Drug & supplement interaction

Iron + emtricitabine, tenofovir

emtricitabine, tenofovir brand name: Truvada.

Moderate Interaction
The bottom line Moderate

Iron has a moderate interaction with emtricitabine, tenofovir. Iron might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.

Read the full interaction report
SeverityModerate
LikelihoodProbable
EvidenceD
What do Severity, Likelihood & Evidence mean?
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Interaction report

Iron and emtricitabine, tenofovir

Here is the interaction we found between these two, with the evidence behind it.

Moderate

BICTEGRAVIR/EMTRICITABINE/TENOFOVIR ALAFENAMIDE (Biktarvy)

Iron might decrease levels of bictegravir/emtricitabine/tenofovir alafenamide by reducing its absorption when taken in a fasting state.
Advise patients that bictegravir/emtricitabine/tenofovir alafenamide and iron can be taken together if taken with food. However, if taken on an empty stomach, bictegravir/emtricitabine/tenofovir alafenamide should not be taken with, or 2 hours after, iron containing products.
Severity Moderate Likelihood Probable Evidence D

Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports..

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the practical side of this one. Iron can grab onto certain HIV medicines in your stomach and keep them from being fully absorbed, especially the integrase-type drugs often paired with your Truvada (emtricitabine and tenofovir). If less of your medicine gets into your blood, it may not control the virus as well over time, which is the real concern with HIV therapy. This is based on how the drugs behave chemically, not a long list of patient reports, so think of it as a sensible precaution.

The easy fix: taking them together with food usually avoids the problem. If you take them on an empty stomach, separate your iron so it isn't taken at the same time. Always run timing changes past your pharmacist or doctor first.

References
  1. US Food and Drug Administration (FDA). Biktarvy Prescribing Information. October 2024. Available at: https://www.accessdata.fda.gov/drugsatfda_docs/label/2024/210251Orig1s020lbl.pdf. Accessed July 16, 2025.

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Iron Also Interacts With Other Medications

Iron has 78 moderate, 1 minor known drug interactions in our database — the emtricitabine, tenofovir one above is one of them. If you take anything else, check it against the full list below.

Taking anything else?

Check Another of Your Medications Against Iron

Covers the 2,830 medications we’ve checked against Iron. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With emtricitabine, tenofovir

This page covers Iron only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the emtricitabine, tenofovir page lists 64 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: Activated Charcoal (major), Asarabacca (major), Beer (major), Siberian Cocklebur (major) and Wine (major).

By severity: 5 major · 49 moderate · 10 minor.

From our pharmacist’s overview on the emtricitabine, tenofovir page

“Truvada (emtricitabine and tenofovir) is taken every day to treat or prevent HIV, and its protection depends on steady drug levels and healthy organs to process it, so the 64 supplements on this page warrant real vigilance rather than a quick skim. The largest group, 38 ingredients, can stress the liver, and heavy alcohol leads it (bot…”

Reviewed by 2 · Jul 18, 2026

Open the emtricitabine, tenofovir interaction page

One more smart check

Taking Iron as Part of a Dietary Supplement Product? Check It for Interactions

We hold 16,325 real supplement products containing Iron, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Iron. Your product may carry other ingredients that interact with emtricitabine, tenofovir too, on top of Iron — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Iron and emtricitabine, tenofovir Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Iron
Top 1%

#15 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication emtricitabine, tenofovir
Top 10%

#228 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Iron

What is Iron?

  • Iron-deficiency anemia
  • Low iron stores during pregnancy
  • Fatigue from iron deficiency
  • Heavy menstrual blood loss
  • Restless legs syndrome (with low iron)

Iron is an essential mineral your body needs to make hemoglobin and carry oxygen in the blood. Supplements are mainly useful for treating or preventing iron deficiency and iron-deficiency anemia, ideally after a blood test confirms you are low. Because too much iron can be harmful, take it only when needed and under the guidance of a pharmacist or doctor.

Read the full Iron monograph & all interactions
Keep checking

Other Drugs & Iron

Browse every other medication we’ve checked against Iron — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
78Moderate
1Minor
2,750No known interaction
Moderate

78 interactions

Showing 60 of 78 moderate interactions — see all 78 on the Iron page.

Minor

1 interaction

No interaction 2,750 drugs checked — show the list
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

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Pharmacist Counseling Corner

Taking Iron and emtricitabine, tenofovir Together: Common Questions

Can you take Iron with emtricitabine, tenofovir?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Iron and emtricitabine, tenofovir interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.