| Human immunodeficiency virus I infection
Symtuza vs Tivicay
Side-by-side clinical, coverage, and cost comparison for human immunodeficiency virus i infection.Deep comparison between: Symtuza vs Tivicay 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 signalsTivicay has a higher rate of injection site reactions vs Symtuza based on FDA-approved prescribing information
Coverage gaps3 major payers require step therapy for Tivicay but not Symtuza, including UnitedHealthcare
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Category
Symtuza
Tivicay
At A Glance
Oral
Once daily
Protease inhibitor + CYP3A inhibitor + NRTI combination
Oral
Once daily (or twice daily with certain inducers)
Integrase strand transfer inhibitor (INSTI)
Indications
- Human immunodeficiency virus I infection
- Human immunodeficiency virus I infection
Dosing
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).
Human immunodeficiency virus I infection (treatment-naive or INSTI-naive adults) 50 mg orally once daily, with or without food. Adjust to 50 mg twice daily if coadministered with UGT1A or CYP3A inducers.
Human immunodeficiency virus I infection (INSTI-experienced adults with resistance) 50 mg orally twice daily, with or without food, combined with optimized background therapy.
Human immunodeficiency virus I infection (pediatric patients 3 kg to <6 kg) TIVICAY PD 5 mg orally once daily. Adjust to twice daily if coadministered with UGT1A or CYP3A inducers.
Human immunodeficiency virus I infection (pediatric patients 6 kg to <10 kg) TIVICAY PD 15 mg orally once daily. Adjust to twice daily if coadministered with UGT1A or CYP3A inducers.
Human immunodeficiency virus I infection (pediatric patients 10 kg to <14 kg) TIVICAY PD 20 mg orally once daily. Adjust to twice daily if coadministered with UGT1A or CYP3A inducers.
Human immunodeficiency virus I infection (pediatric patients 14 kg to <20 kg) TIVICAY PD 25 mg orally once daily or TIVICAY tablets 40 mg once daily. Adjust to twice daily if coadministered with UGT1A or CYP3A inducers.
Human immunodeficiency virus I infection (pediatric patients >=20 kg) TIVICAY PD 30 mg orally once daily or TIVICAY tablets 50 mg once daily. Adjust to twice daily if coadministered with UGT1A or CYP3A inducers.
Human immunodeficiency virus I infection (virologically suppressed adults switching to dual therapy) 50 mg orally once daily in combination with rilpivirine 25 mg once daily, with or without food.
Contraindications
- 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
- Hypersensitivity to dolutegravir
- Coadministration with dofetilide
Adverse Reactions
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
Most common (>=2%, treatment-naive) Insomnia, headache, diarrhea, nausea, fatigue, rash
Serious Hypersensitivity reactions, hepatotoxicity, immune reconstitution syndrome
Postmarketing Sideroblastic anemia, acute liver failure, weight increased, arthralgia, myalgia, anxiety
Pharmacology
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).
Dolutegravir is an HIV-1 integrase strand transfer inhibitor that blocks the strand transfer step of retroviral DNA integration essential for HIV replication by binding to the integrase active site.
Enter your patient's insuranceCheck specific coverage details for your patient.
Most Common Insurance
Anthem BCBS
Symtuza
- Covered on 5 commercial plans
- PA (5/12) · Step Therapy (5/12) · Qty limit (11/12)
Tivicay
- Covered on 5 commercial plans
- PA (0/12) · Step Therapy (0/12) · Qty limit (11/12)
UnitedHealthcare
Symtuza
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (2/8)
Tivicay
- Covered on 4 commercial plans
- PA (0/8) · Step Therapy (0/8) · Qty limit (4/8)
Humana
Symtuza
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (3/3)
Tivicay
- Covered on 0 commercial plans
- PA (0/3) · Step Therapy (0/3) · Qty limit (3/3)
Coverage data sourced from MMIT. Updated monthly.
Savings
Cost estimate not availableGood Days: HIV, AIDS Treatment & Prevention
Commercial 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.