Recommended Dose of Descovy for PrEP

Dosing Recommendations by Population

The American Medical Association recommends that men who have sex with men (MSM) with or at risk for kidney dysfunction, osteopenia, or osteoporosis take one tablet of Descovy (emtricitabine 200 mg/tenofovir alafenamide 25 mg) orally once daily for PrEP 1, 2, 3
Descovy (emtricitabine/tenofovir alafenamide) is specifically indicated for MSM and transgender women who have sex with men who have or are at risk for kidney dysfunction, osteopenia, or osteoporosis 2, 4
The standard dosage is one tablet (emtricitabine 200 mg/tenofovir alafenamide 25 mg) taken orally once daily 1, 4
Unlike Truvada (emtricitabine/tenofovir disoproxil fumarate), there is no recommendation for a double loading dose on the first day when starting Descovy 1, 5
Descovy should be taken daily for continued protection, not on an event-driven or "2-1-1" dosing schedule 1, 6

Descovy is NOT currently recommended for cisgender women or prevention of HIV-1 infection from receptive vaginal sex 1, 7
Descovy is also not recommended for on-demand or event-driven PrEP (the "2-1-1" dosing schedule) 1, 6

Before initiating Descovy, patients should undergo combined HIV antibody and antigen testing, serum creatinine level and estimated creatinine clearance, hepatitis B surface antigen, hepatitis C antibody testing, and STI testing (gonorrhea, chlamydia, syphilis) 2, 3
During Descovy PrEP, patients should have HIV testing at 1 month and quarterly thereafter, creatinine clearance at first quarterly visit and annually thereafter, and STI testing quarterly 2, 3

Descovy is preferred over Truvada specifically for MSM with renal impairment (creatinine clearance between 30-60 mL/min) or bone health concerns 1, 8
Descovy should not be initiated in persons with suspected or confirmed HIV infection 2, 7