cabotegravir/rilpivirine (Cabenuva)
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Indications
- treatment of HIV1 infection
- inability to take oral antiretroviral therapy[4]
- high risk for HIV1 disease progression
- CD4 count < 200/uL or history of AIDS-defining illness[4]
- access to intensive clinical follow-up & case management[4]
Contraindications
Dosage
- month 1: start cabotegravir 30 mg plus rilpivirine 25 mg to assess tolerability
- month 2: 2 IM injections cabotegravir 600 mg/3mL plus rilpivirine 900 mg/3mL
- month 3: 2 IM injections cabotegravir 600 mg/3mL plus rilpivirine 900 mg/3mL
- month 5: 2 IM injections cabotegravir 600 mg/3mL plus rilpivirine 900 mg/3mL
- month 7: 2 IM injections cabotegravir 600 mg/3mL plus rilpivirine 900 mg/3mL
- continue same 2 IM injections every 2 months
* long-acting cabotegravir 200 mg/mL (600 mg) plus rilpivirine 300 mg/ml (900 mg) every 8 weeks (2 injections) IM[1][2] Durg interactions:
- anticonvulsants carbamazepine, oxcarbazine, phenobarbital & phenytoin decrease plasma levels of cabotegravir & rilpivirine
- antimicobials rifampin, rifapentine, rifabutin decrease plasma levels of cabotegravir & rilpivirine
- dexamethasone decreases plasma levels of rilpivirine
- St John's wort decreases plasma levels of rilpivirine
- macrolides increase plasma levels of rilpivirine (risk or QT prolongation & torsades de pointes)
More general terms
Components
References
- ↑ 1.0 1.1 Margolis DA, Gonzalez-Garcia J, Stellbrink HJ et al Long-acting intramuscular cabotegravir and rilpivirine in adults with HIV-1 infection (LATTE-2): 96-week results of a randomised, open-label, phase 2b, non-inferiority trial. Lancet. July 24, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28750935 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31917-7/fulltext
Boyd MA, Cooper DA Long-acting injectable ART: next revolution in HIV? Lancet. July 24, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28750936 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(17)31962-1/fulltext
FDA News Release. Jan 21, 2021 FDA Approves First Extended-Release, Injectable Drug Regimen for Adults Living with HIV. https://www.fda.gov/news-events/press-announcements/fda-approves-first-extended-release-injectable-drug-regimen-adults-living-hiv - ↑ 2.0 2.1 Saag MS, Gandhi RT, Hoy JF, et al Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults. 2020 Recommendations of the International Antiviral Society-USA Panel. JAMA. Published online October 14, 2020 PMID: https://www.ncbi.nlm.nih.gov/pubmed/33052386 https://jamanetwork.com/journals/jama/fullarticle/2771873
- ↑ 3.0 3.1 Gandhi RT, Bedimo R, Hoy JF et al Antiretroviral Drugs for Treatment and Prevention of HIV Infection in Adults. 2022 Recommendations of the International Antiviral Society - USA Panel. JAMA. Published online December 1, 2022. PMID: https://www.ncbi.nlm.nih.gov/pubmed/36454551 https://jamanetwork.com/journals/jama/fullarticle/2799240
- ↑ 4.0 4.1 4.2 4.3 Sax PE et al. Updated treatment recommendation on use of cabotegravir and rilpivirine for people with HIV from the IAS-USA Guidelines Panel. JAMA 2024 Mar 1; [e-pub] PMID: https://www.ncbi.nlm.nih.gov/pubmed/38427337 https://jamanetwork.com/journals/jama/fullarticle/2816037
- ↑ Cabenuva. extended release injectable suspensions https://cabenuvahcp.com/dosing/every-2-month/
- ↑ Highlights of Prescribing Information CABENUVA (cabotegravir extended-release injectable suspension; rilpivirine extended-release injectable suspension), co-packaged for intramuscular use. https://gskpro.com/content/dam/global/hcpportal/en_US/Prescribing_Information/Cabenuva/pdf/CABENUVA-PI-PIL-IFU2-IFU3.PDF