What is Cabotegravir? A New HIV Injectable Medication

What Is Cabotegravir?

Cabotegravir is a new  medication that prevents the  HIV germ (Virus) from multiplying thereby stopping them from increasing in the body of an infected person. Cabotegravir is the best ARV drug so far because you only get one  injection  every two months unlike the pills where you need to take everyday. This new HIV medication is used for both treatment of HIV and Prevention called PrEP. 

How is Cabotegravir taken?

The following cabotegravir dosages and potencies are available:

• 30 mg pills, under the trade name Vocabria
• Extended-release injectable suspension in single-dose vials weighing 3 milliliters (600 mg; brand name: Apretude)

As directed by your healthcare practitioner, use cabotegravir. Never skip a cabotegravir dose, adjust your dosage, or discontinue taking cabotegravir without first consulting your doctor.

What is cabotegravir used for 

A. HIV Treatment 

Your doctor may advise you to take cabotegravir and rilpivirine tablets together for a month prior to receiving the long-acting injectable regimen of these drugs (brand name: Cabenuva) in order to gauge your tolerance to them. Each day, at the same time, take two cabotegravir and two rilpivirine tablets orally with food.

If you anticipate missing a scheduled Cabenuva injection by more than 7 days, call your doctor straight away to go over your choices. To make up for missing injections, your doctor may advise you to take cabotegravir and rilpivirine tablets together.

B. HIV Prevention.  Pre-Exposure Prophylaxis (PrEP)

Your doctor may instruct you to take one cabotegravir tablet once day for a month prior to having your first cabotegravir injection for HIV PrEP in order to gauge your tolerance to the drug. Orally consume cabotegravir pills with or without food.

Your healthcare practitioner will give you the long-acting injectable cabotegravir for HIV PrEP. For the first two months, you will initially have a cabotegravir intramuscular (IM) injection once each month. Following that, cabotegravir will be administered intramuscularly (IM) once every two months.

Long-acting injectable cabotegravir injections are given every two months, so if you anticipate missing one by more than seven days, call your doctor right away to talk about PrEP options. You can be instructed by your doctor to take cabotegravir tablets in place of a missed injection.

After your last injection, long-acting injectable cabotegravir can persist in your system for up to 12 months. It is crucial that you take cabotegravir as prescribed for PrEP and not simply when you suspect an HIV exposure. Always use condoms and other safe sex practices in addition to PrEP. If you stop taking long-acting injectable cabotegravir, talk to your doctor about your choices for lowering your risk of contracting HIV.

Image Credit:Aidsmap. Is HIV prevention vaccine difficult to make?

Which brands of cabotegravir are approved for use?

The U.S. Food and Drug Administration (FDA) has approved the prescription drug cabotegravir.

For the following uses, it is authorized in two separate dosage forms and under two different brand names:

Oral tablets Cabotegravir brand name: Vocabria

• For the quick treatment of HIV infection in adults and young people 12 years of age and older who weigh at least 77 lb (35 kg) and meet specific criteria as assessed by a healthcare professional. Rilpivirine (trade name: Edurant), an HIV medication, is usually combined with cabotegravir when used as an HIV treatment.
• When using short-term PrEP, adults and teenagers who weigh at least 77 lb (35 kg) can lower their risk of contracting HIV.

Injectable Long-term Acting cabotegravir brand name: Apretude

• Adults and adolescents who weigh at least 77 lb (35 kg), are HIV negative, and are at risk for contracting HIV can use long-acting injectable cabotegravir (brand name: Apretude) as part of HIV PrEP to lower their risk of contracting the virus.
• To lower the risk of contracting more STDs, long-acting injectable cabotegravir for PrEP should always be used in conjunction with safer sex behaviors, such as using condoms.

What are The side effects of cabotegravir?

Cabotegravir could have negative effects. As mentioned above, certain cabotegravir adverse effects might be severe. Many HIV medication side effects, such as occasional nausea or dizziness, are tolerable. For more information, consult the HIV fact sheet on HIV medications and side effects. The following are additional negative effects of cabotegravir tablets used for HIV therapy and/or PrEP:

• Sleep problems
• Diarrhea
• Headache strange dreams Anxiety
• Drowsiness Weakness
• Infection of the upper respiratory tract
• Tiredness
• Constipation or bloating

Long-acting injectable cabotegravir's other potential adverse effects include:

• Reactions at the injection site, including pain, soreness, hardened mass or lump, swelling, bruising, redness, itching, warmth, loss of feeling, abscess, and discolouration
• Diarrhea 
• Headache 
• Fever 
• Tiredness 
• Issues with sleep 
• Releasing gas 
• abdominal pains
• Losing appetite for foods
• Feeling sleepy
• Infection of the upper respiratory tract.
• Nausea and Vomiting 
• Rash, muscle and back pains

Precautions Before taking cabotegravir

Inform your health worker of the following before you are commenced on cabotegravir:

• if you have a medication or cabotegravir allergy.
• If you've ever experienced liver issues, such as hepatitis B or C virus infections, you should tell your doctor.
• if you've ever experienced mental health issues.
• if you suffer from any other illnesses.
• if you are a woman and expecting to get pregnant. Discuss the advantages and disadvantages of using cabotegravir while pregnant with your doctor. After your last injection, long-acting injectable cabotegravir can stay in your system for up to 12 months or more.

Summary

HIV medications cannot treat HIV/AIDS, however daily use of HIV medications prolongs and improves the lives of persons with HIV. HIV medications that are taken for therapy also lower the chance of HIV transmission. Do not reduce, skip, or stop taking your HIV medication(s) until your doctor instructs you to, whether you are using cabotegravir for HIV prevention or HIV therapy (in conjunction with rilpivirine). 

In Zambia cabotegravir is heard to be launched in October 2023. 

References: 

1.World Health Organization (WHO)
2.Clinicalinfo.hiv.org
3.Drug Bank.  Go.drugbank.com
4.www.ncbi.nlm.nih.gov