Compare PrEP Medications: Truvada vs Descovy vs Apretude vs Lenacapavir
All of these prevent HIV — they differ in how you take them, who they’re approved for, how they affect your kidneys, bones and weight, and cost. Use the table to find your fit, then read the deep-dive for any medicine.
Full comparison table
| Truvada (TDF) | Descovy (TAF) | Apretude (CAB) | Lenacapavir | 2-1-1 | |
|---|---|---|---|---|---|
| Form | Daily pill | Daily pill | Injection / 2 mo | Injection / 6 mo | Pills around sex |
| Approved for | All exposures | Anal only | All exposures | All exposures | Anal, MSM |
| Time to protect (anal) | ~7 days | ~7 days | On schedule | After initiation | Pre-dose 2–24 h |
| Time to protect (vaginal) | ~20 days | Not approved | On schedule | After initiation | Not for vaginal |
| Kidney | Monitor | Minimal | None | None | Monitor |
| Bone | ~2–4% yr1 | Negligible | None | None | Low |
| Weight/lipids | Neutral | +1–3 kg | Minimal | Minimal | Neutral |
| Signature effect | Early nausea | Weight/lipids | Injection-site | Injection-site | Fewer pills |
| Pregnancy | Recommended | Limited data | Can use | Emerging data | No |
| Cost | Cheapest | Brand | High | High | Low (generic) |
“On schedule” = protective once the injection series is given at the recommended times. Read each medicine’s full guide below.
Which PrEP is right for you?
⚡ On-demand “2-1-1” dosing — read this first
For anal sex, Truvada can be taken around sex rather than daily: 2 pills 2–24 h before, then 1 pill at 24 h and 1 pill at 48 h. It’s convenient for infrequent, plannable sex — but it comes with firm limits.
🆕 Lenacapavir (Yeztugo) — the twice-a-year option
Approved by the FDA in 2025, lenacapavir is a long-acting capsid inhibitor given as a subcutaneous injection just twice a year. In the PURPOSE trials it showed near-complete protection, including in cisgender women. It’s the newest and least-frequent option — availability and cost are still settling. See it in context on the PrEP Options page →
Still comparing?
Read a full side-effect deep-dive for any medicine, or check whether your other medications interact with PrEP.
Full side-effect guides
PrEP alternatives: other ways to prevent HIV
PrEP is highly effective, but it's part of a bigger toolkit. Depending on your situation, alternatives or add-ons include:
- Condoms — also protect against other STIs (PrEP doesn't).
- PEP — emergency medicine within 72 hours after a possible exposure (not a substitute for ongoing PrEP).
- U=U (treatment as prevention) — a partner with HIV who is on treatment and undetectable cannot pass on HIV sexually. See serodifferent couples.
- Regular testing & Doxy-PEP — to find and cut bacterial STIs alongside HIV prevention.
- A different PrEP regimen — if a daily pill doesn't suit you, on-demand 2-1-1 or a long-acting injection may.
🔬 Sources & review
- U.S. FDA — Prescribing Information for Truvada, Descovy, Apretude and Yeztugo (lenacapavir).
- U.S. CDC — PrEP Clinical Practice Guideline (2021); WHO Consolidated HIV Prevention Guidelines (2021, 2022–2024 updates).
- USPSTF PrEP Recommendation (2023); IPERGAY, DISCOVER, HPTN 083/084 and PURPOSE-1/2 trials.
✔ Last medically reviewed: 3 July 2026 · Prepmedication.com Medical Review Team · Next review due: January 2027 · How we review →
Medical disclaimer. This comparison is general information, not a diagnosis or prescription. Approvals and dosing vary by country and change over time; always confirm your plan with a qualified clinician. If you may have been exposed to HIV in the last 72 hours, see PEP now.
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