Currently, Truvada and Descovy are the only medications that have FDA approval for use as PrEP. Generic versions of both medications are available in some countries, but only the brand name drugs are available through commercial pharmacies in the United States. Other drugs, both oral and injectable, are being studied now, but the results are not in, and none of these alternatives are approved or recommended as PrEP.

Many HIV medications, such as Atripla and Stribild, contain the same two drugs as Truvada (plus others), but these drugs are prescribed only for treatment of people who are HIV-positive. Truvada is sometimes combined with other drugs and prescribed as Post-exposure Prophylaxis (PEP).

Truvada and Descovy are the only drugs currently approved for PrEP.

Alternatives Recognized in Some Countries

In some countries, the combination of TDF (tenofovir) and 3TC (lamivudine) is recognized as an alternative to brand name Truvada or TDF/FTC (generic Truvada).

Brand name Truvada or generic TDF/FTC (generic Truvada) is available in most countries. However, there are countries where neither one is available. The United States President’s Emergency Plan for AIDS Relief (PEPFAR) is a U.S. government initiative to address the global HIV/AIDS epidemic and help save the lives of people living with the disease, primarily in Africa. PEPFAR has issued recommendations on medications for both HIV treatment and PrEP. For those PEPFAR countries where neither brand name nor generic Truvada are available, PEPFAR states that “TDF/3TC is an acceptable alternative to TDF/FTC for PrEP.” Although there have been no clinical trials showing that this combination is effective in adults as PrEP, 3TC and FTC are chemically similar, and there is reason to believe that TDF/3TC may work similarly to Truvada as PrEP. For countries where Truvada and generic TDF/FTC are simply not available, this alternative has been endorsed by PEPFAR. [Note 5]

In Denmark, the Danish Society for Infectious Diseases guidelines state that “a combination of tenofovir and lamivudine may be used instead of Truvada” as PrEP. [Note 6]