References UK clinical guidance from the NHS, the British HIV Association (BHIVA), and the British Association for Sexual Health and HIV (BASHH). Last updated: April 2026.
Genvoya is a once-daily single-tablet HIV treatment containing four active ingredients: elvitegravir (an integrase inhibitor), cobicistat (a pharmacokinetic booster), emtricitabine and tenofovir alafenamide (two NRTIs). It was one of the first TAF-containing regimens available and is still used by some people in the UK, though newer options like Biktarvy have largely replaced it for new prescriptions.
Here’s what Genvoya does and what to consider.
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What’s in Genvoya?
| Ingredient | Class | Role |
|---|---|---|
| Elvitegravir 150mg | Integrase inhibitor | Blocks HIV integration into CD4 DNA |
| Cobicistat 150mg | Pharmacokinetic booster | Keeps elvitegravir levels effective |
| Emtricitabine 200mg | NRTI | Blocks reverse transcription |
| Tenofovir alafenamide 10mg | NRTI | Blocks reverse transcription |
Who Can Take Genvoya?
- Adults and adolescents weighing at least 25kg
- People starting treatment for the first time
- People switching from another regimen with an undetectable viral load
How to Take Genvoya
One tablet once daily with food. Food improves absorption of elvitegravir.
Side Effects
- Nausea (usually settles)
- Diarrhoea
- Headache
- Weight gain (associated with integrase inhibitors and TAF)
- Cobicistat raises creatinine slightly — this is not actual kidney damage
Why Biktarvy Has Largely Replaced Genvoya
Biktarvy uses bictegravir instead of elvitegravir + cobicistat. The advantages are:
- No booster needed — fewer drug interactions
- Can be taken with or without food
- Higher barrier to resistance
- Similar efficacy and tolerability
If you’re currently on Genvoya and doing well, there’s no urgent reason to switch, but discuss with your HIV team if you’d like to simplify your interactions profile.
Drug Interactions
Because Genvoya contains cobicistat (a CYP3A4 inhibitor), it shares many of the same interactions as boosted protease inhibitors:
- Some statins contraindicated
- Erectile dysfunction drugs need dose reduction
- Inhaled fluticasone can cause problems
- Antacids, calcium and iron need timing separation
Read more: Biktarvy | Drug interactions | What is HIV?
Frequently Asked Questions
Should I switch from Genvoya to Biktarvy?
If you’re doing well on Genvoya, there’s no urgency. But Biktarvy has fewer interactions and doesn’t need food. Discuss with your HIV team at your next visit.
Does Genvoya need food?
Yes. Elvitegravir absorption is improved with food.
Why does Genvoya need a booster but Biktarvy doesn’t?
Elvitegravir is broken down quickly by the liver and needs cobicistat to maintain effective levels. Bictegravir (in Biktarvy) has better pharmacokinetics and doesn’t need boosting.
Related reading
- Choosing the Right PrEP Drug: Truvada vs Descovy
- Dovato for HIV: A Two-Drug Regimen
- Triumeq for HIV: A Straightforward Guide
- Efavirenz for HIV: An Older NNRTI Still in Use
- Eviplera: How This Anti-HIV Drug Works
Sources
- NHS — Sexual health conditions
- BASHH — UK clinical guidelines for STI management
- British HIV Association (BHIVA) — HIV treatment guidelines
- Terrence Higgins Trust — sexual health information
- UK Health Security Agency — STI surveillance data
Steve Page is a recognised expert on Sexually Transmitted Diseases (STDs) and STD treatments, having published numerous articles in peer-reviewed journals and presented his research at conferences around the world. He has an in-depth understanding of the latest medical research on STDs, and is an advocate for the development of new treatments and protocols to improve the health of those affected. In addition to his research, he has dedicated his career to understanding the causes and symptoms of STDs, as well as how to best treat those impacted.
