Skip to main content

Descovy Side Effects

Generic name: emtricitabine / tenofovir alafenamide

Medically reviewed by Philip Thornton, DipPharm. Last updated on Apr 14, 2025.

Note: This document provides detailed information about Descovy Side Effects associated with emtricitabine / tenofovir alafenamide. Some dosage forms listed on this page may not apply specifically to the brand name Descovy.

Applies to emtricitabine / tenofovir alafenamide: oral tablet.

Important warnings This medicine can cause some serious health issues

Oral route (tablet)

Severe acute exacerbations of hepatitis B (HBV) have been reported in HBV-infected individuals who have discontinued products containing emtricitabine (FTC) and/or tenofovir disoproxil fumarate (TDF) and may occur with discontinuation of emtricitabine/tenofovir alafenamide.

Hepatic function should be monitored closely with both clinical and laboratory follow-up for at least several months in individuals who are infected with HBV and discontinue emtricitabine/tenofovir alafenamide.

If appropriate, initiation of antihepatitis B therapy may be warranted.

Emtricitabine / tenofovir alafenamide used for HIV-1 pre-exposure prophylaxis must only be prescribed to individuals confirmed to be HIV-negative immediately prior to initiating and at least every 3 months during use.

Drug-resistant HIV-1 variants have been identified with use of FTC during use.

Drug-resistant HIV-1 variants have been identified with use of FTC/TDF for HIV-1 PrEP following undetected acute HIV-1 infection.

Do not initiate emtricitabine / tenofovir alafenamide for HIV-1 pre-exposure prophylaxis if signs or symptoms of acute HIV-1 infection are present unless negative infection status is confirmed.

Serious side effects of Descovy

Along with its needed effects, emtricitabine / tenofovir alafenamide may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking emtricitabine / tenofovir alafenamide:

More common side effects

  • chest pain or tightness
  • confusion
  • cough
  • fever or chills
  • increase in bone pain
  • irregular heartbeat
  • nausea or vomiting
  • nervousness
  • numbness or tingling in the hands, feet, or lips
  • sneezing
  • stomach pain
  • trouble breathing
  • weakness or heaviness of the legs

Incidence not known

  • agitation
  • bloody urine
  • change in consciousness
  • dark urine
  • decreased appetite
  • decreased frequency or amount of urine
  • depression
  • diarrhea
  • fast, shallow breathing
  • general feeling of discomfort
  • headache
  • hostility
  • increased thirst
  • irritability
  • large, hive-like swelling on face, eyelids, lips, tongue, throat, hands, legs, feet, or sex organs
  • light-colored stools
  • loss of appetite
  • loss of consciousness
  • lower back or side pain
  • muscle pain, twitching, or cramping
  • seizures
  • sleepiness
  • stomach discomfort
  • swelling of the face, fingers, or lower legs
  • unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness
  • upper right abdominal or stomach pain
  • vomiting
  • weight gain
  • yellow eyes and skin

For healthcare professionals

Applies to emtricitabine / tenofovir alafenamide: oral kit, oral tablet.

General adverse events

In clinical trials, the most common side effects reported with emtricitabine and tenofovir alafenamide (with elvitegravir and cobicistat) were nausea, diarrhea, and headache.

Side effects have been reported for emtricitabine and/or tenofovir disoproxil fumarate (DF) when taken in combination with other antiretroviral agents. The most common side effects reported in HIV-1-infected patients during a clinical study of efavirenz, emtricitabine, and tenofovir DF included diarrhea, nausea, fatigue, headache, dizziness, depression, insomnia, abnormal dreams, and rash. In this trial, emtricitabine-tenofovir DF (with efavirenz) was used from weeks 96 to 144, replacing emtricitabine plus tenofovir DF (with efavirenz).

In HIV-1-uninfected patients in HIV-1 preexposure prophylaxis trials, the most common side effect reported with emtricitabine-tenofovir alafenamide was diarrhea while the most common side effects reported with emtricitabine-tenofovir DF were headache, abdominal pain, and decreased weight.[Ref]

Dermatologic

Emtricitabine-tenofovir DF:

Emtricitabine plus tenofovir alafenamide:

Emtricitabine:

Products containing emtricitabine and/or tenofovir alafenamide:

Tenofovir alafenamide-containing products:

Tenofovir DF:

Skin discoloration (hyperpigmentation) was very common in pediatric patients using emtricitabine.

