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COMBINATION DRUG
Cabenuva (cabotegravir/rilpivirine) is a prescription medication approved by the U.S. Food and Drug Administration (FDA) to treat human immunodeficiency virus type 1 (HIV-1) infection in adults and adolescents ages 12 years and older who weigh at least 35 kilograms.
These insights are based on 332 comments about Cabenuva from myHIVteam members. These are the experiences of a small number of people and are not meant to be medical advice.
Benefits:
Considerations:
Cabenuva is an antiretroviral treatment for HIV-1. It contains two medicines.
Cabotegravir blocks an HIV enzyme called integrase. HIV uses this enzyme to insert its genetic material into human cells. Rilpivirine blocks an enzyme called reverse transcriptase. HIV uses this enzyme to make copies of itself. Together, these medicines help stop HIV from multiplying.
Doctors prescribe Cabenuva for adults and adolescents aged 12 years and older who weigh at least 35 kilograms. The person’s HIV-1 must already be well controlled on a stable treatment plan. The person must also have no history of treatment failure and no known or suspected resistance to cabotegravir or rilpivirine.
HIV-1 is the virus that causes acquired immune deficiency syndrome (AIDS).
A healthcare provider gives Cabenuva as two injections into the muscles of the buttocks. One injection contains cabotegravir, and the other contains rilpivirine. The injections are given at separate sites. They may be given on opposite sides or at least 2 centimeters apart on the same side.
Cabenuva may be given once a month or once every two months. Some people may first take cabotegravir and rilpivirine tablets for about one month to check how well they tolerate the medicines. This oral lead-in is optional.
For monthly dosing, the starting dose is 600 milligrams of cabotegravir and 900 milligrams of rilpivirine. These injections are given on the last day of the current HIV treatment or oral lead-in. One month later, the continuation dose is 400 milligrams of cabotegravir and 600 milligrams of rilpivirine. These doses are then given every month.
For dosing every two months, the starting dose is 600 milligrams of cabotegravir and 900 milligrams of rilpivirine at month 1 and again at month 2. The same doses are then given every two months, starting at month 4.
When switching from monthly dosing to dosing every two months, the dose is 600 milligrams of cabotegravir and 900 milligrams of rilpivirine one month after the last monthly injections. The same doses are then given every two months.
When switching from dosing every two months to monthly dosing, the dose is 400 milligrams of cabotegravir and 600 milligrams of rilpivirine two months after the last every-two-month injection. The same doses are then given every month.
This information is based on the prescribing information, but your healthcare provider may tailor your treatment plan. Always follow their guidance.
These insights are based on 332 comments about Cabenuva from myHIVteam members.
Members who use Cabenuva often say the biggest tradeoff is fewer daily pills but some soreness or other side effects after injections. Many also stress staying in close touch with their HIV care team about pain, lab changes, scheduling, coverage, and whether Cabenuva is still the right fit for them.
Plan for a few days of soreness after injections.
“I do try to get the injections on a Friday so I can relax and work through the muscle soreness.”
Keep track of side effects after each dose.
“I have had two sets of Cabenuva. The side effects I’ve experienced is pain in the injection sites for about four days. I also have a hip and some muscle and joint pain. I feel a bit sleepy the first day, and I had a low-grade fever with the first set.”
Talk to your doctor about pain or reactions that do not go away.
“The first injection site became infected. The second injection site also became infected just inches away from the first one. And my doctor just had to extract a ton of infection from my hip.”
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In clinical studies of Cabenuva, the most common side effects occurred in about 2 percent to 83 percent of people. These include:
Cabenuva can cause serious side effects that may require immediate medical attention. These include:
Get medical help right away if you think you are having a serious reaction. If you or someone you know needs help, you can contact the 988 Suicide & Crisis Lifeline by calling or texting 988 or by using the online chat.
ViiV Healthcare, the manufacturer of Cabenuva, offers the ViiVConnect Copay Program. Eligible people with commercial insurance may pay as little as $0 per prescribed Cabenuva treatment.
ViiVConnect also offers one-on-one support from a trained access coordinator, including help understanding insurance coverage, verifying benefits, and identifying available savings and assistance programs.
To learn more, visit the ViiVConnect website or call 844-588-3288.
Tell your doctor if you have any allergies to cabotegravir/rilpivirine or any ingredients in Cabenuva.
Before you start Cabenuva, tell your doctor if you:
Tell your doctor about all medicines you take, including prescription drugs, over-the-counter medicines, vitamins, and herbal supplements.
Do not receive Cabenuva if you have had an allergic reaction to cabotegravir or rilpivirine. You also should not receive it if you take:
Contact your healthcare provider right away if you miss or expect to miss an injection visit.
For missed doses, Cabenuva may usually be given up to seven days before or after the scheduled date. If an injection is delayed by more than seven days, your healthcare provider will decide whether restarting injections is still appropriate based on your dosing schedule and how much time has passed since your last injection.
If you are pregnant, planning to become pregnant, or breastfeeding while taking Cabenuva, talk with your doctor about the risks and benefits. Cabenuva can remain in the body for up to 12 months or longer after the last injections. There is not enough information to fully determine its risks during pregnancy.
Rilpivirine has been found in human breast milk after oral use. Breastfeeding may pass HIV-1 to a child who does not have HIV-1. It may also make HIV-1 harder to treat in a child who has HIV-1. A breastfed child may also have side effects similar to those seen in adults.
Healthcare providers can register pregnancies by visiting the Antiretroviral Pregnancy Registry or calling 800-258-4263.
These answers are fact-checked by our editorial staff.
How effective is Cabenuva for HIV?
In studies of adults whose HIV was already well controlled, Cabenuva kept HIV-1 suppressed in most participants.
At week 48:
How long does Cabenuva take to work for HIV?
Cabenuva is used to replace a current HIV treatment in eligible people whose HIV-1 is already well controlled. This means their HIV-1 RNA is below 50 copies per milliliter.
The studies looked at how well Cabenuva maintained viral suppression over time. They included results at week 48 in adults and week 24 in adolescents. The studies did not measure how quickly Cabenuva lowers viral load in people with untreated or uncontrolled HIV.
What should I do if I miss a dose of Cabenuva for HIV?
Contact your healthcare provider if you miss an injection visit. Cabenuva may be given up to seven days before or after the scheduled date. If an injection is delayed by more than seven days and you did not take oral HIV treatment in the meantime, your healthcare provider will decide whether restarting injections is still appropriate.
For monthly dosing:
For dosing every two months:
Your healthcare provider will give you the correct schedule.
On myHIVteam, people share their experiences with HIV, get advice, and find support from others who understand.
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