If you’re already taking Biktarvy and you’re undetectable, you may have heard about Dovato and dual therapy treatments.

Dovato, like Biktarvy, is a safe and effective drug for HIV positive patients to manage their health and remain undetectable. Both are great options, but some prefer Dovato because it’s a dual therapy treatment, which means you take two medications in each dose; Biktarvy is a triple therapy treatment, with three active medications.

Making the switch from Biktarvy to Dovato is common, but trying a new medication comes with questions and can create some anxiety, too. Is it safe to make the switch? How do you know what option is right for you? Is there a bigger risk in taking a dual therapy drug? 

You should have all the information you need before you decide to make the change. Here’s what you need to know, and what you can expect, while considering the switch to Dovato.

Why some patients consider switching from Biktarvy to Dovato

There are a few common reasons why stable, undetectable patients decide to switch from Biktarvy to Dovato:

  • Simplified treatment: Dovato lets you remain undetectable with only two medications, while Biktarvy contains three. Some people feel more comfortable taking fewer medications over the long term. 
  • Reduced long-term side effects: While it’s still a great option, Biktarvy can affect liver and kidney function. Switching to Dovato can help alleviate these concerns. 
  • Weight management: Some people gain weight and find it difficult to manage while taking Biktarvy. Studies show that managing weight gain is easier on Dovato.

Start with a conversation with a care provider — they can help you determine your next steps.

Who can safely switch from Biktarvy to Dovato

Most of the time, undetectable patients without previous treatment failures can safely switch from Biktarvy to Dovato. 

However, you can expect your clinician to thoroughly review your medical history and labs before you switch to mitigate any risk. Here are some of the things they’ll be looking into. 

Are you undetectable? To safely change your medication, you’ll need to be undetectable with at least 6 months of stable suppression. 

Have you had previous treatment failures? If your HIV treatment has experienced virological failure and has not worked in the past, switching medications is not recommended. 

Are you being treated for Hepatitis B? If you have a Hepatitis B co-infection, Biktarvy is a better option, as it treats both Hepatitis B and HIV.

Are there any other health considerations to take into account? Your clinician will want an overall picture of your health before switching your medication. For example, they’ll want to know if you’re pregnant, planning on becoming pregnant, or taking medications that might interact with Dovato.

Once everything is in order and you’ve been approved, your care provider will walk you through the switching process. 

Step-by-step: How the switching process works

Switching your HIV medication can feel overwhelming, but your care provider will support you every step of the way. 

Here’s what you can expect the process to look like:

  1. Consultation: You’ll start by talking with a clinician. Switching from Biktarvy to Dovato is common, and they can answer any questions on your mind. 
  2. Baseline lab tests: Before switching, you’ll start with baseline labs that your clinician can reference to evaluate your current viral load, Hepatitis B & C status, and organ function. You may also get an HIV drug resistance test to make sure that you’ll respond well to Dovato. 
  3. Insurance approval: Once you’ve been prescribed Dovato, your insurance provider might require more information from your clinician. Clearing this prior authorization can take up to two weeks.
  4. Starting the new medication: There’s no gap needed between taking the two medications. You’ll finish your last dose of Biktarvy and take your first dose of Dovato the next day.
  5. Ongoing monitoring: You’ll do another follow-up lab test six weeks after switching to monitor results. From there, you’ll do ongoing labs every 3 to 6 months to make sure Dovato is working as it should.

What you might notice after making the switch

It’s simple to take Dovato — you take one dose at the same time, every day, with or without food.

It can take time for your body to adjust to new medications, but many find the transition simple. You also might notice some weight loss if Biktarvy caused weight gain.

The most common side effects that people experience when they switch to Dovato are headaches, nausea, diarrhea, and trouble sleeping. Stay in touch with your clinician about any side effects. And if you’re experiencing symptoms of an allergic reaction or feeling seriously ill, seek urgent medical care as soon as possible.

Will switching affect viral suppression?

In short: no, switching from Biktarvy to Dovato does not affect viral suppression. 

It’s normal to feel some anxiety when you switch medications. Your health is important, and you want to make sure that you’re making the right choices for your well-being.

But rest assured: there is clinical evidence that patients with undetectable viral loads remain undetectable after switching. In fact, a recent study demonstrated that patients remain undetectable and experience less weight gain and adverse effects on liver function. In short, you may actually feel healthier in the long-term.

You might see the word “non-inferior” used in clinical studies about switching. This term means that there is no evidence that Dovato is less effective than Biktarvy in suppressing infection. 

If you’re still feeling nervous, make sure you keep up with your ongoing labs every 3-6 months. Getting reassurance that you’re still undetectable helps you feel confident in your decision after you switch.

Why dual therapy can work (without the medical jargon)

Dual therapy means that the medication that you’re taking contains two medicines. Dovato is a dual therapy HIV treatment, while Biktarvy is a triple therapy, with three medicines. 

Dual therapy doesn’t mean that a drug is less effective or weaker than other treatments. Approved dual therapy medications have been thoroughly tested to ensure they’re safe and effective.

Sometimes, medical providers opt for dual therapy to make sure you have an effective treatment while taking fewer drugs. If you’re already undetectable, dual therapy keeps your viral load low while reducing any long-term impact that taking more medication could have on your body. That being said, both dual and triple therapy treatments can be safely used long-term. 

Insurance approval and prior authorization

When you’re switching from Biktarvy to Dovato, you’ll want to make sure that you are covered under your health insurance plan and prepared for any additional approvals required. 

