Cabenuva is an injectable treatment for HIV infection. It is given by a healthcare provider as two injections once a month or every two months. People who take Cabenuva commit to a regular schedule of treatment to prevent the HIV virus from developing resistance to the medication.
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Cabenuva
Cabotegravir and rilpivirine
Cabenuva combines two classes of HIV medications taken by injection once a month or every other month. It treats HIV in people 12 years and older who weigh at least 35 kg and are on a stable regimen of HIV medications.
Antiviral, anti-infective agent, HIV-1 integrase strand transfer inhibitor (INSTI) and HIV-1 non-nucleoside reverse transcriptase inhibitor (NNRTI) combination
Injection kit
By injection
Cabenuva, or cabotegravir and rilpivirine, is used to treat HIV infection in people who are 12 and older and who weigh at least 35 kg (77 pounds). It is prescribed for people who have been on a stable HIV treatment regimen with other medications. A change to Cabenuva may be considered after a discussion with your healthcare provider about the risks and benefits of injectable HIV treatment.
Cabenuva may be an option for people who have difficulty taking daily oral HIV treatment. It is important to follow the injection treatment schedule closely to prevent resistance of the HIV virus.
Cabenuva is given as two injections by a healthcare provider. One injection is given in each gluteal muscle (buttock), usually once every two months. Some people may receive a lower dose but come for an injection once a month.
Your healthcare provider will work with you to determine the right schedule and dose. It’s important to keep all injection appointments.
Cabenuva may stay in your system for up to 12 months. Some people may start by taking cabotegravir and rilpivirine tablets first to make sure there are no significant side effects.
Kit of 400 mg/2 mL (200 mg/mL) of cabotegravir injectable suspension and 600 mg/2 mL (300 mg/mL) of rilpivirine injectable suspension
Kit of 600 mg/3 mL (200 mg/mL) of cabotegravir injectable suspension and 900 mg/3 mL (300 mg/mL) of rilpivirine injectable suspension
Starting dose: Cabotegravir 600 mg (3mL) and rilpivirine 900 mg (3mL) injections
Maintenance dose options:
Cabotegravir 400 mg (2mL) and rilpivirine 600 mg (2mL) injections once a month
Cabotegravir 600 mg (3mL) and rilpivirine 900 mg (3mL) injections once a month for two months, then every two months starting with Month 4
Cabenuva
4ml of 400 & 600mg/2ml box
Cabenuva is given as two separate injections in the gluteal muscles (buttocks). A healthcare provider will give the injections.
Cabenuva is typically given every two months on a regular schedule. It may also be given at a lower dose once a month. Your doctor will discuss the schedule that is right for you.
Some people will take cabotegravir and rilpivirine tablets for one month before starting Cabenuva injections. This is to make sure there are no significant side effects with the medication.
It is important to keep all planned appointments to receive Cabenuva injections. This is to prevent viral resistance to the medication.
Cabenuva may be given up to 7 days before or after the target date.
If Cabenuva is stopped, a new HIV treatment regimen should be started no later than 2 months after the final injection.
Talk with your healthcare team right away if you miss or plan to miss an appointment to receive Cabenuva. If more than 7 days have passed since your scheduled injection, you may need to take oral HIV medications before starting Cabenuva again.
Cabenuva should not be used by people who have had an allergic reaction to cabotegravir or rilpivirine
Talk with your healthcare provider if you are pregnant or plan to become pregnant. There is not enough information from studies to know the full effects of Cabenuva during pregnancy. Your healthcare provider will discuss the potential risks and benefits.
Breastfeeding is not recommended for people who have been diagnosed with HIV. The virus can be transmitted through breast milk.
Cabenuva should not be used by children under 12 years old or people who weigh less than 35 kg (77 pounds).
Tell your healthcare provider about all current and past medical conditions. Cabenuva should be used with caution in people who have:
Liver problems
Hepatitis B or C infection
Kidney problems
Heart failure or heart rhythm problems
Depression and other mental health conditions
Cabenuva should not be used by people who take the following medications:
Seizure medications: carbamazepine, oxcarbazepine, phenobarbital, or phenytoin
Tuberculosis antibiotics: rifabutin, rifampin, or rifapentine
Glucocorticoid medication: dexamethasone
Herbal supplement: St. John’s wort
Cabanuva may have other interactions that affect how well medications work. Tell your healthcare provider about all medications you take, including prescription and over-the-counter medicines, vitamins, herbs, and supplements.
Serious side effects of Cabenuva may include:
Severe allergic reactions: hives or severe rash, swelling of the lips or tongue, trouble breathing, redness or swelling of the eyes
Post-injection reactions (right after getting the injection): trouble breathing, rash, stomach cramps, feeling warm, feeling faint, chest or back pain
Liver problems: abdominal pain, brownish urine, yellow eyes or skin, stools that are very light in color, nausea, vomiting, and itching
Mood changes: feeling sad, depressed, or anxious, thoughts of suicide
Less serious and more common side effects may include:
Itching, irritation, or redness at the site of the injection
Feeling tired
Headache
Body aches
Fever
Nausea
Rash
Dizziness
Trouble sleeping
Get immediate medical help if you have signs of a severe allergic reaction or thoughts of suicide. Let your doctor know if you have any type of rash, symptoms of liver problems, or side effects that are getting worse or not improving.
Cabenuva (for patients), ViiV Healthcare (2024)
Cabenuva (for healthcare professionals), ViiV Healthcare (2024)
CABENUVA- cabotegravir and rilpivirine kit, National Library of Medicine DailyMed (2023)
Anne Jacobson, MD, MPH, is a board-certified family physician, writer, editor, teacher, and consultant. She is a graduate of University of Wisconsin School of Medicine and Public Health, and trained at West Suburban Family Medicine in Oak Park, Illinois. She later completed a fellowship in community medicine at PCC Community Wellness and a master's in Public Health at the University of Illinois-Chicago. She lives with her family near Chicago.
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