about drug effects that may be dangerous. For more information, see the “Boxed warning: Risk of worsening hepatitis B” section near the beginning of this article.
Severe liver problems: Your doctor likely won’t prescribe Biktarvy if you have a severe liver problem, such as liver failure. The drug may cause liver problems. And if you already have a liver condition, Biktarvy could worsen it. Talk with your doctor about whether Biktarvy is right for you.
Kidney problems: Taking Biktarvy may lead to new or worsened kidney problems. If you have a kidney problem, your doctor may recommend a treatment other than Biktarvy.
Depression or other mental health conditions: Before taking Biktarvy, tell your doctor if you have any mental health conditions. In rare cases, Biktarvy may cause depression or suicidal thoughts and behaviors. Your risk of these side effects may be higher if you already have depression or another mental health condition.
If you have a mental health condition, your doctor can determine whether it’s safe for you to take Biktarvy.
Pregnancy: It’s not known whether Biktarvy is safe to take during pregnancy. If you’re pregnant or planning a pregnancy, talk with your doctor about whether Biktarvy is right for you.
If you take Biktarvy during pregnancy, consider enrolling in the Antiretroviral Pregnancy Registry. The registry collects information about the use of antiretroviral drugs, including Biktarvy, during pregnancy. To learn more, call 800-258-4263 or talk with your doctor.
Breastfeeding: Biktarvy passes into breast milk, but it’s not known how the drug may affect a child who is breastfed.
However, the
If you’re breastfeeding or planning to do so, talk with your doctor about your options.
Allergic reaction: If you’ve had an allergic reaction to Biktarvy or any of its ingredients, your doctor will likely not prescribe Biktarvy. This is because taking the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better choices for you.
Taking certain steps can help you avoid interactions with Biktarvy. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:
- Whether you drink alcohol or use cannabis.
- Other medications you take, as well as any vitamins, supplements, and herbs. Your doctor or pharmacist can help you fill out a
medication list . - What to do if you start taking a new drug during your Biktarvy treatment.
It’s also important to understand Biktarvy’s
If you have difficulty reading or understanding this information, your doctor or pharmacist can help.
Taking Biktarvy exactly as prescribed can also help prevent interactions.
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.