Switching to Dovato can trigger prior authorizations (or “prior auths”) depending on your provider and plan. Prior authorization is when your insurance provider requests additional documentation or information from a clinician before covering costs. Dovato may trigger a prior authorization because it is a specialized drug, and insurers want to be certain it’s being distributed responsibly.

Your provider also may have a preferred medication for HIV+ patients, which can also trigger a prior authorization. If Dovato is a non-preferred medication, that doesn’t mean that it won’t be covered — it means that a medical professional needs to provide more detailed information about why you’re trying Dovato instead of your insurer’s preferred option.

To avoid delays in switching medication:

  • Review your insurance plan to check your coverage
  • Discuss what might happen if a prior auth is triggered, and how fast your care provider can submit documentation
  • Prior authorizations can take up to 2 weeks to clear; make sure you continue taking Biktarvy until you’re approved and covered for Dovato

What changes day-to-day after switching

Day-to-day, many people don’t notice a difference after switching from Biktarvy to Dovato. You’ll continue to take one dose per day at the same time, and get routine labs every 3 to 6 months to ensure your treatment is working effectively.

One common side effect of Biktarvy is weight gain. Some patients report that after switching to Dovato, they found it easier to lose and maintain their weight. 

You might experience side effects such as headaches, nausea, diarrhea, and sleep disturbances. If side effects are affecting your daily activities, check in with a clinician for a sustainable solution.

If you don’t notice a big difference, that doesn’t mean that Dovato isn’t working. Most people find the transition very smooth, and their viral load remains undetectable as it was when they used Biktarvy.

Potential downsides or considerations

While many patients are successfully using Dovato, some people might not be a good fit:

  • People with Hepatitis B (HBV): If you have HBV, talk to your clinician — Dovato can lead to serious side effects. 
  • Pregnant people: Tell your care provider if you are pregnant and want to switch to Dovato, and they can determine if switching during pregnancy is recommended.
  • People taking certain medications: Some medications, like dofetilide (for abnormal heart rhythms), should not be taken alongside Dovato. Always consult with a clinician before taking new medications or supplements.

Can you switch back to Biktarvy?

Yes, you can safely switch back to Biktarvy. 

You might decide to switch back if you’ve been diagnosed with HBV or require a medication that you can’t take alongside Dovato. 

Alternatively, you might just feel better when you’re taking Biktarvy. Very rarely, people who use Dovato might experience anxiety or depression. Your mental health is important — if you notice any shifts in your mental health after switching medications, talk to your health provider to see what the best steps are. 

No matter the reason, if Dovato doesn’t feel like the right choice for you, you can go back to your Biktarvy treatment.

Questions to ask your provider before switching

Here are some questions to ask a clinician before you decide to change treatments:

  • Am I a good candidate for a dual-therapy treatment, like Dovato?
  • Do I have any resistance history that I should be aware of?
  • What do I need to do before I make the switch?
  • What follow-up labs will we do and when?
  • What should I watch for in the first 4–8 weeks?
  • What common side effects do your patients mention after switching?
  • How will we handle insurance approval?

How care coordination helps support treatment transitions

Working alongside a care service like Freddie can help you move forward confidently while switching medications.

Freddie has a dedicated team devoted to providing HIV+ patients with discreet and inclusive care. Your team helps you book lab tests and coordinate pharmacy deliveries with community-based organizations. They’re here to help with coverage checks and can see you quickly, reducing delays and ensuring prompt follow-ups when needed. 

Working with Freddie’s care team can help bring you peace of mind as you switch from Biktarvy to Dovato. Find out more about care with Freddie here.

Frequently asked questions about switching from Biktarvy to Dovato

Here are some common questions people have before switching from Biktarvy to Dovato.

Can I switch directly from Biktarvy to Dovato?

Yes, you can switch directly from Biktarvy to Dovato. Many people have safely made the switch, and some clinicians recommend Dovato to reduce the number of medications you are taking long-term. 

Do I need to be undetectable first?

Yes, you need to be undetectable for at least 6 months before switching from Biktarvy to Dovato, without a history of treatment failure.

Is dual therapy as effective as triple therapy?

Dual therapy is as effective as triple therapy for undetectable HIV+ patients. Clinical evidence suggests that dual therapy medications are as effective as triple therapy for viral suppression.

How long does switching take?

There’s no gap when you switch from Biktarvy to Dovato — you’ll finish your daily Biktarvy dose and start taking Dovato the next day. You’ll have a follow-up lab 6 weeks later to make sure that the drug is working and you’re still undetectable.

Will insurance approve Dovato?

Dovato is covered under many health insurance providers and plans. Make sure to check with your provider to confirm your coverage.

Switching to Dovato might trigger a prior authorization, requiring a medical professional to send your insurance provider additional documentation before you are covered.

What should I ask my provider before switching?

Before switching from Biktarvy to Dovato, ask your provider:

  • Am I a good candidate for dual therapy?
  • Do I have any resistance history that prevents me from switching?
  • What documentation might my health insurance provider need?
  • What do I need to do before I switch, and what follow-ups will I need?
  • What side effects should I be aware of?

Still thinking about switching?

If you’re considering switching from Biktarvy to Dovato, start by talking with a clinician. They’ll review your treatment history, answer your questions, and support you if you decide to make the switch. 

For a simple first step, connect with the Freddie team for a free consultation. They’re happy to help you discuss your options and choose the medication that works best for you.

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