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SYMTUZA® Tolerability Profile | SYMTUZA® (darunavir/cobicistat/emtricitabine/tenofovir alafenamide) HCP

Adverse Event Profile

SYMTUZA®: A Tolerability Profile That Patients Need and That You Can Rely On

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Across pivotal trials, no new cases of type 2 diabetes related to SYMTUZA® or clinically relevant changes in blood pressure over 96 weeks.1*

Adverse reactions ≥2% in treatment-naïve patients1,2

Adverse reactions percentages

*Week 96 was an open-label, single-arm extension, not a primary endpoint.3,4

Includes pooled reported terms: dermatitis, dermatitis allergic, erythema, photosensitivity reaction, rash generalized, rash macular, rash maculopapular, rash morbilliform, rash pruritic, toxic skin eruption, and urticaria.1

One Grade 3 and no Grade 4 adverse reactions were reported with SYMTUZA® at 48 weeks.1‡

In virologically suppressed patients:

  • The safety profile of SYMTUZA® was similar to that of treatment-naïve patients1
  • Through 48 weeks, the most common treatment-related adverse events were diarrhea (2%, n=16/763) and osteopenia (1%, n=5/763)5
  • Most adverse events were mild to moderate in severity (Grades 1 and 2)5
    • The most common Grade 3 adverse event was pneumonia, which was reported for 3 (<1%) patients. No Grade 4 adverse events were reported in 2 or more patients
In a study of rapid initiation6:
Less than 1% icon

of patients (N=109) discontinued due to adverse events over 48 weeks

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discontinuations due to weight gain, metabolic, CNS, or GI AEs

  • Only one patient discontinued due to adverse events
    • This patient had allergic dermatitis (Grade 3), pyrexia (Grade 2), and lip swelling (Grade 2)
    • All adverse events resolved after discontinuation of study treatment
At 48 weeks, the most common adverse reactions (≥2%, all Grades) in patients rapidly initiating SYMTUZA® were:
Adverse reactions percentages

Most adverse reactions during treatment with SYMTUZA® were mild to moderate in severity (Grade 1 or Grade 2)

  • Few Grade 3 and 4 clinical laboratory abnormalities occurred in ≥2% of patients (increased bilirubin in 3% of patients, increased ALT in 3% of patients, and increased AST in 5% of patients)

This is not a complete list of all adverse reactions reported with the use of SYMTUZA®. See Important Safety Information section below for the most common adverse reactions in the treatment-naïve pivotal trial. Please refer to the full Prescribing Information for a complete list of adverse reactions.

Few treatment-naïve patients started a lipid-lowering medication. 1.7% (n=6) of patients in the SYMTUZA® arm and 0.6% (n=2) in the control arm started a lipid-lowering drug during treatment.2

§Pooled preferred terms of allergic dermatitis, dermatitis, rash, macular rash, maculopapular rash, papular rash, and pruritic rash.6

AE=adverse event; ALT=alanine aminotransferase; AST=aspartate aminotransferase; BL=baseline; CNS=central nervous system; DRV/c=darunavir/cobicistat; FTC=emtricitabine; GI=gastrointestinal; TDF=tenofovir disoproxil fumarate.



  • Severe acute exacerbations of hepatitis B (HBV) have been reported in patients who are coinfected with HIV-1 and HBV and have discontinued products containing emtricitabine and/or tenofovir disoproxil fumarate (TDF) and may occur with discontinuation of SYMTUZA®.

Action: Monitor hepatic function with both clinical and laboratory follow-up for at least several months in patients who are coinfected with HIV-1 and HBV and discontinue SYMTUZA®. If appropriate, anti-hepatitis B therapy may be warranted.


  • Do not coadminister SYMTUZA® and the following drugs due to the potential for serious and/or life-threatening events or loss of therapeutic effect: alfuzosin, carbamazepine, colchicine (in patients with renal and/or hepatic impairment), dronedarone, elbasvir/grazoprevir, ergot derivatives (such as: dihydroergotamine, ergotamine, methylergonovine), ivabradine, lomitapide, lovastatin, lurasidone, oral midazolam, naloxegol, phenobarbital, phenytoin, pimozide, ranolazine, rifampin, St. John’s wort (Hypericum perforatum), sildenafil for pulmonary arterial hypertension, simvastatin, and triazolam.

References: 1. Data on file. Janssen Therapeutics, Division of Janssen Products, LP. 2. SYMTUZA® [package insert]. Titusville, NJ: Janssen Therapeutics, Division of Janssen Products, LP. 3. Orkin C, Eron JJ, Rockstroh J, et al; AMBER Study Group. Week 96 results of a phase 3 trial of darunavir/cobicistat/emtricitabine/tenofovir alafenamide in treatment-naive HIV-1 patients. AIDS. 2020;34(5):707-718. 4. Eron JJ, Orkin C, Cunningham D, et al; EMERALD Study Group. Week 96 efficacy and safety results of the phase 3, randomized EMERALD trial to evaluate switching from boosted-protease inhibitors plus emtricitabine/tenofovir disoproxil fumarate regimens to the once daily, single-tablet regimen of darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) in treatment-experienced, virologically-suppressed adults living with HIV-1. Antiviral Res. 2019;170:104543. 5. Orkin C, Molina JM, Negredo E, et al; EMERALD Study Group. Efficacy and safety of switching from boosted protease inhibitors plus emtricitabine and tenofovir disoproxil fumarate regimens to single-tablet darunavir, cobicistat, emtricitabine, and tenofovir alafenamide at 48 weeks in adults with virologically suppressed HIV-1 (EMERALD): a phase 3, randomised, non-inferiority trial. Lancet HIV. 2018;5(1):e23-e34. 6. Huhn GD, Crofoot G, Ramgopal M, et al. Darunavir/cobicistat/emtricitabine/tenofovir alafenamide in a rapid-initiation model of care for human immunodeficiency virus type 1 infection: primary analysis of the DIAMOND study. Clin Infect Dis. 2020;71(12):3110-3117.

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