For virologically suppressed adults with HIV-1. See Full Indication.

Dosing & Drug
Interactions of CABENUVA

CABENUVA must be administered by a healthcare professional. Before initiation of clinician-administered CABENUVA, ensure patients agree to the required monthly dosing schedule and counsel patients about the importance of adherence to scheduled dosing visits.1 Patients who miss a scheduled injection visit should be clinically reassessed to ensure resumption of therapy remains appropriate.

Recommended Dosing Schedule

Oral lead-in: month 1 (at least 28 days)

CABOTEGRAVIR
1 x 30-mg TABLET

RILPIVIRINE
1 x 25-mg TABLET

To assess tolerability of CABENUVA, patients switching to CABENUVA will take an oral lead-in, 2 pills once daily with a meal, for one month (at least 28 days).1

Initiation injections: (one-time dosing)

LONG-ACTING CABOTEGRAVIR
600 mg (3 mL)

LONG-ACTING RILPIVIRINE
900 mg (3 mL)

On the last day of oral lead-in, patients will receive their initiation injections. The initiation injections are administered as 2 IM injections at separate gluteal sites (opposite sides or 2 cm apart) during same visit.1

Continuation injections: (once-monthly)

LONG-ACTING CABOTEGRAVIR
400 mg (2 mL)

LONG-ACTING RILPIVIRINE
600 mg (2 mL)

Starting in Month 3, patients will begin continuation injections of CABENUVA. Continuation injections are administered as 2 IM injections at separate gluteal sites (opposite sides or 2 cm apart) during same visit.1 CABENUVA has dosing flexibility, allowing for continuation injections to be given up to 7 days before or 7 days after the Target Treatment Date.1

IM=intramuscular

Scheduling monthly injections

Adherence to the monthly injection dosing schedule is strongly recommended. Before initiating CABENUVA, counsel your patients about the importance of continued medication adherence and scheduled visits to help maintain viral supression.1

Setting a consistent monthly injection date, the Target Treatment Date, can help keep your patients on track. It is recommended that patients receive their monthly injection on the same date each month, making the Target Treatment Date fall between the 1st and 28th of each month.

CABENUVA has dosing flexibility, allowing for continuation injections to be given up to 7 days before or 7 days after the Target Treatment Date.1

CABENUVA monthly dosing
CABENUVA monthly dosing key

Missed injections

Adherence to the monthly injection dosing schedule is strongly recommended. Patients who miss a scheduled injection visit should be clinically reassessed to ensure resumption of therapy remains appropriate.1

Planned Missed Injections

If a patient plans to miss a scheduled injection visit by more than 7 days, oral therapy (one 30-mg cabotegravir tablet and one 25-mg rilpivirine tablet once-daily with a meal) can be taken to replace up to 2 consecutive monthly injection visits. The first dose of oral therapy should be taken approximately 1 month after the last injection dose of CABENUVA and continued until the day injection dosing is restarted.

Unplanned Missed Injections

If monthly injections are missed or delayed by more than 7 days and oral therapy has not been taken in the interim, clinically reassess the patient to determine if resumption of injection dosing remains appropriate.

RECOMMENDATIONS AFTER MISSED INJECTIONS

Time Since Last Injection1

Recommendation

<2 months

Resume with 400-mg (2-mL) cabotegravir and 600-mg (2-mL) rilpivirine IM monthly injections as soon as possible

>2 months

Re-initiate the patient with 600-mg (3-mL) cabotegravir and 900-mg (3-mL) rilpivirine IM injections, then continue to follow the 400-mg (2-mL) cabotegravir and 600-mg (2-mL) rilpivirine IM monthly injection dosing schedule

Dosing and administration guide

Download this guide to receive information on:

  • CABENUVA dosing kits and storage
  • The oral lead-in and CABENUVA dosing schedule
  • Administering the initiation and continuation injections
  • Managing missed injections
  • Injection considerations to share with your patients
Download 

Drug-drug interactions

  • Recommendations are based on drug-drug interactions observed after oral administration of cabotegravir and rilpivirine or predicted interactions due to the expected magnitude of the interaction and potential loss of virologic response1

Concomitant drug class
Drug name1

Effect on concentration1

Recommendation1

Anticonvulsants:

Carbamazepine

Oxcarbazepine

Phenobarbital

Phenytoin

Cabotegravir
Rilpivirine
Coadministration with CABENUVA is contraindicated due to potential for loss of virologic response and development of resistance.

Antimycobacterials:

Rifampin

Rifapentine

Rifabutin

Cabotegravir
Rilpivirine

Glucocorticoid (systemic):

Dexamethasone

(more than a single-dose treatment)

Rilpivirine

Herbal product:

St John’s wort (Hypericum perforatum)

Rilpivirine

Macrolide or ketolide antibiotics:

Azithromycin

Clarithromycin

Erythromycin

↔︎Cabotegravir
Rilpivirine
Macrolides are associated with risk of Torsade de Pointes. Where possible, consider alternatives such as azithromycin, which increases rilpivirine concentrations less.

Narcotic analgesic:

Methadone


↔︎ Cabotegravir
↔︎ Rilpivirine
No dose adjustment required when starting coadministration with CABENUVA. Clinical monitoring is recommended as methadone maintenance therapy may need to be adjusted in some patients.

↑ = Increase, ↓ = Decrease, ↔︎ = No Change

Reference:

  1. CABENUVA [package insert]. Research Triangle Park, NC: ViiV Healthcare; 2021.

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