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CABOTEGRAVIR
Generic Name: CABOTEGRAVIR
ABSTRACT -
Cabotegravir (Vocabria/Apretude) is an oral and long-acting injectable HIV integrase strand transfer inhibitor (INSTI) approved in combination with rilpivirine for treatment of HIV-1 in virologically suppressed adults, and as monotherapy long-acting injection for HIV pre-exposure prophylaxis (PrEP). The injectable formulation (cabotegravir LA) administered monthly or every 2 months provides sustained drug levels with high efficacy.
DOSAGE -
For treatment: oral 30 mg once daily for 4-week lead-in, then 600 mg IM injection with rilpivirine 900 mg IM every 2 months. For PrEP: 600 mg IM every 2 months after two initial monthly injections.
SIDE EFFECTS-
- Injection site reactions (pain, induration)
- Headache
- Pyrexia
- Fatigue
- Nausea
ALLERGIC REACTIONS -
These symptoms may indicate an allergic reaction and require immediate medical attention.
- Hypersensitivity reactions
- Skin rash
- Hepatitis (rare immune-mediated)
- Anaphylaxis (rare)
DRUG INTERACTIONS-
- Rifampicin substantially reduces cabotegravir levels — contraindicated
- Other strong inducers reduce INSTI exposure
- Metformin interaction with MATE transporters — monitor renal function
PREAUTONS–
- HIV resistance testing mandatory before switch to injectable
- Missed injection window requires oral bridging or reinitiation plan
- Hepatitis B: cabotegravir not active against HBV — co-manage appropriately
- Weight-based considerations for injection site tolerability
WARNINGS –
- HIV-1 resistance may emerge with sub-therapeutic drug levels between injections
- Post-injection reactions (systemic) reported — 15-minute observation post-injection
- Depressive disorder — monitor mental health
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