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Apretude vs Cabenuva, what is the difference?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on April 12, 2022.

Official answer

by Drugs.com

Overview: Apretude vs Cabenuva

  • Apretude (cabotegravir) extended-release injection is a long-acting pre-exposure prophylaxis (PrEP) prescription medicine used to prevent HIV infection in people at risk for sexually-acquired HIV exposure. It is injected into the muscles of your buttocks (gluteal muscles) every 2 months by your healthcare provider.
  • Cabenuva (cabotegravir and rilpivirine) is also a long-acting injection but is used to treat (not prevent) HIV-1 infection. It is also injected (as 2 separate shots) into your gluteal muscles once every month OR once every other month by your doctor.
  • Apretude contains cabotegravir, an antiviral in a class of medicines known as integrase strand transfer inhibitors (INSTI). Cabenuva consists of 2 medicines in a kit (cabotegravir and rilpivirine) given as 2 separate injections. Rilpivirine is an antiviral classified as a non-nucleoside reverse transcriptase inhibitor (NNRTI).
  • These medicines keep HIV from multiplying in your body. HIV is the virus that can cause acquired immunodeficiency syndrome (AIDS).

Common side effects for both medicines include injection site reactions, fever, headache and tiredness. Both Apretude and Cabenuva are manufactured by ViiV Healthcare.

Related: Comparing Apretude vs Cabenuva

Man with HIV undergoing treatment

What is Apretude?

Apretude (cabotegravir extended-release injection) is a single agent, long-acting injection for HIV pre-exposure prophylaxis (PrEP). Using Apretude PrEP can reduce the risk of getting sexually acquired HIV-1 infection. A negative HIV test is required prior to each injection of Apretude.

Apretude is in a class of medicines known as integrase strand transfer inhibitors. It works by preventing viral DNA from integrating into the genetic material of human immune cells (T-cells).

In two Apretude clinical trials with over 7,700 participants, Apretude was proven superior to daily oral Truvada (emtricitabine / tenofovir disoproxil fumarate) in reducing the risk of acquiring HIV. In these 2 studies, those receiving Apretude had a 69% and a 90% lower incidence of HIV compared to those receiving Truvada tablets.

Apretude is given as a gluteal (in the buttocks area) intramuscular injection once a month for the first 2 months, then once every 2 months by a healthcare provider.

Apretude is manufactured by ViiV Healthcare.

What is Cabenuva?

Cabenuva consists of two long-acting injections (cabotegravir and rilpivirine) and is given as a gluteal (buttocks area) intramuscular injection for the treatment of HIV-1 infection in adults and adolescents 12 years of age and older and weighing at least 35 kg. It is not used to prevent HIV infection like Apretude. Cabenuva is a complete regimen for the treatment of HIV-1 infection and is not used with other antiviral medicines.

Cabenuva is used to replace the current antiretroviral regimen in those who are virologically suppressed (HIV-1 RNA <50 copies/mL) on a stable antiretroviral regimen with no history of treatment failure and with no known or suspected resistance to either cabotegravir or rilpivirine.

Cabenuva contains the integrase strand transfer inhibitor (INSTI) called cabotegravir, but it also comes with rilpivirine, a non-nucleoside reverse transcriptase inhibitor (NNRTI). Cabenuva contains two injectable drugs in one package. You may take about one month of once-daily starter pills (cabotegravir) to see how well you tolerate the medicine.

In pivotal studies, Cabenuva was as effective in maintaining viral suppression when injected intramuscularly in the buttocks every 4 weeks as continuing a daily oral three-drug regimen. It can also be given on an every 2 month regimen.

Cabenuva is made by the same company as Apretude, ViiV Healthcare.

Apretude clinical trials

Apretude (cabotegravir extended-release injection) is a single agent, long-acting injection for HIV pre-exposure prophylaxis (PrEP). Using Apretude PrEP can reduce the risk of getting sexually acquired HIV-1 infection. A negative HIV test is required prior to each injection of Apretude.

Apretude is in a class of medicines known as integrase strand transfer inhibitors. It works by preventing viral DNA from integrating into the genetic material of human immune cells (T-cells).

In two Apretude clinical trials with over 7,700 participants, Apretude was proven superior to daily oral Truvada (emtricitabine / tenofovir disoproxil fumarate) in reducing the risk of acquiring HIV. In these 2 studies, those receiving Apretude had a 69% and a 90% lower incidence of HIV compared to those receiving Truvada tablets.