Rash has also been reported during postmarketing experience with tenofovir DF.[Ref]

Endocrine

Tenofovir DF:

Gastrointestinal

Emtricitabine-tenofovir alafenamide:

Emtricitabine-tenofovir DF:

Emtricitabine plus tenofovir alafenamide:

Emtricitabine:

Tenofovir DF:

Increased serum amylase (greater than 175 units/L) has been reported in up to 8% of patients using emtricitabine-tenofovir DF.

In clinical trials, nausea was the most common side effect reported in antiretroviral therapy-naive HIV-1-infected patients using emtricitabine plus tenofovir alafenamide with elvitegravir plus cobicistat.

Increased amylase (greater than 2 times the upper limit of normal [2 x ULN]) has been reported in 3% and 5% of patients using emtricitabine plus tenofovir alafenamide and emtricitabine plus tenofovir DF, respectively, each with elvitegravir plus cobicistat. Increased lipase has been reported in 5% and 8% of patients using emtricitabine plus tenofovir alafenamide and emtricitabine plus tenofovir DF, respectively, each with elvitegravir plus cobicistat.

Pancreatitis, abdominal pain, and increased amylase have also been reported during postmarketing experience with tenofovir DF.[Ref]

Genitourinary

Emtricitabine-tenofovir DF:

Emtricitabine plus tenofovir alafenamide:

Tenofovir DF:

Hematuria (greater than 75 RBC/high power field: up to 3%) and glycosuria (3+ or greater: less than 1%) have been reported with emtricitabine-tenofovir DF.

Hematuria (greater than 75 RBC/high power field) has been reported in 3% and 3% of patients using emtricitabine plus tenofovir alafenamide and emtricitabine plus tenofovir DF, respectively, each with elvitegravir plus cobicistat.

Proteinuria has also been reported during postmarketing experience with tenofovir DF.[Ref]

Hematologic

Emtricitabine-tenofovir DF:

Emtricitabine:

Tenofovir DF:

Decreased neutrophils (1000 to 1300 cells/mm3: up to 13%; less than 750 cells/mm3: up to 5%) and hemoglobin (8.5 to 10 mg/dL: 4%; less than 9.4 mg/dL: up to 2%) have been reported with emtricitabine-tenofovir DF.

Anemia was common in pediatric patients using emtricitabine.[Ref]

Hepatic

Emtricitabine-tenofovir DF:

Emtricitabine plus tenofovir alafenamide:

Emtricitabine:

Products containing emtricitabine and/or tenofovir alafenamide:

Tenofovir DF:

Increased AST (1.25 to less than 2.5 x ULN: up to 14%; greater than 2.6 x ULN: up to 5%) and ALT (1.25 to less than 2.5 x ULN: up to 14%; greater than 2.6 x ULN: up to 7%) have been reported with emtricitabine-tenofovir DF.

Increased AST (greater than 180 units/L) and ALT (greater than 215 units/L) have been reported in 3% and 2% of males using emtricitabine-tenofovir DF, respectively. Increased AST (greater than 170 units/L) and ALT (greater than 170 units/L) have been reported in 3% and 2% of females using emtricitabine-tenofovir DF, respectively.

Increased AST (greater than 5 x ULN) has been reported in 3% and 4% of patients using emtricitabine plus tenofovir alafenamide and emtricitabine plus tenofovir DF, respectively, each with elvitegravir plus cobicistat. Increased ALT (greater than 5 x ULN) has been reported in 3% and 3% of patients using emtricitabine plus tenofovir alafenamide and emtricitabine plus tenofovir DF, respectively, each with elvitegravir plus cobicistat.

Severe acute exacerbations of hepatitis have been reported in patients with hepatitis B after discontinuation of this drug and were associated with liver failure and liver decompensation in some emtricitabine-treated patients.

