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Combination Therapies

Treatment with multiple HIV medications from a variety of different drug classes has been shown to be the most effective in helping an individual achieve viral suppression. Using multiple medications or classes of medications to treat HIV is referred to as antiretroviral therapy (ART) or combination antiretroviral therapy (cART).

In the past, HIV treatment options were available only as monotherapies, or medications that contained one active ingredient. Today, combination therapies are available that combine multiple medications, sometimes from different drug classes, in one tablet. This helps make taking and adhering to HIV treatment simpler, which is especially important in preventing HIV from mutating and developing resistance against a medication.1-3

Some examples of common combination therapies that combine multiple medications are below. Several of these are designed to be stand-alone therapies and are not to be taken with other HIV medications. Others need to be taken with additional HIV therapies. Other medications that might be added to these combination regimens include any additional medications from the classes listed, as well as medications classified as fusion inhibitors, CCR5 antagonists, and post-attachment inhibitors. Your healthcare provider will let you know which medications you should be taking and when.

NRTI combination therapies

NRTI combination therapies use two or more NRTI (nucleoside reverse transcriptase inhibitor) medications. Examples of NRTI combination therapies include:

  • Epzicom (abacavir and lamivudine)
  • Trizivir (abacavir, lamivudine, and zidovudine)
  • Descovy (emtricitabine and tenofovir alafenamide)
  • Cimduo (lamivudine and tenofovir disoproxil fumarate)
  • Combivir (lamivudine and zidovudine)
  • Truvada (emtricitabine and tenofovir disoproxil fumarate)

NRTI/NNRTI combination therapies

NRTI/NNRTI combination therapies typically use two NRTI medications and one NNRTI (non-nucleoside reverse transcriptase inhibitor). Examples of NRTI/NNRTI combination therapies include:

  • Delstrigo (doravirine, lamivudine, and tenofovir disoproxil fumarate)
  • Atripla (efavirenz, emtricitabine, and tenofovir disoproxil fumarate)
  • Symfi/Symfi Lo (efavirenz, lamivudine, and tenofovir disoproxil fumarate)
  • Odefsey (emtricitabine, rilpivirine, and tenofovir alafenamide)
  • Complera (emtricitabine, rilpivirine, and tenofovir disoproxil fumarate)

NRTI/integrase inhibitor combination therapies

NRTI combination therapies use one or more NRTI medications and one integrase inhibitor medication. Examples of NRTI/integrase inhibitor combination therapies include:

  • Triumeq (abacavir, dolutegravir, and lamivudine)
  • Biktarvy (bictegravir, emtricitabine, and tenofovir alafenamide)
  • Dovato (dolutegravir and lamivudine)

NNRTI/integrase inhibitor combination therapies

NNRTI combination therapies typically use one NNRTI medication and one integrase inhibitor medication. Examples of NNRTI/integrase inhibitor combination therapies include:

  • Juluca (dolutegravir and rilpivirine)

Protease inhibitor therapies

Protease inhibitor combination therapies typically use two protease inhibitor medications. Examples of protease inhibitor combination therapies include:

  • Kaletra (lopinavir and ritonavir)

Protease inhibitor/pharmacokinetic enhancer combination therapies

Protease inhibitor/pharmacokinetic enhancer combination therapies typically use one protease inhibitor medication and one pharmacokinetic enhancer medication. Examples of protease inhibitor/pharmacokinetic enhancer combination therapies include, but are not limited to:

Multi-class combination therapies

Other combination therapies are available that combine three different drug classes. Several of these include:

  • Symtuza, an NRTI/protease inhibitor/pharmacokinetic enhancer combination (darunavir, cobicistat, emtricitabine, and tenofovir alafenamide)
  • Genvoya, an NRTI/integrase inhibitor/pharmacokinetic enhancer (elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide)
  • Stribild, an NRTI/integrase inhibitor/pharmacokinetic enhancer (elvitegravir, cobicistat, emtricitabine, and tenofovir disoproxil fumarate)
Written by: Casey Hribar | Last reviewed: September 2019
  1. HIV Treatment: The Basics. United States Department of Health and Human Services: AIDSinfo. https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/21/51/hiv-treatment--the-basics. Published January 15, 2019. Accessed July 25, 2019.
  2. FDA-Approved HIV Medicines. United States Department of Health and Human Services: AIDSinfo. https://aidsinfo.nih.gov/understanding-hiv-aids/fact-sheets/21/58/fda-approved-hiv-medicines. Published June 24, 2019. Accessed July 25, 2019.
  3. Maenza J, Flexner C. Combination Antiretroviral Therapy for HIV Infection. American Family Physician. 1 Jun 1998; 57(11), 2789-98. Available from: https://www.aafp.org/afp/1998/0601/p2789.html. Accessed July 25, 2019.