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Cabotegravir and rilpivirine

Generic Name: cabotegravir and rilpivirine (KA boe TEG ra vir and RIL pi VIR een)
Brand Name: Cabenuva 400/600, Cabenuva 600/900
Dosage Forms: intramuscular suspension, extended release (200 mg-300 mg/mL)

Medically reviewed by Drugs.com on Feb 11, 2021. Written by Cerner Multum.

What is cabotegravir and rilpivirine?

Cabotegravir and rilpivirine are antiviral medicines that prevent human immunodeficiency virus (HIV) from multiplying in your body. HIV is the virus that can cause acquired immunodeficiency syndrome (AIDS).

Cabotegravir and rilpivirine is a combination medicine that is used without any other antiviral medicines to treat HIV. cabotegravir and rilpivirine is not a cure for HIV or AIDS.

Cabotegravir and rilpivirine is for use in adults who have already used other antiviral HIV medications that have controlled their viral load.

Cabotegravir and rilpivirine may also be used for purposes not listed in this medication guide.

Warnings

Tell your doctor about all your current medicines and any you start or stop using. Many drugs can interact, and some drugs should not be used together.

Before taking this medicine

You should not use cabotegravir and rilpivirine if you are allergic to it.

Many drugs can interact and cause dangerous effects. Some drugs should not be used together with cabotegravir and rilpivirine. Your doctor may change your treatment plan if you also use:

Cabotegravir and rilpivirine can stay in your system for 12 months or longer. If you stop using cabotegravir and rilpivirine, follow your doctor's instructions about using any other medicines during the first year afterward.

Tell your doctor if you have ever had:

  • a skin rash or an allergic reaction after taking medicine that contains cabotegravir or rilpivirine;

  • liver disease, including hepatitis B or C (cabotegravir and rilpivirine can affect the results of your liver function tests);

  • mental illness; or

  • long QT syndrome (in you or a family member).

Tell your doctor if you are pregnant or plan to become pregnant. It is not known whether cabotegravir and rilpivirine will harm an unborn baby. However, HIV can be passed to your baby if the virus is not controlled during pregnancy. Your name may be listed on a registry to track any effects of cabotegravir and rilpivirine on the baby.

Women with HIV or AIDS should not breastfeed a baby. Even if your baby is born without HIV, the virus may be passed to the baby in your breast milk.

How should I take cabotegravir and rilpivirine?

At least 28 days before your first injection, you will take cabotegravir and rilpivirine in tablet forms once per day with a meal. This "lead-in dose" will help determine that you can safely use these medicines together. Follow all directions on your prescription label and use the medicines exactly as directed.

On the last day you take the tablets, you will receive your first injectable dose of this medicine. Cabotegravir and rilpivirine is injected into a muscle once per month. A healthcare provider will give you this medicine as 2 separate injections in opposite sides of your buttocks.

One month after your first injectable dose, you will begin regular monthly cabotegravir and rilpivirine injections. You will be watched closely for about 10 minutes after each injection, to make sure you do not have a serious reaction.

The timing of your monthly injections is very important to the success of your HIV treatment. Your doctor may set a calendar day as your "target treatment date" to help keep you on schedule. If needed, you may receive an injection early or late, up to 7 days before or 7 days after your target date.

You must remain under the care of a doctor while receiving cabotegravir and rilpivirine injections. Stay on schedule to get the most benefit. Missing doses can increase your risk of HIV that is resistant to medication.

If you stop using cabotegravir and rilpivirine, you will need to start using other HIV medicines within 1 month to prevent your condition from becoming resistant.

You will need frequent medical tests. Cabotegravir and rilpivirine can have long lasting effects on your body (up to 12 months after your last dose). You may still need medical tests for a short time after you stop using this medicine.

What happens if I miss a dose?

Call your doctor for instructions if you miss an appointment for your cabotegravir and rilpivirine injection.

If you plan to miss an injection by more than 7 days, you may need to take cabotegravir and rilpivirine tablets each day until your next monthly injection is due. You should start taking the tablets about 1 month after your last injection was given. If needed, daily tablets can replace cabotegravir and rilpivirine injections for up to 2 months in a row.

If you miss an injection by more that 7 days and you have not started taking the medicine in tablet form, your doctor may need to decide whether or not cabotegravir and rilpivirine is the best treatment for you.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking cabotegravir and rilpivirine?

Cabotegravir and rilpivirine is a complete treatment for HIV. Do not use other HIV medications unless your doctor tells you to.

Using cabotegravir and rilpivirine may not prevent your disease from spreading. Do not have unprotected sex or share razors or toothbrushes. Talk with your doctor about safe ways to prevent HIV transmission during sex. Sharing drug or medicine needles is never safe, even for a healthy person.

Cabotegravir and rilpivirine side effects

Get emergency medical help if you have signs of an allergic reaction: hives; fever, tiredness, body aches, not feeling well; sores or blisters in your mouth; red or puffy eyes; difficult breathing; swelling of your face, lips, tongue, or throat.

Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes.

Your cabotegravir and rilpivirine injections may be permanently discontinued if you have an allergic reaction.

Some side effects may occur within a few minutes after an injection. Tell your caregiver if you feel anxious, warm, light-headed, sweaty, or have stomach pain, or numbness in your mouth.

Call your doctor at once if you have:

  • unusual changes in mood or behavior;

  • suicidal thoughts or actions; or

  • liver problems--loss of appetite, nausea, vomiting, stomach pain (upper right side), itching, dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes).

Common side effects may include:

  • pain, redness, swelling, itching, bruising, warmth, or a hard lump where an injection was given;

  • fever;

  • nausea;

  • pain in your bones, joints or muscles;

  • feeling tired, sleep problems;

  • headache, dizziness; or

  • rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Cabotegravir and rilpivirine dosing information

Usual Adult Dose for HIV Infection:

Initiation Injections:
-Cabotegravir: 600 mg IM once as a single dose
-Rilpivirine: 900 mg IM once as a single dose

Continuation Injections:
-Cabotegravir: 400 mg IM once a month
-Rilpivirine: 600 mg IM once a month

Comments:
-Initiation injections of this drug should follow oral lead-in (a cabotegravir 30 mg tablet plus a rilpivirine 25 mg tablet once a day); oral lead-in should be used for about 1 month (at least 28 days) before initiation of this drug to assess tolerability of cabotegravir and rilpivirine.
-Initiation injections should be started on the final day of oral lead-in.
-Continuation injections should be started 1 month after the initiation injections.
-Cabotegravir and rilpivirine injections (initiation and continuation) should be administered at separate gluteal injection sites (on opposite sides or 2 cm apart) during the same visit.
-Patients may be given this drug up to 7 days before or after the date of the scheduled monthly injection dosing visit.

Use: As a complete regimen, for the treatment of HIV-1 infection to replace the current antiretroviral regimen in patients who are virologically suppressed (HIV-1 RNA less than 50 copies/mL) on a stable antiretroviral regimen with no history of treatment failure and with no known/suspected resistance to either cabotegravir or rilpivirine

What other drugs will affect cabotegravir and rilpivirine?

Cabotegravir and rilpivirine can cause a serious heart problem. Your risk may be higher if you also use certain other medicines for infections, asthma, heart problems, high blood pressure, depression, mental illness, cancer, malaria, or HIV.

Other drugs may affect cabotegravir and rilpivirine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.

More about cabotegravir / rilpivirine

Consumer resources

Other brands
Cabenuva

Professional resources

Related treatment guides

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.