Biktarvy, as an HIV compound preparation, commonly has side effects including headache, diarrhea, and metabolic abnormalities. Most symptoms are mild and can be relieved on their own, but serious reactions such as lactic acidosis and immune reconstitution syndrome should be monitored. The risk can be effectively controlled through dose adjustment, symptomatic treatment, and regular monitoring.

1. Common side effects and mitigation measures

(1) Headache: The incidence rate is about 10% -15%, usually occurring in the early stages of medication. It is recommended to drink water in portions and use acetaminophen if necessary to relieve symptoms.

(2) Diarrhea: The incidence rate is about 8%. To maintain electrolyte balance, mild symptoms can be treated with oral montmorillonite powder. If it persists for more than 48 hours, medical attention is required.

(3) Fatigue: Avoid driving or operating machinery, adjust medication time to evening to alleviate daytime drowsiness.

2. Serious reactions requiring medical intervention

(1) Lactic acidosis: manifested as difficulty breathing, abdominal pain with vomiting, requiring immediate discontinuation of medication and hospitalization to monitor blood lactate levels.

(2) Immune reconstitution syndrome: In the early stages of treatment, opportunistic infections may worsen, and prophylactic use of antibiotics is necessary.

(3) Hepatorenal toxicity: Regularly monitor ALT/AST and creatinine levels, and adjust dosage if jaundice or decreased urine output occurs.

3. Precautions for special populations

(1) Pregnant women: The viral load needs to be evaluated, and the newborn should receive 6 weeks of zidovudine prophylactic treatment after delivery.

(2) Renal insufficiency: When the creatinine clearance rate is 30-50ml/min, the dose needs to be adjusted. If it is lower than 30ml/min, it is prohibited.

(3) Combined with hepatitis B: discontinuation of the drug may lead to acute hepatitis, and simultaneous monitoring of HBV DNA is required.

4. Drug interaction management

(1) Magnesium/aluminum antacids: should be taken every 2 hours to avoid reducing the absorption rate of bikinamivir.

(2) Rifampicin: Combination use is prohibited as it may significantly reduce drug concentration and lead to treatment failure.

(3) St. John's wort: Chinese herbal medicine induces metabolic enzymes, and other antidepressant drugs need to be used instead.