Dosing and Drug
Once-monthly CABENUVA is administered as two intramuscular (IM) injections by a healthcare professional every month. Adherence to the dosing schedule is strongly recommended.
Recommended Once-Monthly Dosing Schedule
Starting patients on once-monthly CABENUVA injections
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. Patients who miss a scheduled injection visit should be clinically reassessed to ensure resumption of therapy remains appropriate.
ONCE-MONTHLY DOSING SCHEDULE
Starting patients with optional oral lead-in
An optional oral lead-in can be used to assess tolerability prior to CABENUVA. If using the oral lead-in, prescribe 2 tablets (1 x 30-mg cabotegravir tablet and 1 x 25-mg rilpivirine tablet) to be taken once daily with a meal for approximately 1 month (at least 28 days). Initiation injections (cabotegravir 600 mg/3 mL and rilpivirine 900 mg/3 mL) should be administered on the last day of oral lead-in, if used.
- 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 response
Concomitant drug class
Effect on concentration
|Coadministration with CABENUVA is contraindicated due to potential for loss of virologic response and development of resistance.|
(more than a single-dose treatment)
St John’s wort (Hypericum perforatum)
Macrolide or ketolide antibiotics:
|Macrolides are associated with risk of Torsade de Pointes. Where possible, consider alternatives such as azithromycin, which increases rilpivirine concentrations less.|
|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
Dosing recommendations when switching from every-2-month to once-monthly CABENUVA
Administer 2-mL doses of cabotegravir and rilpivirine 2 months after the last 3-mL doses of each medicine, and continue once monthly thereafter.
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.
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 injections 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.
Continuing once-monthly CABENUVA after missed injections
Adherence to the dosing schedule is strongly recommended. Patients who miss a scheduled injection visit should be clinically reassessed to ensure resumption of therapy remains appropriate.
Planned Missed Injections
- If a patient plans to miss a scheduled injection visit by more than 7 days:
- Any fully suppressive oral antiretroviral regimen may be used to cover a planned missed injection visit, or
- Oral cabotegravir (30-mg tablet) in combination with rilpivirine (25-mg tablet) once daily may be used for up to 2 consecutive months to cover a planned missed injection visit
- 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
CONTINUING AFTER PLANNED MISSED INJECTIONS
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 injections remains appropriate.
CONTINUING AFTER UNPLANNED MISSED INJECTIONS
Dosing and administration guide
Alternative Site for Administration (ASA)
For practices that are not yet equipped to administer CABENUVA injections or prefer to have injections administered to patients off-site, an ASA may be an appropriate option.
What is an ASA?
An ASA is a flexible option for patients to receive CABENUVA injections outside of the prescribing physician’s office.
How to ﬁnd an ASA for your patient
Find an ASA nearby with the CABENUVA ASA Locator Tool located on the ViiVConnect website. Enter the ZIP code or use your location to search for injection facilities within a selected search radius. Inclusion of facilities in this ASA Locator does not imply a referral, recommendation, or endorsement by ViiV Healthcare.
Is your facility interested in becoming an ASA?
If you would like to list your facility on the CABENUVA ASA Locator Tool, download and complete the agreement form on the ASA Locator page.