Antiretroviral Therapy (ART) is the standard medical approach for managing Human Immunodeficiency Virus (HIV) infection. This treatment involves taking a combination of medications daily to suppress the virus, allowing the immune system to recover and preventing disease progression. Adherence to a prescribed regimen is paramount for treatment success, making the correct identification of these pills important. This article offers a visual guide to help identify some of the most common HIV medications. Understanding the visual characteristics, such as shape, color, and imprint code, is a starting point, but it should never replace verification by a healthcare professional.
Understanding HIV Medication Types
The foundation of modern HIV treatment is highly active antiretroviral therapy (HAART), which typically combines at least three different medications from two or more drug classes. These combinations work by targeting various stages of the HIV life cycle to prevent the virus from replicating. The need for multiple drugs explains why HIV regimens can involve one pill or several distinct pills taken together.
The treatment structure generally falls into two main categories: single-tablet regimens (STRs) and multi-pill regimens. Single-tablet regimens combine multiple active drug components into one pill taken once daily, simplifying the dosing schedule for the patient. Multi-pill regimens use two or more separate tablets or capsules to achieve the required combination of drugs. The differences in active ingredients and the manufacturing process dictate the wide variation in size, shape, and color observed across different medications.
The drug classes, such as Integrase Strand Transfer Inhibitors (INSTIs), Nucleoside Reverse Transcriptase Inhibitors (NRTIs), and Protease Inhibitors (PIs), each contribute different chemical structures. For instance, the size of the active pharmaceutical ingredient necessary for a therapeutic dose directly affects the overall tablet size. This chemical diversity, combined with manufacturing coatings and binders, results in the unique visual signature of each approved pill.
Visual Identification Guide: Modern Combination Tablets
Modern HIV care relies heavily on single-tablet regimens (STRs) due to their convenience, which often improves adherence. These pills are designed to contain a complete combination of drugs in a single dose. Visual identification is important, as confusing one STR for another can lead to improper dosing or drug interactions.
One of the most frequently prescribed STRs is Biktarvy, which contains three active ingredients: bictegravir, emtricitabine, and tenofovir alafenamide. The standard Biktarvy tablet is a purplish-brown, oblong, film-coated tablet. The pill is debossed with the letters “GSI” on one side and the number “9883” on the reverse side.
Another common STR is Triumeq, a combination of dolutegravir, abacavir, and lamivudine. This tablet is distinctly purple and oval-shaped. The pill’s visual identifier is the imprint “572 Tri” on one face. The unique color and imprint help distinguish it from other purple-colored medications.
Genvoya, which combines elvitegravir, cobicistat, emtricitabine, and tenofovir alafenamide, presents as a green, capsule-shaped, film-coated tablet. This pill is marked with the letters “GSI” on one side and the number “510” on the other. Like Biktarvy, the “GSI” imprint helps narrow down the search.
Dovato is a two-drug STR, containing dolutegravir and lamivudine. The tablet is white, oval, and biconvex. The definitive identifying imprint on a Dovato tablet is “SV 137” on one face.
Visual Identification Guide: Individual Components and PrEP
Multi-pill regimens and medications used for prevention, such as Pre-Exposure Prophylaxis (PrEP), also feature unique visual characteristics. These pills often contain one or two active ingredients and can look very similar to the components found within the single-tablet combinations.
Descovy is one such two-drug combination containing emtricitabine and tenofovir alafenamide, used for both HIV treatment and PrEP. The tablet is blue and rectangular, with the imprints “GSI” on one side and “225” on the other. The original formulation for PrEP, Truvada (emtricitabine and tenofovir disoproxil fumarate), is also blue but is oval-shaped and imprinted with “GILEAD” and “701.”
Many multi-pill regimens require a protease inhibitor, such as darunavir (brand name Prezista), which must be paired with a pharmacological booster. Darunavir tablets come in various strengths; the 400 mg tablet is light orange and oval-shaped, debossed with “TMC” and “400MG.”
Ritonavir (Norvir), often used solely as a booster, is a 100 mg white, ovaloid tablet. The brand-name Norvir tablet is imprinted with an “a” logo and the code “NK,” while generic versions of ritonavir may feature different imprints, such as “247” or “54.” The requirement to take a protease inhibitor and a separate booster pill together is common in these multi-pill regimens.
Steps for Positive Identification and Safety
Visual identification based on color, shape, and imprint code offers a clue, but it is not a final form of verification. Pills can be misidentified due to variations in lighting, color interpretation, or the presence of similar-looking generic medications with different imprints. The imprint code is consistently the most specific physical identifier required by regulatory bodies, making it the most reliable feature.
For definitive confirmation, the physical pill must be cross-referenced against official identification databases, such as the NIH Pillbox or DailyMed, using the imprint code. The most conclusive source of information remains the prescription label on the medication bottle itself. This label contains the drug name, dosage strength, and the patient’s name, confirming that the pill matches the intended prescription.
Patients should consult a pharmacist whenever there is any doubt about a pill’s identity, as pharmacists have access to comprehensive drug databases and can visually verify the medication. Taking an unknown or misidentified pill can severely compromise the efficacy of the entire treatment regimen, potentially leading to drug resistance. If an unidentified pill is found, or if a dose is missed due to confusion, a healthcare provider should be contacted immediately for guidance.