STRIBILD

ELVITEGRAVIR; COBICISTAT; EMTRICITABINE; TENOFOVIR DISOPROXIL FUMARATE (el vye TEG ra veer; koe BIS i stat; em tri SIT uh bean; te NOE fo veer dye soe PROX il FUE ma rate) helps manage the symptoms of HIV infection. It works by limiting the spread of HIV in the body. It is a combination of three antiretroviral medications. This medication is not a cure for HIV or AIDS and it may still be possible to spread HIV to others while taking it. It does not prevent other sexually transmitted infections (STIs).

This medicine may be used for other purposes; ask your health care provider or pharmacist if you have questions.

Take this medication by mouth with water. Take this medication with food. Do not cut, crush, or chew this medication. For your therapy to work as well as possible, take each dose exactly as prescribed on the prescription label. Do not skip doses. Skipping doses can make the HIV virus resistant to this and other medications. Keep taking this therapy unless your care team tells you to stop.
Talk to your care team about the use of this medication in children. While this medication may be prescribed for children as young as 12 years of age for selected conditions, precautions do apply.

Overdosage: If you think you have taken too much of this medicine contact a poison control center or emergency room at once.
NOTE: This medicine is only for you. Do not share this medicine with others.

Do not take this medication with any of the following:
-Adefovir
-Alfuzosin
-Certain medications for seizures, such as carbamazepine, oxcarbazepine, phenobarbital, phenytoin, fosphenytoin, primidone
-Cisapride
-Irinotecan
-Lumacaftor; ivacaftor
-Lurasidone
-Medications for cholesterol, such as lovastatin, simvastatin
-Medications for headaches, such as dihydroergotamine, ergotamine, methylergonovine
-Midazolam
-Naloxegol
-Other antiviral medications for HIV or AIDS
-Pimozide
-Rifampin
-Sildenafil
-St. John's Wort
-Triazolam
This medication may also interact with the following:
-Antacids
-Atorvastatin
-Bosentan
-Buprenorphine; naloxone
-Certain antibiotics, such as clarithromycin, telithromycin, rifabutin, rifapentine
-Certain medications for anxiety or sleep, such as buspirone, clorazepate, diazepam, estazolam, flurazepam, zolpidem
-Certain medications for blood pressure or heart disease, such as amlodipine, diltiazem, felodipine, metoprolol, nicardipine, nifedipine, timolol, verapamil
-Certain medications for depression, anxiety, or mental health conditions
-Certain medications for erectile dysfunction, such as avanafil, sildenafil, tadalafil, vardenafil
-Certain medications for fungal infection, such as itraconazole, ketoconazole, voriconazole
-Certain medications that treat or prevent blood clots, such as warfarin, apixaban, betrixaban, dabigatran, edoxaban, and rivaroxaban
-Colchicine
-Cyclosporine
-Estrogen and progestin hormones
-Medications for infection, such as acyclovir, cidofovir, valacyclovir, ganciclovir, valganciclovir
-Medications for irregular heartbeat, such as amiodarone, bepridil, digoxin, disopyramide, dofetilide, flecainide, lidocaine, mexiletine, propafenone, quinidine
-Metformin
-Phenothiazines, such as perphenazine, risperidone, thioridazine
-Salmeterol
-Sirolimus
-Steroid medications, such as betamethasone, budesonide, ciclesonide, dexamethasone, fluticasone, methylprednisolone, mometasone, triamcinolone
-Tacrolimus

This list may not describe all possible interactions. Give your health care provider a list of all the medicines, herbs, non-prescription drugs, or dietary supplements you use. Also tell them if you smoke, drink alcohol, or use illegal drugs. Some items may interact with your medicine.

Visit your care team for regular checks on your progress. Tell your care team if your symptoms get worse or if you have new symptoms.
You may need blood work done while you are taking this medication.
Do not stop taking this medication without first talking to your care team. If you have HIV and hepatitis B, the symptoms of hepatitis B may worsen when you stop taking this medication. Your care team will check your liver and general health for several months after treatment is stopped.
Using this medication for a long time may weaken your bones. The risk of bone fractures may be increased. Talk to your care team about your bone health.
Estrogen and progestin hormones may not work as well while you are taking this medication. Your care team can help you find the contraceptive option that works for you.
HIV is spread to others through sexual or blood contact. Talk to your care team about how to stop the spread of HIV.

If you miss a dose, take it as soon as you can. If it is almost time for your next dose, take only that dose. Do not take double or extra doses.

Side effects that you should report to your care team as soon as possible:
-Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
-High lactic acid level—muscle pain or cramps, stomach pain, trouble breathing, general discomfort and fatigue
-Infection—fever, chills, cough, or sore throat
-Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
-Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
-Diarrhea
-Nausea

This list may not describe all possible side effects. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Keep out of the reach of children and pets.
Store between 15 and 30 degrees C (59 and 86 degrees F). Get rid of any unused medication after the expiration date.
To get rid of medications that are no longer wanted or have expired:
-Take the medication to a medication take-back program. Check with your pharmacy or law enforcement to find a location.
-If you cannot return the medication, check the label or package insert to see if the medication should be thrown out in the garbage or flushed down the toilet. If you are not sure, ask your care team. If it is safe to put it in the trash, empty the medication out of the container. Mix the medication with cat litter, dirt, coffee grounds, or other unwanted substance. Seal the mixture in a bag or container. Put it in the trash.

NOTE: This sheet is a summary. It may not cover all possible information. If you have questions about this medicine, talk to your doctor, pharmacist, or health care provider.