What is this medication for?

Bictegravir (available only as a fixed-dose combination tablet with Emtricitabine and Tenofovir Alafenamide) is an antiretroviral medication that is used to treat the Human Immunodeficiency Virus (HIV) infection. It works by preventing the virus from replicating (reproducing), and hence, reducing the amount of viruses (viral load) in your body. This increases the CD4 cell count in your body. CD4 cells are a type of immune cells that help your body fight off infections. However, Bictegravir is not a cure for HIV infection. It must be taken consistently every day to slow the progression of the disease. It is usually given in combination with other anti-retroviral medications (combination therapy).

How should I take/use this medication?

  • Do not stop taking your medication without checking with your healthcare professional. Stopping medication may result in a worsening of infection and/ or acquisition of other infections.
  • It is important to take the antiretroviral combination therapy exactly as prescribed every day to prevent the virus from becoming resistant to the medication.
  • You may take this medication with or without food.
  • Dissolving the tablet may be an alternative for those with difficulties swallowing but crushing is not recommended.

What should I do if I forget to take/use this medication?

If you forget to take a dose, take it as soon as you remember. Then take your next dose at the usual time. Do not take two doses to make up for the missed dose.

What precautions should I take?

Inform your healthcare professional if:

  • You are allergic to this medication or any of the other ingredients of this medication
  • You are pregnant, planning to become pregnant, or breastfeeding
  • You are taking any other medications, including supplements, traditional medications and herbal remedies (eg. St. John’s wort).

What are some common side-effects of this medication?

  • Headache
    • Mild painkiller (Paracetamol) can be taken to reduce the pain
  • Nausea
    • Try taking Bictegravir with or after food
    • Avoid fatty meals and take  smaller frequent meals
    • Try sucking on hard candy to prevent the nausea sensation
  • Diarrhea
    • Hydrate regularly to replenish the loss of fluids (if there is no fluid limitation)
    • Anti-diarrheal medications can be taken when  needed

Inform your healthcare professional if these side effects persist or are intolerable.

What are some rare but serious side-effects that I need to seek medical advice immediately?

  • Drowsiness, insomnia, dizziness, abnormal dreams
    • Take the medication at bedtime if you experience drowsiness after taking. Take the medication in the daytime if you experience insomnia instead. These side effects may also resolve on their own after 2 to 4 weeks. Consult your doctor if they persist and/or bother you.
    • If you experience drowsiness or dizziness with the medication, do not drive or perform any tasks that require you to be alert.
    • Avoid consuming alcohol with the medication as it may worsen any drowsiness or dizziness that you experience with the medication.
  • Mood changes, thoughts of self-harm
    • Inform your healthcare professional if noticeable mood changes or thoughts of self-harm arise. There is an increased risk if you have a preexisting history of depression, psychiatric illness.

Stop your medication and see your healthcare professional immediately if you experience any symptoms of a drug allergy which include(s) one or more of the following:

  • Swollen face/eyes/lips/tongue
  • Difficulty in breathing
  • Itchy skin rashes over your whole body

What food or medication should I avoid when I take this medication?

Bictegravir clashes with medications or supplements containing polyvalent cations (eg. calcium, iron, magnesium, zinc)

  • Bictegravir can be taken with supplements containing calcium or iron together with food
  • Bictegravir can be taken 2 hours before or6 hours after supplements containing calcium or iron under fasting conditions

How should I store this medication?

Store in a cool and dry place, away from direct sunlight. Keep this medication away from children.

How should I throw away this medication safely?

Pack the medication into a bag and bring it back to the pharmacy where you received the medication from.

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