Cabotegravir
HIV Infections
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
NO
Known Teratogen
No
Pharmaceutical Class
Human Immunodeficiency Virus Integrase Strand Transfer Inhibitor
Controlled Drug Substance
No
Cabotegravir
Summary
Cabotegravir is used for the treatment of HIV-1 infection in combination with another medication called rilpivirine. It's also used as a pre-exposure prophylaxis (PrEP) to reduce the risk of HIV-1 infection in high-risk adults and adolescents.
Cabotegravir works by inhibiting an enzyme called HIV integrase, which is essential for the virus to multiply. By blocking this enzyme, Cabotegravir reduces the amount of HIV in the blood, helping to prevent the virus from multiplying.
For adults and adolescents aged 12 years and older weighing at least 35 kg, the usual daily dose of Cabotegravir is one 30 mg tablet taken once daily. This dosage is used both for the treatment of HIV-1 infection and for pre-exposure prophylaxis (PrEP).
Common side effects of Cabotegravir include headache, nausea, abnormal dreams, anxiety, and insomnia. More serious adverse effects can include hypersensitivity reactions, liver toxicity, and depressive disorders.
Cabotegravir should not be used by individuals with a known hypersensitivity to it or those taking certain medications like carbamazepine, oxcarbazepine, phenobarbital, phenytoin, rifampin, and rifapentine. Individuals must be confirmed HIV-negative before starting Cabotegravir for PrEP to prevent resistance development.
Indications and Purpose
How does Cabotegravir work?
Cabotegravir works by inhibiting the HIV integrase enzyme, which is crucial for the integration of viral DNA into the host cell's DNA. This action prevents the virus from replicating and spreading within the body, helping to maintain viral suppression and reduce the risk of transmission.
Is Cabotegravir effective?
Cabotegravir has been shown to be effective in clinical trials for both the treatment and prevention of HIV-1 infection. In trials like FLAIR and ATLAS, it demonstrated efficacy in maintaining viral suppression in patients who were already virologically suppressed. For pre-exposure prophylaxis (PrEP), studies like HPTN 083 and HPTN 084 showed that Cabotegravir significantly reduced the risk of acquiring HIV-1 compared to other treatments.
What is Cabotegravir?
Cabotegravir is used for the treatment and prevention of HIV-1 infection. It works by inhibiting the HIV integrase enzyme, which is essential for viral replication. While it does not cure HIV, it helps maintain viral suppression and reduces the risk of transmission. Cabotegravir is often used in combination with other medications for optimal effectiveness.
Directions for Use
For how long do I take Cabotegravir?
Cabotegravir is typically used for about one month (at least 28 days) as an oral lead-in to assess tolerability before starting long-acting injectable forms. For missed injections, it can be used for up to 2 months. The exact duration may vary based on individual treatment plans, so follow your doctor's guidance.
How do I take Cabotegravir?
Cabotegravir should be taken once daily, with or without food. If you are taking it in combination with rilpivirine for HIV-1 treatment, it should be taken with a meal. There are no specific food restrictions, but it's important to follow your doctor's instructions and maintain a consistent routine for taking your medication.
How long does it take for Cabotegravir to start working?
Cabotegravir begins to work within hours of administration, achieving concentrations associated with significant antiviral activity. However, the exact time to maximal protection against HIV-1 infection is unknown. It's important to follow your doctor's instructions and maintain consistent use for the best results.
How should I store Cabotegravir?
Cabotegravir should be stored in its original container, tightly closed, and kept out of reach of children. It should be stored at room temperature, away from excess heat and moisture, and not in the bathroom. Proper storage helps maintain the medication's effectiveness and safety.
What is the usual dose of Cabotegravir?
The usual daily dose of Cabotegravir for adults and adolescents aged 12 years and older, weighing at least 35 kg, is one 30 mg tablet taken once daily. This dosage is consistent for both treatment and prevention of HIV-1 infection. Always follow your doctor's specific instructions.
Warnings and Precautions
Can Cabotegravir be taken safely while breastfeeding?
Cabotegravir may pass into breast milk, and there are potential risks to the infant, including HIV transmission and adverse reactions. If you are taking Cabotegravir for HIV-1 treatment, breastfeeding is not recommended. If you are HIV-negative and taking Cabotegravir for PrEP, discuss the benefits and risks of breastfeeding with your doctor.
Can Cabotegravir be taken safely while pregnant?
There is limited human data on the use of Cabotegravir during pregnancy, and its effects on fetal development are not well established. A pregnancy registry is available to monitor outcomes in those exposed to Cabotegravir during pregnancy. It's important to discuss the benefits and risks with your doctor if you are pregnant or planning to become pregnant while taking this medication.
Can I take Cabotegravir with other prescription drugs?
Significant drug interactions with Cabotegravir include anticonvulsants like carbamazepine and phenytoin, and antimycobacterials like rifampin and rifapentine, which can decrease its effectiveness. These medications are contraindicated with Cabotegravir. Always inform your doctor of all medications you are taking to avoid potential interactions.
Is Cabotegravir safe for the elderly?
There is limited data on the use of Cabotegravir in individuals aged 65 years and older. While no specific dosage adjustments are recommended for elderly patients, caution should be exercised due to the greater likelihood of decreased hepatic, renal, or cardiac function and the presence of other medical conditions or treatments. Always consult a healthcare provider for personalized advice.
Who should avoid taking Cabotegravir?
Important warnings for Cabotegravir include the risk of hypersensitivity reactions, hepatotoxicity, and depressive disorders. It is contraindicated in individuals with a known hypersensitivity to Cabotegravir or those taking certain medications like carbamazepine or rifampin, which can decrease its effectiveness. Patients should be confirmed HIV-negative before starting Cabotegravir for PrEP to avoid resistance development.