Lactic acidosis and severe hepatomegaly with steatosis (including fatal cases) have been reported with the use of nucleoside analogs.

Hepatic steatosis and hepatitis have also been reported during postmarketing experience with tenofovir DF.[Ref]

Hypersensitivity

Emtricitabine:

Tenofovir DF:

Immunologic

Emtricitabine-tenofovir DF:

Metabolic

Emtricitabine-tenofovir alafenamide:

Emtricitabine-tenofovir DF:

Emtricitabine:

Tenofovir DF:

Antiretroviral therapy:

Hyperglycemia (greater than 250 mg/dL) has been reported in up to 2% of patients using emtricitabine-tenofovir DF.

Lactic acidosis and severe hepatomegaly with steatosis (including fatal cases) have been reported with the use of nucleoside analogs.

Hypokalemia and hypophosphatemia may occur as a result of proximal renal tubulopathy.

Hypokalemia, lactic acidosis, and hypophosphatemia have also been reported during postmarketing experience with tenofovir DF.[Ref]

Musculoskeletal

Emtricitabine-tenofovir alafenamide:

Emtricitabine-tenofovir DF:

Emtricitabine plus tenofovir alafenamide:

Emtricitabine:

Tenofovir DF:

Combination antiretroviral therapy:

In clinical trials of HIV-1-uninfected patients, decreased BMD was reported. During treatment with emtricitabine-tenofovir DF, 13% of patients lost at least 5% of BMD at the spine.

Increased creatine kinase (males: greater than 990 units/L; females: greater than 845 units/L) has been reported in up to 9% of patients using emtricitabine-tenofovir DF.

Increased creatine kinase (at least 10 x ULN) has been reported in 11% and 10% of patients using emtricitabine plus tenofovir alafenamide and emtricitabine plus tenofovir DF, respectively, each with elvitegravir plus cobicistat.

In virologically-suppressed tenofovir DF-treated patients who switched to emtricitabine plus tenofovir alafenamide with elvitegravir plus cobicistat, mean BMD increased between baseline and week 48; decreased BMD was also reported.

Rhabdomyolysis, osteomalacia, muscular weakness, and myopathy may occur as a result of proximal renal tubulopathy.

Rhabdomyolysis, muscular weakness, and myopathy have also been reported during postmarketing experience with tenofovir DF.[Ref]

Nervous system

Emtricitabine-tenofovir alafenamide:

Emtricitabine-tenofovir DF:

Emtricitabine plus tenofovir alafenamide:

Emtricitabine:

Tenofovir DF:

Other

Emtricitabine-tenofovir alafenamide:

Emtricitabine-tenofovir DF:

Emtricitabine plus tenofovir alafenamide:

Emtricitabine:

Tenofovir DF:

Antiretroviral therapy:

Increased fasting cholesterol (greater than 240 mg/dL: up to 22%), decreased phosphorus (2.5 to less than the lower limit of normal: up to 7%; less than 2 mg/dL: up to 10%), increased fasting triglycerides (greater than 750 mg/dL: up to 5%), and increased alkaline phosphatase (greater than 550 units/L: 1%) have been reported with emtricitabine-tenofovir DF.

In clinical trials, the following mean increases were reported in antiretroviral therapy-naive patients after using emtricitabine plus tenofovir alafenamide with elvitegravir plus cobicistat for 48 weeks: total cholesterol increased by 30 mg/dL, LDL cholesterol by 15 mg/dL, HDL cholesterol by 7 mg/dL, triglycerides by 29 mg/dL. In clinical trials, the following mean increases were reported in patients using emtricitabine plus tenofovir alafenamide and emtricitabine plus tenofovir DF, respectively, each with elvitegravir plus cobicistat for 144 weeks: fasted total cholesterol increased by 31 and 14 mg/dL, fasted LDL cholesterol by 20 and 8 mg/dL, fasted HDL cholesterol by 7 and 3 mg/dL, fasted triglycerides by 29 and 17 mg/dL.

