Can You Drink Alcohol While Taking BikTarVy for PEP Treatment?

Post-Exposure Prophylaxis (PEP)

Hello doctor, today I went to Mackay Memorial Hospital for PEP treatment, and the doctor prescribed me BikTarVy (bictegravir/emtricitabine/tenofovir alafenamide).
Can I drink alcohol while taking this medication? If so, how long should I wait after taking the medication? Will this medication interact with the Taiwanese version of sildenafil (樂軒昂)?

Liang, 20~29 year old female. Ask Date: 2024/07/06

Dr. Liao Zhongxin reply Internal Medicine

1.
First, regarding the precautions for using Loxone (Tadalafil): When using Loxone film-coated tablets, please adhere to the following precautions and medication recommendations:
- Follow the physician's prescription: Before using Loxone film-coated tablets, obtain an evaluation and prescription from a physician.
Follow the physician's instructions for medication use and do not adjust the dosage on your own.

- Regular follow-up: It is very important to have regular follow-up visits after using Loxone film-coated tablets.
This helps the physician assess the drug's efficacy and make timely adjustments to the treatment plan.

- Medication storage: Store Loxone film-coated tablets away from sunlight and moisture, and avoid high-temperature environments.
Additionally, keep the medication out of reach of children.

- Inappropriate populations: Loxone film-coated tablets are not suitable for women and minors, nor for patients with severe heart, liver, or kidney diseases.

2.
As for the usage and precautions for Biktarvy:
- Common dosage: The recommended dosage is one tablet taken once daily, with or without food.

- Side effects/warnings: Possible side effects include diarrhea, nausea, vomiting, headache, fatigue, dizziness, insomnia, and abnormal dreams.
Other adverse reactions occurring at a rate of less than 2% include vomiting, gastrointestinal bloating, dyspepsia, abdominal pain, rash, and depression.

- Contraindications: Biktarvy should not be used in conjunction with the following medications:
• Dofetilide, as it may increase the blood concentration of dofetilide, potentially leading to serious and/or life-threatening events.

• Rifampin, as it may decrease the blood concentration of BIC, which could result in loss of efficacy and development of resistance to Biktarvy.

- Precautions:
1.
Can be taken with or without food.

2.
Not recommended for patients with severe hepatic impairment.

3.
If taking calcium or iron supplements, take this medication with food.

4.
If aluminum/magnesium or calcium antacids are necessary, take this medication on an empty stomach at least 2 hours prior.

5.
For patients infected with HIV-1, testing for chronic hepatitis B virus (HBV) infection should be conducted before or at the start of treatment.

6.
Any patient with clinical test results indicating lactic acidosis or significant hepatotoxicity (which may include hepatomegaly and fatty liver, even without obvious transaminase elevation) should discontinue Biktarvy treatment.

Reply Date: 2024/07/06

More Info

When taking Biktarvy as part of Post-Exposure Prophylaxis (PEP) treatment, it is essential to consider the potential interactions with alcohol and other medications. Biktarvy, which contains the active ingredients bictegravir, emtricitabine, and tenofovir alafenamide, is an antiretroviral medication used to prevent HIV infection after potential exposure.

Alcohol Consumption While on Biktarvy
1. Alcohol and Biktarvy: Generally, moderate alcohol consumption is not contraindicated while taking Biktarvy. However, it is crucial to be cautious. Excessive alcohol intake can lead to liver toxicity, especially since Biktarvy is metabolized in the liver. Therefore, while you may be able to enjoy a drink or two, it is advisable to limit your alcohol consumption to avoid any potential adverse effects on your liver function.

2. Timing and Interactions: After completing a 30-day course of PEP, including Biktarvy, you can typically return to your normal dietary habits, including alcohol consumption. However, it is always wise to consult your healthcare provider for personalized advice, especially if you have other underlying health conditions or are taking additional medications.

Interactions with Other Medications
1. Biktarvy and Tadalafil (樂軒昂): If you are considering taking Tadalafil (often known by the brand name Cialis or 樂軒昂), it is essential to be aware of potential interactions. While there is no direct contraindication between Biktarvy and Tadalafil, both medications can have effects on blood pressure. Therefore, it is advisable to consult your healthcare provider before combining these medications to ensure it is safe for you.

2. General Medication Guidelines: When taking any medication, including Biktarvy, it is crucial to follow the prescribing physician's instructions. This includes being aware of any potential interactions with other medications you may be taking. Always inform your healthcare provider about all medications, supplements, and over-the-counter drugs you are using to avoid adverse interactions.

Dietary Considerations
1. Calcium and Other Supplements: While taking Biktarvy, it is recommended to avoid taking calcium, magnesium, or aluminum-containing supplements or antacids within two hours of taking the medication, as these can interfere with its absorption. If you consume dairy products like milk, which contains calcium, it is generally safe as long as you space it out from your medication by at least two hours.

2. Nutritional Supplements: After completing your PEP treatment, you can resume taking multivitamins or other nutritional supplements. However, be mindful of the ingredients in these supplements, as some may interact with other medications you might be prescribed in the future.

Conclusion
In summary, while moderate alcohol consumption is generally acceptable while taking Biktarvy, it is essential to be cautious about liver health and potential interactions with other medications like Tadalafil. Always consult your healthcare provider for personalized advice tailored to your specific health needs. After completing your PEP treatment, you can typically return to your normal dietary habits, but ongoing communication with your healthcare provider is crucial for maintaining your health and safety.

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