Apretude (cabotegravir) is a newer, long-acting injection used to lower the risk of getting an HIV infection. It was approved by the FDA in 2021 for pre-exposure prophylaxis (PrEP). It's injected into the gluteal muscle (buttock muscle) every other month by a healthcare provider, but the injections can be painful.
HIV pre-exposure prophylaxis (PrEP)
Apretude (cabotegravir) is an integrase inhibitor. Integrase is an enzyme (protein) that the HIV virus uses to enter your cells and make more copies of itself. When integrase is stopped, the virus can't grow and spread.
Source: DailyMed
Side effects that you should report to your care team as soon as possible:
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Only FDA-approved injection for HIV PrEP
After the first two injections, only need to get one injection every other month
Works well to prevent HIV-1 infection in people at high risk
Good option for people who can't tolerate pills
Injections can be painful; 90-98% of people reported pain or tenderness with the injection
Unknown if safe in pregnancy
Brand only, so might be expensive
In addition to getting Apretude (cabotegravir) injections, there are other things you can do to help lower your risk of HIV infection. For example, know if your partner has HIV, get tested for sexually transmitted diseases (STDs), and wear a latex condom during sexual activity.
Apretude (cabotegravir) doesn't always work to prevent HIV. Getting injections on time can lower your risk of infection. Speak to your provider if you have concerns.
Call your provider if you think you were exposed to HIV. They might want to do tests to make sure you're HIV negative, since you can only take Apretude (cabotegravir) if you're negative.
Let your provider know if you have symptoms of HIV infection, including fever, muscle pain, feeling tired, or rash so you can be tested right away. Apretude (cabotegravir) isn't a complete treatment for HIV infection.
If you decide to stop taking Apretude (cabotegravir) and are still at risk for getting infected with HIV, speak with your provider about starting alternative treatment within 2 months of your last injection.
Even though Apretude (cabotegravir) can stay in your body for up to 12 months, it has only been shown to prevent HIV infection when taken every 2 months. If you need to miss or already missed your injection, discuss options with your provider right away.
If you're pregnant or breastfeeding, speak to your provider about the risks and benefits of Apretude (cabotegravir).
Apretude (cabotegravir) doesn't prevent other STDs. Always practice safe sex to lower your risk of getting STDs.
Apretude (cabotegravir) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Unknown if positive or negative for HIV-1
Before you can take Apretude (cabotegravir), you must be tested for HIV. This medication can only be used if you've tested negative for HIV because there's a risk of resistance occurring in people who don't know if they're HIV positive or negative. This might make an HIV infection harder to treat over time. Your provider will test you before each injection. If you test positive for HIV, your provider will stop Apretude (cabotegravir) and start you on a more complete treatment.
Apretude (cabotegravir) might not work well if you develop an HIV infection either before, during, or after treatment. For this reason, you'll be tested for HIV before each Apretude (cabotegravir) injection. This medication should be used along with other methods to reduce your risk of HIV infection. Other things you can do to lower your risk include safe sex practices (e.g., using latex condoms), knowing if your partners are infected with HIV, and getting tested regularly for HIV. Getting Apretude (cabotegravir) injections on time will help lower your risk of getting infected with HIV.
Before starting Apretude (cabotegravir), your provider might ask you about your potential exposure to HIV. These events might include recent condomless sex, or if you have a recent history of sexually transmitted diseases (STDs). You'll also be asked to get an HIV test before starting this medication and before every injection. Let your provider know if you have symptoms of HIV before or during your treatment with Apretude (cabotegravir), including fever, feeling tired, muscle pain, and skin rash.
Life-threatening or severe allergic reactions have occurred with medications similar to Apretude (cabotegravir). This is why your provider might ask you to take a tablet form of this medication before the long-acting injection form to see how you tolerate it. They might also monitor you for at least 10 minutes after your injection. Get medical help right away if you experience shortness of breath, rash, fever, muscle pain, swelling in your face, or tightness in your throat.
In some rare cases, some people have experienced liver damage from Apretude (cabotegravir). Speak to your provider about your medical history before taking this medication. Watch out for signs of liver damage such as stomach pain, yellowing of the skin or whites of your eyes, and nausea or vomiting. If you experience any of these symptoms, get medical help right away.
Some people have experienced depression and suicidal thoughts or attempt(s) while taking Apretude (cabotegravir). If you notice any mood changes, call your provider so they can determine if your symptoms might be related to this medication. They'll also evaluate whether Apretude (cabotegravir) is still safe for you to continue taking.
It's possible for other medications to interact with Apretude (cabotegravir). Some medications can lower the amount of Apretude (cabotegravir) in your body, which could make it work less well to prevent HIV infection. Examples include some antiseizure medications (e.g., carbamazepine (Tegretol), phenytoin (Dilantin)) and antibiotics (e.g., rifampin (Rifadin), rifabutin (Mycobutin)). Make sure to tell your provider all of the medications you're taking before starting Apretude (cabotegravir) and if you start any new medications. They can help you screen for potential interactions.
Adults and adolescents weighing 35 kg or greater: The typical dose is 600 mg injected into the muscle (IM) every month for 2 months. Afterwards, the typical dose is 600 mg every 2 months.
Unknown if positive for HIV-1
HIV-1 positive
Receiving certain antiseizure medications (e.g., carbamazepine (Tegretol), oxcarbazepine (Trileptal), phenobarbital, phenytoin (Dilantin)
Receiving certain antibiotics (e.g., rifampin (Rifadin), Priftin (rifapentine))
Treatment of HIV infection
Prevention of HIV infection (PrEP or pre-exposure prophylaxis)
Treatment of HIV infection
Prevention of HIV infection (PrEP) through sexual intercourse, except for receptive vaginal sex
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