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Cabenuva
Cabenuva is a long-acting injectable regimen containing cabotegravir and rilpivirine, used to treat HIV-1 infection in adults. This combination therapy is an alternative to daily oral HIV medications, as it is administered once a month or once every two months, making it a convenient option for maintaining viral suppression in patients already on stable antiretroviral therapy (ART).
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Frequently Asked Questions
How is Cabenuva administered?
Cabenuva is administered as two intramuscular injections (cabotegravir and rilpivirine), usually in the buttocks, once every month or every two months.
What happens if I miss an injection of Cabenuva?
Contact your healthcare provider immediately if you miss a dose, as missing injections can increase the risk of viral rebound and drug resistance.
Can Cabenuva cure HIV?
No, Cabenuva does not cure HIV but helps manage the infection by keeping viral loads undetectable when taken as prescribed.
Can Cabenuva be used in pregnant women?
Cabenuva is not recommended for use in pregnant women, as there are limited data on its safety during pregnancy.
Does Cabenuva have interactions with other medications?
Yes, Cabenuva can interact with certain medications like rifampin and St. John's Wort. Always inform your healthcare provider about any medications or supplements you are taking.
Comprehensive Drug Guide
How Does Cabenuva Work?
Cabotegravir, an INSTI, blocks the integration of HIV DNA into the human genome, preventing viral replication. Rilpivirine, an NNRTI, inhibits the reverse transcriptase enzyme, blocking the conversion of viral RNA into DNA. Together, these drugs suppress HIV viral replication and maintain low viral loads.
Common Dosages
- Cabotegravir injectable suspension: 400 mg/mL and 600 mg/mL
- Rilpivirine injectable suspension: 600 mg/mL and 900 mg/mL
Typical Dosing
- For HIV-1 infection: The typical dosing regimen is a monthly injection of cabotegravir and rilpivirine, or every two months for those who are virologically suppressed and meet certain criteria.
Typical Dosing
FDA Approved Indications
- HIV-1 infection in adults who are virologically suppressed (HIV RNA <50 copies/mL) on a stable antiretroviral regimen
Who Shouldn't Take Cabenuva?
- Known hypersensitivity to cabotegravir, rilpivirine, or any component of the formulation.
- HIV-1 infection with resistance to either cabotegravir or rilpivirine.
Advice From The Pharmacist
- Cabenuva is administered as two separate injections (cabotegravir and rilpivirine) by a healthcare provider. Follow the monthly or bi-monthly schedule as directed by your healthcare provider.
- Do not miss scheduled injections, as missing doses could increase the risk of HIV resistance.
- If you experience severe reactions at the injection site (e.g., swelling, pain), inform your healthcare provider immediately.
Side Effects of Cabenuva
Common Side Effects
- Injection site reactions (pain, swelling, redness)
- Fever
- Headache
- Fatigue
- Diarrhea
Uncommon/Severe Side Effects
- Hypersensitivity reactions (rash, fever, breathing difficulty)
- Hepatotoxicity
Risks and Warnings of Cabenuva
- Injection Site Reactions: Pain, swelling, or redness at the injection site is common. Severe reactions should be reported to a healthcare provider.
- HIV Resistance: Missing doses or discontinuing Cabenuva without switching to another HIV regimen can increase the risk of developing drug-resistant HIV.
Interactions with Cabenuva
Common Drug Interactions
- Rifampin: Rifampin and other CYP3A inducers may reduce the levels of cabotegravir and rilpivirine, reducing their effectiveness.
- Antacids: Medications containing aluminum or magnesium can reduce rilpivirine absorption when taken orally, but this is less of a concern with injections.
- St. John's Wort: This herbal supplement may reduce the effectiveness of rilpivirine and cabotegravir.
Alternatives to Cabenuva
- Triumeq (abacavir/dolutegravir/lamivudine): A single-tablet regimen for the treatment of HIV-1 infection.
- Genvoya (elvitegravir/cobicistat/emtricitabine/tenofovir alafenamide): A once-daily oral tablet for HIV-1 treatment.
- Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide): A once-daily oral tablet for the treatment of HIV-1 infection.
