Apretude
Apretude (cabotegravir) is a long-acting injection used to lower the risk of getting an HIV infection in people at risk. It's an antiviral medication that's FDA approved for pre-exposure prophylaxis (PrEP), which means it helps prevent HIV before you're exposed to it. The injection is typically given every other month as a shot in the buttock muscle by a healthcare professional. The most common side effects are injection site reactions like pain, redness, and hardening of the skin.
What is Apretude (cabotegravir)?
What is Apretude (cabotegravir) used for?
- HIV pre-exposure prophylaxis (PrEP)
How Apretude (cabotegravir) works
Apretude (cabotegravir) is an integrase inhibitor. It works by blocking an enzyme (protein) called integrase that HIV uses to insert its genetic material into your cells. By stopping this step, the virus can't cause an infection in your body.
Drug facts
More on Apretude (cabotegravir) essentials
Side effects of Apretude (cabotegravir)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Injection site reaction (38-82%)
- Headache (4-12%)
- Diarrhea (4%)
- Nausea (3-4%)
- Dizziness (2-4%)
- Fever (up to 4%)
- Upper respiratory tract infection (up to 4%)
Less Common Side Effects
- Feeling tired
- Trouble sleeping
- Abnormal dreams
- Stomach pain
- Vomiting
- Muscle pain
- Rash
- Lower appetite
- Drowsiness
Apretude (cabotegravir) serious side effects
Contact your healthcare provider immediately if you experience any of the following.
- Serious allergic reactions: rash, mouth sores, feeling ill, trouble breathing, tiredness, fever, muscle or joint pain, swelling in the face, redness or swelling in the eyes
- Liver problems: upper right stomach pain, yellowing of the skin or eyes, dark urine, light-colored stools nausea, vomiting, reduced appetite, itching
- Mood changes: feeling sad, restlessness, anxiety, suicidal thoughts and behavior
The following Apretude (cabotegravir) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Thoughts of suicide or self-harm, worsening mood, feelings of depression
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
Pros and cons of Apretude (cabotegravir)
Pros
- Only FDA-approved injection for HIV PrEP
- After the first two doses, only need to get an injection every other month
- Works well at reducing the risk of HIV infection
Cons
- Commonly causes pain at the injection site
- Must be injected in the buttock muscle
- Requires regular visits to a healthcare professional for injections
Pharmacist tips for Apretude (cabotegravir)
- In addition to getting Apretude (cabotegravir) injections, it's important to take other steps to lower your risk of HIV. These include using condoms during sex, knowing your partner’s HIV status, and getting tested regularly for sexually transmitted infections (STIs).
- It’s important to get your Apretude (cabotegravir) injections on time for them to work best. If you miss a dose, your prescriber will decide whether to continue or switch your medication. You might need extra doses depending on how late your shot was.
- If you know you’ll miss your Apretude (cabotegravir) injection by more than 7 days, your prescriber might recommend Vocabria (cabotegravir) tablets. This tablet can be taken to cover the gap, but only for up to 2 months.
- Let your prescriber know if you have HIV symptoms, like fever, muscle pain, tiredness, or rash so you can be tested right away. Apretude (cabotegravir) is only for prevention — it doesn't treat HIV.
- If you decide to stop taking Apretude (cabotegravir) but still have HIV risk, talk to your prescriber within 2 months of your last shot. They can help you switch to another option to stay protected.
- Apretude (cabotegravir) is a long-acting injection that can stay in your body for 12 months or longer after your last dose. Because it stays in your system for a long time, talk to your prescriber before stopping so you can make a plan and lower your risk of getting HIV.
- Apretude (cabotegravir) can interact with other medications. Tell your care team about all prescriptions, over-the-counter medications, and supplements you take before starting.
- Call your care team if you get a rash while taking Apretude (cabotegravir). Get medical help right away if the rash comes with fever, blisters, swelling, or trouble breathing. These could be signs of a serious allergic reaction, and you might need to stop receiving the medication.
- If you're pregnant or planning to be, there’s a registry that tracks how Apretude (cabotegravir) affects pregnancy. Talk to your prescriber about the risks versus benefits of taking this medication in pregnancy.
- If you’re breastfeeding, talk with your care team about the risks and benefits of taking Apretude (cabotegravir). This medication can stay in your body for up to 12 months, and small amounts might pass to your baby.
Common questions about Apretude (cabotegravir)
In studies, for cisgender men and transgender women, Apretude (cabotegravir) reduced the risk of getting HIV by 67% compared to taking a daily Truvada (emtricitabine/tenofovir) pill. And for cisgender women, Apretude (cabotegravir) lowered the risk by 88% compared to a daily Truvada (emtricitabine/tenofovir) pill.
Yes, women can take Apretude (cabotegravir) for HIV PrEP. It's FDA approved for use in people 12 years and older who weigh at least 77 lbs, including cisgender and transgender women.
