Bictegravir–emtricitabine–tenofovir alafenamide

A single-tablet HIV regimen (bictegravir, emtricitabine and tenofovir alafenamide), FDA-approved as a complete treatment for HIV-1 infection.

psilodex.org/m/bictegravir-emtricitabine-tenofovir-alafenamide · data v2026.10.05

Clinical contraindication: None listed; No label contraindication covering psilocybin was found. This is not a finding that the combination has been shown to be without risk.
Psilocybin evidence: No psilocybin data
Half-life: ~17 h; Approximate, in adults. Source under Interaction below.

Named in state rules?

Not namedColorado

Not namedOregon

PendingNew Mexico

Cite asPsilodex, “Bictegravir–emtricitabine–tenofovir alafenamide”, v2026.10.05. psilodex.org/m/bictegravir-emtricitabine-tenofovir-alafenamide

Clinical data and state rules are separate facts. Both are shown; neither is a decision.

What it is used for

FDA status

FDA-approved

FDA-approved for

HIV-1 infection (complete regimen; adults and children weighing at least 14 kg)

Sources [1]

Other safety

Boxed warning: severe acute hepatitis B flares after stopping in people with HIV and hepatitis B. The label also warns of new or worsening kidney problems and lactic acidosis.

About the medication itself, separate from any interaction with psilocybin.

Sources [1]

01 Interaction with psilocybin

Not studied with psilocybin; no linking mechanism is described. Separately, stopping it can cause a hepatitis B flare in people who also have hepatitis B.

Detail Not studied with psilocybin, and no mechanism linking them has been described.

Human data with psilocybin: No psilocybin data; based on its label
Half-life: bictegravir ~17 h; emtricitabine ~10 h; tenofovir alafenamide ~0.5 h (FDA label, checked 2026-10-04) Median terminal plasma half-lives (label Table). Tenofovir diphosphate persists 150–180 h within PBMCs.

Evidence types on this record

No psilocybin dataNo psilocybin data: no human data with psilocybin or another classic psychedelic; the text draws on the medication's own pharmacology and its label or reference facts

02 Pharmacology relevant to psilocybin

2 listed · counted on reports

Withdrawal or rebound if stopped abruptly: Stopping suddenly can cause withdrawal or a rebound of symptoms. Sources [1]
Liver injury: The label or source warns of liver injury, from raised liver enzymes to liver failure. Liver disease also affects how the body clears psilocin. Sources [1]

03 State rules

Plain-language summary · official text governs

CO4 CCR 755-1

Not named

No provision names this medication or its class.

Colorado · checked 2026-10-04

OROAR 333-333

Not named

No provision names this medication or its class.

Oregon · checked 2026-10-04

NM7.35.3 NMAC (proposed)

Pending

New Mexico's clinical rules (proposed 7.35.3 NMAC) are not final. No provision naming this medication has been found.

New Mexico · checked 2026-10-04

04 Conditions to ask about

None linked

No condition named in state rules is linked to this medication.

05 Sources

BIKTARVY (bictegravir, emtricitabine, and tenofovir alafenamide) - Gilead · FDA label (DailyMed) — revised 2026-09 | Withdrawal or rebound if stopped abruptly: Boxed Warning: Post Treatment Acute Exacerbation of Hepatitis B "Severe acute exacerbations of hepatitis B have been reported in patients with HIV-1 and HBV who have discontinued products containing emtricitabine (FTC) and/or tenofovir disoproxil fumarate (TDF), and may occur with discontinuation of BIKTARVY." | Liver injury: Boxed Warning (same sentence) | 12.3 "t1/2 values refer to median (Q1, Q3) terminal plasma half-life. Note that the active metabolite of TAF, tenofovir diphosphate, has a half-life of 150-180 hours within PBMCs. 17.3 (14.8, 20.7) 10.4 (9.0, 12.0) 0.51 (0.45, 0.62)"
Halman A, Kong G, Sarris J, Perkins D. Drug–drug interactions involving classic psychedelics: a systematic review. J Psychopharmacol 2024;38(1):3–18. — no reported interaction
Sarparast A, Thomas K, Malcolm B, Stauffer CS. Drug-drug interactions between psychiatric medications and MDMA or psilocybin: a systematic review. Psychopharmacology 2022;239(6):1945–1976. — no reported interaction

Record history

v2026.10.02First published.
2026-10-04Last reviewed against its sources.

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