Is Descovy (emtricitabine and tenofovir alafenamide) associated with decreased red blood cells (anemia) and white blood cells (leukopenia)?

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Last updated: March 24, 2025View editorial policy

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From the Guidelines

Descovy (emtricitabine and tenofovir alafenamide) is not typically associated with significant decreases in red blood cells (anemia) or white blood cells (leukopenia) according to the most recent guidelines 1. When considering the potential side effects of Descovy, it's essential to weigh the benefits of this antiretroviral medication against possible risks. The 2020 recommendations of the international antiviral society-USA panel, published in JAMA 1, provide valuable insights into the use of Descovy and other antiretroviral regimens. Some key points to consider include:

  • The potential uses and cautions for various antiretroviral regimens, including those that contain tenofovir alafenamide and emtricitabine, are outlined in the guidelines 1.
  • While mild decreases in white blood cell counts can occasionally occur with antiretroviral therapy, severe blood cell abnormalities are not common side effects of Descovy specifically.
  • Regular monitoring of blood counts is part of standard care for patients on HIV medications to detect any potential issues early. If you're experiencing symptoms like unusual fatigue, weakness, frequent infections, or bruising while taking Descovy, you should contact your healthcare provider promptly for evaluation. These symptoms could indicate blood cell abnormalities that may be due to other causes or medications. Your doctor may recommend blood tests to check your complete blood count and determine if Descovy is related to any changes in your blood cells. If significant blood cell decreases are detected, your provider might consider alternative medications.

From the FDA Drug Label

Laboratory Abnormalities: Laboratory abnormalities in these trials occurred with similar frequency in the emtricitabine and comparator groups A summary of Grades 3 to 4 laboratory abnormalities is provided in Table 3. Table 3 Treatment-Emergent Grades 3 to 4 Laboratory Abnormalities Reported in ≥1% of Emtricitabine-Treated Subjects in Either Trial 301A or 303 Neutrophils (<750 mm3) 5% 3% 5% 7% Table 5 Significant Laboratory Abnormalities Reported in ≥1% of Subjects in Any Treatment Group in Trial 934 (0 to 144 Weeks) Neutrophils (<750/mm3) 3% 5% Hemoglobin (<8. 0 mg/dL) 0% 4% Anemia (7%)

Anemia and Leukopenia

  • Anemia: The drug label reports anemia in 7% of pediatric subjects.
  • Leukopenia: The label also reports decreased neutrophils (<750/mm3) in 3-7% of subjects, which is a sign of leukopenia. 2

From the Research

Adverse Effects of Descovy (Emtricitabine and Tenofovir Alafenamide)

  • The provided studies do not directly address the association of Descovy (emtricitabine and tenofovir alafenamide) with decreased red blood cells (anemia) and white blood cells (leukopenia) 3, 4, 5, 6, 7.
  • However, the studies suggest that emtricitabine and tenofovir alafenamide is generally well-tolerated, with a low number of participants reporting adverse events that led to discontinuation of the study drug 3, 4.
  • Tenofovir alafenamide has been shown to have a more favorable safety profile compared to tenofovir disoproxil fumarate, with improved bone mineral density and renal safety biomarkers 3, 4, 5, 6.
  • There is no direct evidence in the provided studies to suggest that Descovy (emtricitabine and tenofovir alafenamide) is associated with decreased red blood cells (anemia) and white blood cells (leukopenia) 3, 4, 5, 6, 7.

Efficacy and Safety of Emtricitabine and Tenofovir Alafenamide

  • Emtricitabine and tenofovir alafenamide has been shown to be non-inferior to emtricitabine and tenofovir disoproxil fumarate for HIV prevention 3, 4.
  • The combination of emtricitabine and tenofovir alafenamide has been approved for use in HIV pre-exposure prophylaxis and has been shown to be effective in reducing the risk of sexually acquired HIV-1 infection in at-risk adults 7.
  • Tenofovir alafenamide has been shown to have a more favorable safety profile compared to tenofovir disoproxil fumarate, with improved bone mineral density and renal safety biomarkers 3, 4, 5, 6.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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