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Apretude
Apretude (cabotegravir) is a long-acting injectable medication used for HIV-1 pre-exposure prophylaxis (PrEP) in individuals at risk of contracting HIV. It belongs to the class of drugs known as integrase strand transfer inhibitors (INSTIs), which prevent the HIV virus from replicating in the body. Apretude is designed to be administered once every 2 months, offering a convenient alternative to daily oral PrEP medications, such as Truvada or Descovy.
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Frequently Asked Questions
How soon does Apretude start working?
Apretude begins to work after the initial two loading doses, which are given 1 month apart. Once you receive both doses, you are protected against HIV, with maintenance doses every 2 months thereafter.
Can I switch from oral PrEP to Apretude?
Yes, individuals on oral PrEP can switch to Apretude. Your healthcare provider may prescribe oral cabotegravir for 1 month before transitioning to the injectable form, to ensure that you tolerate the medication.
What happens if I miss a dose of Apretude?
If you miss a dose, it’s important to contact your healthcare provider as soon as possible to schedule the next injection. Missing doses may increase your risk of contracting HIV.
Does Apretude protect against other sexually transmitted infections (STIs)?
No, Apretude only helps prevent HIV. It does not protect against other STIs, such as gonorrhea, chlamydia, or syphilis. Use condoms to protect yourself against these infections.
Is Apretude suitable for everyone at risk of HIV?
Apretude is recommended for adults and adolescents weighing at least 35 kg who are at risk for HIV. However, it is not suitable for individuals who are already infected with HIV or who cannot commit to the regular injection schedule.
Comprehensive Drug Guide
How Does Apretude Work?
Apretude works by inhibiting the HIV integrase enzyme, which is essential for the viral replication process. By blocking the action of this enzyme, Apretude prevents HIV from integrating its genetic material into the DNA of human immune cells, thereby stopping the virus from multiplying and reducing the risk of HIV infection in individuals exposed to the virus.
Common Dosages
- Intramuscular injection: 600 mg/3 mL (cabotegravir)
Typical Dosing
- The initial dosing schedule for Apretude involves two injections:
- One injection of 600 mg on day 1.
- A second injection of 600 mg given 1 month later.
- After the initial loading doses, Apretude is administered every 2 months as a 600 mg intramuscular injection.
- Patients transitioning from oral PrEP to Apretude may start with oral cabotegravir for 1 month before beginning injections, to ensure tolerability.
Typical Dosing
FDA Approved Indications
- Pre-exposure prophylaxis (PrEP) to reduce the risk of sexually acquired HIV-1 infection in adults and adolescents weighing at least 35 kg who are at risk of acquiring HIV.
Who Shouldn't Take Apretude?
- Known hypersensitivity to cabotegravir or any component of the formulation
- Current HIV infection (Apretude is not intended for HIV treatment and may lead to resistance if used improperly)
Advice From The Pharmacist
- Apretude is administered by a healthcare provider every 2 months. Be sure to adhere to the dosing schedule, as missing doses may increase the risk of HIV infection.
- If a dose is missed, contact your healthcare provider as soon as possible to reschedule the injection.
- Use of condoms is still recommended for protection against sexually transmitted infections (STIs) other than HIV.
- Continue regular HIV testing while on Apretude to ensure that the medication is being used effectively and to detect any potential breakthrough infections.
Side Effects of Apretude
Common Side Effects
- Injection site reactions (pain, redness, swelling)
- Headache
- Fatigue
- Fever
- Rash
Uncommon/Severe Side Effects
- Hypersensitivity reactions, such as fever, rash, or difficulty breathing
- Hepatotoxicity (liver damage)
- Depression or mood changes
Risks and Warnings of Apretude
- Hypersensitivity reactions: Apretude can cause severe allergic reactions, including symptoms like fever, rash, and trouble breathing. Patients should discontinue use and seek medical attention if these symptoms occur.
- Hepatotoxicity: Apretude has been associated with liver enzyme elevations. Patients should be monitored for signs of liver dysfunction, such as jaundice or dark urine.
- HIV infection risk: Apretude is intended for HIV prevention, not treatment. If HIV infection is detected, patients should switch to an appropriate antiretroviral therapy to avoid resistance.
Interactions with Apretude
Common Drug Interactions
- Rifampin and rifapentine: These medications may reduce the effectiveness of Apretude by speeding up its breakdown in the liver, leading to a decreased concentration of the drug in the body.
- Carbamazepine and phenytoin: These anticonvulsants can also reduce Apretude levels and compromise its effectiveness.
- St. John’s Wort: This herbal supplement may decrease the effectiveness of Apretude by inducing enzymes that break down the drug.
Alternatives to Apretude
- Truvada (emtricitabine/tenofovir disoproxil fumarate): A daily oral PrEP medication that also reduces the risk of HIV infection.
- Descovy (emtricitabine/tenofovir alafenamide): Another daily oral PrEP option, suitable for some populations at risk for HIV.
- Islatravir (an investigational drug in clinical trials): A long-acting oral medication currently under development for HIV PrEP.
- Condoms: While not a pharmaceutical option, condoms remain a crucial barrier method for HIV prevention.
