Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States

The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.

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Nucleoside and Nucleotide Analogue Reverse Transcriptase Inhibitors

Tenofovir Alafenamide (Vemlidy, TAF)

Last Updated: December 7, 2018; Last Reviewed: December 7, 2018

Excerpt from Table 10a

Note: When using FDCs, refer to other sections in Appendix B and Table 10 for information about the dosing and safety of individual drug components of the FDC during pregnancy.

Generic Name
(Abbreviation)
Trade Name
Formulation Dosing Recommendations Use in Pregnancy
Tenofovir Alafenamide
(TAF)
Vemlidy

(TAF/BIC/FTC)
Biktarvy

(TAF/FTC)
Descovy

(TAF/EVG/COBI/FTC)
Genvoya

(TAF/FTC/RPV)
Odefsey

(TAF/DRV/COBI/FTC)
Symtuza

Note: Generic available for some formulations.
TAF (Vemlidy)d
Tablet:
  • 25 mg
TAF/BIC/FTC (Biktarvy):
  • TAF 25 mg plus BIC 50 mg plus FTC 200 mg tablet
TAF/FTC (Descovy):
  • TAF 25 mg plus FTC 200 mg tablet
TAF/EVG/COBI/FTC (Genvoya):
  • TAF 10 mg plus EVG 150 mg plus COBI 150 mg plus FTC 200 mg tablet
TAF/FTC/RPV (Odefsey):
  • TAF 25 mg plus FTC 200 mg plus RPV 25 mg tablet
TAF/DRV/COBI/FTC (Symtuza):
  • TAF 10 mg plus DRV 800 mg plus COBI 150 mg plus FTC 200 mg tablet
Standard Adult Dose
TAF (Vemlidy):
  • 1 tablet once daily with food
TAF/BIC/FTC (Biktarvy):
  • 1 tablet once daily with or without food
TAF/FTC (Descovy):
  • 1 tablet once daily with or without food
  • Same dose (TAF 25 mg) can be used with or without pharmaco-enhancers.
TAF/EVG/COBI/FTC (Genvoya):
  • 1 tablet once daily with food
TAF/FTC/RPV (Odefsey):
  • 1 tablet once daily with food
TAF/DRV/COBI/FTC (Symtuza):
  • 1 tablet once daily with food
PK in Pregnancy:
  • Plasma PK not significantly altered in pregnancy.
Dosing in Pregnancy:
  • No change in dose indicated.
  • For guidance about use of combination products in pregnancy, please see the specific sections on other components (i.e., BIC, COBI. DRV, EVG, FTC, RPV).
Low placental transfer to fetus.b

Insufficient data to assess for teratogenicity in humans. No evidence of teratogenicity in rats.

Renal function should be monitored because of potential for renal toxicity.
a Individual ARV drug doses may need to be adjusted in patients with renal or hepatic insufficiency (for details, see the Adult and Adolescent Guidelines Appendix B, Table 8).
b Placental transfer categories are determined by mean or median cord blood/maternal delivery plasma drug ratio:
          High: >0.6
          Moderate: 0.3–0.6
          Low: <0.3
d Generic formulation available

Key to Acronyms: COBI = cobicistat; BIC = bictegravir; DRV = darunavir; EVG = elvitegravir; FDC = fixed-dose combination; FTC = emtricitabine; PK = pharmacokinetic; RPV = rilpivirine; TAF = tenofovir alafenamide

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