Apretude is given as a gluteal (in the buttocks area) intramuscular injection once a month for the first 2 months, then once every 2 months by a healthcare provider.

Apretude is manufactured by ViiV Healthcare.

Cabenuva clinical trials

Cabenuva consists of two injections (cabotegravir and rilpivirine) and is given as a gluteal (in the buttocks area) intramuscular injection for the treatment of HIV-1 infection in adults and adolescents 12 years of age and older and weighing at least 35 kg. It is not used to prevent HIV infection like Apretude. Cabenuva is a complete regimen for the treatment of HIV-1 infection and is not used with other antiviral medicines.

Cabenuva is used to replace the current antiretroviral regimen in those who are virologically suppressed (HIV-1 RNA <50 copies/mL) on a stable antiretroviral regimen with no history of treatment failure and with no known or suspected resistance to either cabotegravir or rilpivirine.

Cabenuva contains the integrase strand transfer inhibitor (INSTI) called cabotegravir, but it also comes with rilpivirine, a non-nucleoside reverse transcriptase inhibitor (NNRTI). Cabenuva contains two injectable drugs in one package. You may take about one month of once-daily starter pills (cabotegravir) to see how well you tolerate the medicine.

In pivotal studies, Cabenuva was as effective in maintaining viral suppression when injected intramuscularly in the buttocks every 4 weeks as continuing a daily oral three-drug regimen. It can also be given on an every 2 month regimen.

Cabenuva is made by the same company as Apretude, ViiV Healthcare.

Dosing for Apretude and Cabenuva

Long-acting injections to help prevent or treat HIV-1 infection may be easier than taking a daily pill for some patients. It can be more convenient and does not require remembering a daily pill. It is important to remember your appointment as scheduled for your injections.

  • Apretude for HIV-1 PrEP is used in at-risk adults and adolescents who weigh at least 77 pounds (35 kg or more). The recommended starting dose is a single 600-mg (3-mL) injection given 1 month apart for 2 consecutive months on the last day of an oral lead-in (if used) or within 3 days. Then you will continue with the injections, given by your healthcare provider, every 2 months thereafter.
  • Cabenuva as treatment for HIV-1 infection is used in adults and adolescents 12 years of age and older and weighing at least 77 pounds (35 kg or more). It is given by your healthcare provider as 2 injections every month or every other month. Your every other month regimen begins after two consecutive months of injections. You and your doctor will decide which frequency of injections works best for you.
  • You may also take about one month of once-daily starter pills (cabotegravir and rilpivirine) to see how well you tolerate the medicine before the injections start.

Are the side effects the same for Apretude and Cabenuva?

No, the side effects for Apretude or Cabenuva differ but they also share some similar side effects. Most drugs have common or serious side effects, but they do not occur in all patients. If you experience any side effects with Apretude or Cabenuva that are concerning to you, contact your doctor right away.

  • Common side effects (>2%) with Apretude included injection site reactions (such as pain, tenderness, swelling, bruising, redness, itching, warmth or loss of sensation, or a hardened mass or lump at the injection site). Other side effects can include diarrhea, headache, fever (pyrexia), fatigue (tiredness), sleep problems, nausea, or dizziness.
  • Common side effects (>2%) with Cabenua include injection site reactions, fever, fatigue, headache, muscle pain, nausea, sleep disorders, dizziness, and rash.

Learn more: Side effects and warnings with Apretude and Cabenuva (in more detail)

What is Vocabria?

In addition to the injectable form, cabotegravir is also available as a short-term oral HIV treatment known as Vocabria (used with rilpivirine).

Before the first Apretude injection for HIV-1 PrEP, patients may take oral Vocabria for at least 28 days to determine if they can tolerate cabotegravir (although this is not always required). However, no Apretude study information is available for use of this medicine without the use of Vocabria first.

Oral Vocabria and rilpivirine may also be given as a daily "lead-in dose" to help determine if you can safely use a combination form of these medicines given as a long-acting injection for HIV-1 treatment (Cabenuva).

Vocabria and rilpivirine may also be given short-term in place of the monthly injectable combination (Cabenuva or Apretude) if you plan to miss a scheduled injection. Speak to your doctor to learn more about this option.

This is not all the information you need to know about Apretude (cabotegravir injection), Cabenuva (cabotegravir and rilpivirine injection) or Vocabria (oral cabotegravir) for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

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