| Human immunodeficiency virus I infection
Delstrigo vs Symtuza
Side-by-side clinical, coverage, and cost comparison for human immunodeficiency virus i infection.Deep comparison between: Delstrigo vs Symtuza with Prescriber.AI
AI compares prescribing info and payer-specific access barriers across 1,200+ formularies. Here's a preview of what prescribers are already asking.Safety signalsSymtuza has a higher rate of injection site reactions vs Delstrigo based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Symtuza but not Delstrigo, including UnitedHealthcare
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Category
Delstrigo
Symtuza
At A Glance
Oral
Once daily
NNRTI/NRTI combination
Oral
Once daily
Protease inhibitor + CYP3A inhibitor + NRTI combination
Indications
- Human immunodeficiency virus I infection
- Human immunodeficiency virus I infection
Dosing
Human immunodeficiency virus I infection One tablet orally once daily with or without food in adults and pediatric patients weighing at least 35 kg.
With rifabutin co-administration Take one tablet of DELSTRIGO once daily plus one tablet of doravirine 100 mg (PIFELTRO) approximately 12 hours after the DELSTRIGO dose for the duration of rifabutin co-administration.
Human immunodeficiency virus I infection One tablet orally once daily with food in adults and pediatric patients weighing at least 40 kg (800 mg darunavir/150 mg cobicistat/200 mg emtricitabine/10 mg tenofovir alafenamide).
Contraindications
- Co-administration with strong CYP3A inducers, including carbamazepine, oxcarbazepine, phenobarbital, phenytoin, enzalutamide, rifampin, rifapentine, mitotane, or St. John's wort
- Previous hypersensitivity reaction to lamivudine
- Alfuzosin co-administration
- Carbamazepine, phenobarbital, or phenytoin co-administration
- Colchicine in patients with renal and/or hepatic impairment
- Rifampin co-administration
- Lurasidone or pimozide co-administration
- Dronedarone, ivabradine, or ranolazine co-administration
- Ergot derivatives (dihydroergotamine, ergotamine, methylergonovine) co-administration
- St. John's wort co-administration
- Elbasvir/grazoprevir co-administration
- Lomitapide, lovastatin, or simvastatin co-administration
- Naloxegol co-administration
- Sildenafil when used for pulmonary arterial hypertension
- Orally administered midazolam or triazolam co-administration
Adverse Reactions
Most common (>=5%) Dizziness, nausea, abnormal dreams
Serious Severe acute exacerbation of hepatitis B, new onset or worsening renal impairment, bone loss and mineralization defects, immune reconstitution syndrome
Postmarketing Stevens-Johnson syndrome/toxic epidermal necrolysis, hepatitis, lactic acidosis, hepatic steatosis, rhabdomyolysis, acute renal failure, Fanconi syndrome, anaphylaxis, anemia
Most common (>=2%) Diarrhea, rash, nausea, fatigue, headache, abdominal discomfort, flatulence
Serious Severe acute exacerbations of hepatitis B, hepatotoxicity, severe skin reactions, immune reconstitution syndrome, new onset or worsening renal impairment, lactic acidosis/severe hepatomegaly with steatosis
Postmarketing Redistribution of body fat, rhabdomyolysis, toxic epidermal necrolysis, acute generalized exanthematous pustulosis, drug rash with eosinophilia and systemic symptoms, acute renal failure, acute tubular necrosis, proximal renal tubulopathy, Fanconi syndrome, crystal nephropathy, crystalluria
Pharmacology
DELSTRIGO combines doravirine, an NNRTI that non-competitively inhibits HIV-1 reverse transcriptase; lamivudine, a nucleoside analogue NRTI that terminates HIV-1 DNA chain elongation after phosphorylation to lamivudine triphosphate; and tenofovir disoproxil fumarate, a nucleotide analogue prodrug that, following conversion to tenofovir diphosphate, competitively inhibits HIV-1 reverse transcriptase and causes DNA chain termination.
Symtuza is a fixed-dose combination containing darunavir (an HIV-1 protease inhibitor that prevents cleavage of Gag-Pol polyproteins), cobicistat (a CYP3A inhibitor that enhances darunavir exposure), emtricitabine (an NRTI that inhibits HIV reverse transcriptase through chain termination), and tenofovir alafenamide (an NRTI prodrug converted to tenofovir diphosphate that inhibits HIV reverse transcriptase).
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Most Common Insurance
Anthem BCBS
Delstrigo
- Covered on 5 commercial plans
- PA (4/12) · Step Therapy (0/12) · Qty limit (11/12)
Symtuza
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
UnitedHealthcare
Delstrigo
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (6/8)
Symtuza
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Delstrigo
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (3/3)
Symtuza
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
$0/fillfill
Delstrigo or Pifeltro Savings CouponCommercial or private insurance
Medicare, Medicaid, VA, TRICARE
Cost estimate not availableGood Days: HIV, AIDS Treatment & Prevention
Commercial or private insurance
Medicare, Medicaid, VA, TRICARE
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Clinical data sourced from FDA-approved labeling. Coverage data via MMIT. Updated monthly.