| Human immunodeficiency virus I infection
Sunlenca vs Symtuza
Side-by-side clinical, coverage, and cost comparison for human immunodeficiency virus i infection.Deep comparison between: Sunlenca 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 Sunlenca based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Symtuza but not Sunlenca, including UnitedHealthcare
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Category
Sunlenca
Symtuza
At A Glance
SC injection
Every 6 months
HIV-1 capsid inhibitor
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 (Initiation Option 1) Day 1: 927 mg SC injection (2 x 1.5 mL) plus 600 mg oral (2 x 300 mg tablets); Day 2: 600 mg oral (2 x 300 mg tablets); then 927 mg SC every 6 months (26 weeks) for maintenance.
Human immunodeficiency virus I infection (Initiation Option 2) Days 1 and 2: 600 mg oral (2 x 300 mg tablets); Day 8: 300 mg oral (1 x 300 mg tablet); Day 15: 927 mg SC injection (2 x 1.5 mL); then 927 mg SC every 6 months (26 weeks) for maintenance.
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
- Concomitant use of strong CYP3A inducers
- 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 (>=3%) Injection site reactions, nausea
Serious Grade 3 injection site reactions (erythema, pain, swelling)
Postmarketing Injection site necrosis
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
Lenacapavir is a multistage, selective HIV-1 capsid inhibitor that directly binds to capsid protein (p24) subunits in hexamers, inhibiting multiple essential steps of the viral lifecycle including capsid-mediated nuclear uptake of proviral DNA, virus assembly and release, and capsid core formation.
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
Sunlenca
- Covered on 5 commercial plans
- PA (10/12) · Step Therapy (9/12) · Qty limit (11/12)
Symtuza
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
UnitedHealthcare
Sunlenca
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (0/8)
Symtuza
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Humana
Sunlenca
- Covered on 0 commercial plans
- PA (1/3) · 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
Gilead Advancing Access Co-Pay Program: SunlencaCommercial 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.