Cabenuva (Cabotegravir/Rilpivirine)

Description

Cabenuva comprises two medications: Cabotegravir and Rilpivirine, both essential in treating human immunodeficiency virus type 1 (HIV-1) infection. Cabotegravir acts as an integrase strand transfer inhibitor (INSTI), blocking the virus's ability to integrate its genetic material into human DNA, a crucial step in its replication process. On the other hand, Rilpivirine is categorized as a non-nucleoside reverse transcriptase inhibitor (NNRTI), disrupting a different stage of HIV replication by targeting the reverse transcriptase enzyme. Together, they provide a long-acting injectable form that serves as a maintenance option for HIV-1 infection.

Directions

Patients may receive the initial injections of Cabotegravir 600 mg and Rilpivirine 900 mg on the same day at the end of an oral lead-in period, if applicable, to confirm the tolerability of the medications. The standard Cabenuva dosing schedule involves once-monthly injections, although patients may choose once-every-two-months as an alternative schedule with their healthcare provider's guidance.

The injections are given directly into the muscle of the buttocks by a healthcare provider. It is important for patients to understand the importance of sticking to their dosing schedule, as consistent administration is key for sustaining the treatment's effectiveness.

Ingredients

Cabotegravir and Rilpivirine are the two active ingredients in Cabenuva.

Contraindications

Avoid taking or using Cabenuva if any of the following apply:

• Known hypersensitivity reactions, such as rash or swelling, to Cabotegravir or Rilpivirine, as these can indicate an allergy to the active ingredients or any component of the formulation.
• Concurrent use with other medications that may interact and cause undesirable effects, including but not limited to certain anticonvulsants, antimycobacterials, and herbal supplements like St. John’s wort.

Cautions

• Before initiating treatment with Cabenuva, make sure to disclose the following to your healthcare provider:
  • Any existing health conditions
  • Known allergies
  • A complete list of medications you are currently using
  • Your status regarding pregnancy or breastfeeding
• If you have any signs of a serious allergic reaction, such as a severe rash or trouble breathing, stop using Cabenuva immediately and seek emergency medical care.
• After each injection, you should be observed for about 10 minutes for any adverse reactions, like chest pain or difficulty breathing.
• Keep up with regular liver function tests if you have existing liver conditions, as Cabenuva can affect liver health.
• Alert your healthcare provider if you experience symptoms of depression or sudden mood changes to determine if continuing with Cabenuva is safe.
• Be mindful of other medications you are taking as they may interact with Cabenuva, potentially leading to side effects or reduced effectiveness.
• Adhere to the prescribed injection schedule because Cabenuva stays active in your body for a long time. Missing doses can lead to resistance to the medication.

Side Effects

Cabenuva often causes reactions at the injection site, including pain, swelling, and redness. Other common effects are fever, fatigue, headaches, muscle pain, nausea, sleep issues, dizziness, and rash.

Serious risks include allergic reactions, which may present with fever, tiredness, skin and eye swelling, and difficulty breathing. Immediate medical attention is necessary for these symptoms. Post-injection reactions can occur, such as trouble breathing, stomach cramps, and feeling faint, which usually resolve quickly after the injection. Liver issues might also arise, with symptoms like jaundice, dark urine, and abdominal pain. Depression or mood changes, particularly thoughts of self-harm, require urgent medical care.

References:

1. Cabenuva (Cabotegravir/Rilpivirine) Product Monograph. Durham, NC: ViiV Healthcare; 2023.
2. Cabenuva (Cabotegravir/Rilpivirine) Drug Label Information. Durham, NC: ViiV Healthcare; 2023.

About Dr. Gerardo Sison (Page Author)

An honors graduate of the University of Florida, Dr. Sison started his pharmacy career in a community setting, extending his services to hospitals and clinics over time. He has also worked in medication therapy management, advising patients on proper medication use for their chronic health conditions. Read More....