Increased fasting LDL cholesterol (greater than 190 mg/dL) has been reported in 11% and 5% of patients using emtricitabine plus tenofovir alafenamide and emtricitabine plus tenofovir DF, respectively, each with elvitegravir plus cobicistat. Increased fasting total cholesterol (greater than 300 mg/dL) has been reported in 4% and 3% of patients using emtricitabine plus tenofovir alafenamide and emtricitabine plus tenofovir DF, respectively, each with elvitegravir plus cobicistat.

Asthenia has also been reported during postmarketing experience with tenofovir DF.[Ref]

Psychiatric

Emtricitabine-tenofovir DF:

Emtricitabine plus tenofovir alafenamide:

Emtricitabine:

Tenofovir DF:

Renal

Emtricitabine-tenofovir alafenamide:

Emtricitabine-tenofovir DF:

Emtricitabine plus tenofovir alafenamide:

Products containing emtricitabine and/or tenofovir alafenamide:

Tenofovir alafenamide-containing products:

Tenofovir DF:

Tenofovir prodrugs:

Increased creatinine (1.1 to 1.3 x ULN: up to 2%; greater than 1.4 x ULN: less than 1%) has been reported with emtricitabine-tenofovir DF.

In 2 trials in antiretroviral therapy-naive HIV-1-infected patients (median estimated glomerular filtration rate [eGFR] 115 mL/min at baseline) using emtricitabine plus tenofovir alafenamide with elvitegravir plus cobicistat, mean serum creatinine increased by 0.1 mg/dL from baseline to week 48; median UPCR was 44 mg/g at baseline and at week 48. In a trial in virologically-suppressed tenofovir DF-treated patients (mean eGFR 112 mL/min at baseline) who switched to emtricitabine plus tenofovir alafenamide with elvitegravir plus cobicistat, mean serum creatinine was similar to baseline; median UPCR was 61 mg/g at baseline and 46 mg/g at week 48. In a trial in renal dysfunction patients (baseline eGFR 30 to 69 mL/min) using emtricitabine plus tenofovir alafenamide with elvitegravir plus cobicistat, mean serum creatinine was 1.5 mg/dL at baseline and week 24; median UPCR was 161 mg/g at baseline and 93 mg/g at week 24.

Proximal renal tubulopathy generally resolved or improved after tenofovir DF was stopped; however, decreased CrCl did not completely resolve in some HIV-1-infected patients after stopping the drug. Rhabdomyolysis, osteomalacia, bone abnormalities (infrequently contributing to fractures), hypokalemia, muscular weakness, myopathy, and hypophosphatemia may occur as a result of proximal renal tubulopathy.

Renal failure, acute renal failure, Fanconi syndrome, proximal renal tubulopathy, increased creatinine, nephrogenic diabetes insipidus, and acute tubular necrosis have also been reported during postmarketing experience with tenofovir DF.[Ref]

Respiratory

Emtricitabine-tenofovir alafenamide:

Emtricitabine-tenofovir DF:

Emtricitabine:

Tenofovir DF:

References

1. (2020) "Product Information. Truvada (emtricitabine-tenofovir)." Gilead Sciences, SUPPL-61

2. (2022) "Product Information. Descovy (emtricitabine-tenofovir)." Gilead Sciences, SUPPL-20

3. (2020) "Product Information. Truvada (emtricitabine-tenofovir)." Gilead Sciences Pty Ltd

4. (2021) "Product Information. Descovy (emtricitabine-tenofovir)." Gilead Sciences Pty Ltd, v 6.0

5. (2021) "Product Information. Truvada (emtricitabine-tenofovir)." Gilead Sciences Ltd

6. (2022) "Product Information. Descovy (emtricitabine-tenofovir)." Gilead Sciences Ltd

7. de Perio MA, Gomez FJ, Frame PT, Fichtenbaum CJ (2007) "A truvada hypersensitivity reaction simulating abacavir hypersensitivity." AIDS, 21, p. 2252-3

Frequently asked questions

Further information

Descovy side effects can vary depending on the individual. Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Note: Medication side effects may be underreported. If you are experiencing side effects that are not listed, submit a report to the FDA by following this guide.