Yes. Apretude (cabotegravir) should be kept in the refrigerator at your prescriber's office until it's ready for use. The medication should be brought to room temperature before the injection to help reduce pain during the shot.
Apretude (cabotegravir) can stay in your body for 12 months or longer after you stop taking it. But that doesn’t mean it will keep protecting you that whole time. After about 2 months, the amount of medication in your system gets too low to work well. To stay protected from HIV, you need to get this medication every 2 months.
It isn't known exactly how long it takes for Apretude (cabotegravir) to start working, and this can vary from person to person. Studies show that it takes about a week to reach protective levels in your body, but about 50% of people reach those levels just 1 day after the shot. Talk to your prescriber if you have questions about how soon this medication will start protecting you.
No, Apretude (cabotegravir) isn't a vaccine. It's an antiviral medication that prevents HIV infection in your body as long as there's enough of the medication in your blood.
Apretude (cabotegravir) is a prescription medication that must be given by a healthcare professional. Talk to your healthcare professional to see if Apretude (cabotegravir) is right for you based on your HIV risk and overall health. Once prescribed, it's usually injected by a healthcare professional in their office, but you might also be able to receive it at a public health clinic.
Protection from Apretude (cabotegravir) against HIV lasts for 2 months after you complete the starting doses. To stay protected, it's important to keep getting your injection on time every 2 months.
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Risks and warnings for Apretude (cabotegravir)
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.
Take extra steps to prevent HIV
Apretude (cabotegravir) can help lower your risk of getting HIV, but it works best when used with other protection methods. This includes getting your injections on time and practicing safer sex, like using condoms and getting tested regularly for STIs.
Before starting Apretude (cabotegravir), your prescriber might ask you about any recent situations where you could have been exposed to HIV — like unprotected sex or a recent STI. You'll also need to take an HIV test before each injection. Let your prescriber know if you have symptoms of HIV, such as fever, feeling tired, muscle pain, and skin rash, either before or during treatment.
HIV resistance
There’s a chance that HIV could become harder to treat if you get infected before, during, or shortly after stopping Apretude (cabotegravir). To help prevent this, your prescriber will test you for HIV before each injection to make sure you’re still HIV-negative. If you test positive, you’ll need to switch to full HIV treatment.
If you stop getting Apretude (cabotegravir) but are still at risk for HIV, your prescriber might recommend another type of PrEP. It's best to start the new medication within 2 months after your last injection.
Long-acting effects of the injection
Apretude (cabotegravir) can stay in your body for up to 12 months or longer after your last injection. That’s why it’s important to get your shots on time every 2 months. Missing doses can raise your risk of getting HIV and make the virus harder to treat if you do get infected.
Serious allergic reaction
Some people have had serious allergic reactions while taking cabotegravir, the active ingredient in Apretude (cabotegravir). In rare cases, these reactions have included serious skin problems like Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). In studies, some people started with Vocabria (cabotegravir) tablets first to help spot early signs of a reaction before getting injections. Stop taking the medication right away and call your care team if you get a severe rash or a rash with other symptoms like fever, feeling very tired, muscle or joint pain, blisters, mouth sores, red or irritated eyes, facial swelling, or trouble breathing.
Liver problems
Liver problems have been reported in some people taking Apretude (cabotegravir), even in those without known liver issues. Your prescriber might check your liver with blood tests during treatment to watch for any signs of damage. Call your prescriber right away if you notice signs of liver problems like pain in the upper right side of your stomach, yellowing of your skin or eyes, dark urine, pale stools, nausea, vomiting, loss of appetite, or itching.
Depression and mood changes
Mood changes, including depression and suicidal thoughts of behavior, have been reported in some people taking Apretude (cabotegravir). If you or someone close to you notices any changes in your mood, call your prescriber right away. They will help decide if it’s safe for you to keep taking Apretude (cabotegravir).
Interactions with other medications
Apretude (cabotegravir) can interact with many other medications. These interactions can lead to side effects, making the medication not work as it should for preventing HIV. Before and while taking Apretude (cabotegravir), tell your prescriber about everything you take — prescription, over-the-counter products, and supplements — so they can help manage any possible interactions.
Apretude (cabotegravir) dosage
Typical dosage for Apretude (cabotegravir)
Apretude (cabotegravir) is approved for adults and teens ages 12 and older, weighing at least 35 kg (77 lbs).
The typical starting dose is one 600 mg injection into the buttock muscle once a month for 2 months. After that, the maintenance dose is one 600 mg injection once every 2 months.
*Note: You might need to take Vocabria (cabotegravir) tablets for about a month before receiving Apretude (cabotegravir) injections.
Apretude (cabotegravir) contraindications
Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Apretude (cabotegravir) will not be safe for you to take.
- Have a positive or unknown HIV status
- Taking certain seizure medications that cause Apretude (cabotegravir) to not work as well (e.g., carbamazepine, oxcarbazepine, phenobarbital, phenytoin)
- Taking certain antibiotics that cause Apretude (cabotegravir) to not work as well (e.g., rifampin, rifapentine)
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