Vocabria
Vocabria (cabotegravir) is a medication that's taken by mouth used to treat or lower the risk of getting a human immunodeficiency virus (HIV) infection. It's typically given for a short period of time before starting an injectable form of cabotegravir to see how your body will react to the medication.
What is Vocabria (cabotegravir)?
What is Vocabria (cabotegravir) used for?
Short-term treatment of HIV-1 infection in certain people, used in combination with Edurant (rilpivirine) before starting Cabenuva (cabotegravir / rilpivirine)
Short-term HIV pre-exposure prophylaxis (PrEP) before starting Apretude (cabotegravir)
Oral (by mouth) treatment for people who already know they'll miss a Cabenuva (cabotegravir / rilpivirine) or Apretude (cabotegravir) injection
How Vocabria (cabotegravir) works
Vocabria (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 inhibited or stopped, the virus can't grow. Vocabria (cabotegravir) works by blocking integrase, which helps prevent HIV viruses from spreading.
Drug Facts
What are the side effects of Vocabria (cabotegravir)?
Common Side Effects
- Headache (up to 7%)
- Nausea (up to 7%)
- Diarrhea (up to 4%)
- Dizziness (up to 4%)
- Vomiting (up to 3%)
Other Side Effects
- Feeling tired
- Drowsiness
- Feeling weak
- Trouble sleeping
- Abnormal dreams
- Anxiety
- Bloated belly
- Low appetite
- Itching
- Upper respiratory tract infection (e.g., common cold)
Serious Side Effects
- Suicidal thoughts and behaviors
- Serious allergic reactions: mouth sores, shortness of breath, rash, fever, muscle pain, swelling in your face, tightness in your throat
- Liver problems: upper right stomach pain, yellowing of the skin or whites of the eyes, dark urine, nausea
Source: DailyMed
The following 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 Vocabria (cabotegravir)
Pros
Taken by mouth once a day, so it's convenient for people with a busy schedule
Tests if you tolerate the medication before switching to a long-acting, injection form
Can be used in certain people with kidney or liver problems
Cons
Only available as a brand medication so it might be expensive
Only for short-term use
Unknown if it's safe or works well in children under 12
Pharmacist tips for Vocabria (cabotegravir)
Vocabria (cabotegravir) might not always protect you from HIV. It also doesn't protect you from hepatitis or other sexually transmitted diseases (STDs). Always use a condom along with Vocabria (cabotegravir) to help lower your risk of an infection.
If you're transitioning from Vocabria (cabotegravir) tablets to Cabenuva (cabotegravir / rilpivirine) or Apretude (cabotegravir) injections, follow your provider's instructions on how to make the transition. Typically, you can receive your first injection on the same day as your the last Vocabria (cabotegravir) tablet.
Tell your provider right away if you think you were exposed to HIV or if you have symptoms of an HIV infection, such as fever, muscle pain, feeling tired, or rash. Your provider might want to do tests to make sure you don't have HIV (HIV-negative) since Vocabria (cabotegravir) alone isn't a complete treatment for HIV infection.
It's important for you to take Vocabria (cabotegravir) around the same time every day. Missing doses often can make it easier for the HIV virus to change form and cause Vocabria (cabotegravir) to stop working. If you accidentally forget to take the medication, take your missed dose as soon as possible and tell your provider.
Vocabria (cabotegravir) can interact with many medications. Let your provider or pharmacist know what medications you're taking, including over-the-counter products and supplements, before you start Vocabria (cabotegravir). Talk with your provider or pharmacist if you have any questions about interactions with this medication.
Tell your provider if you or your child experiences any changes in weight while taking Vocabria (cabotegravir). It's not clear whether this medication works well for people who weigh less than 77 pounds. Let your provider know if you or your child has nausea, vomiting, or diarrhea that won’t go away since this can also be a cause of weight loss.
Frequently asked questions about Vocabria (cabotegravir)
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What are the risks and warnings for Vocabria (cabotegravir)?
Vocabria (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 additional precautions to prevent HIV when used for PrEP
Vocabria (cabotegravir) might not always work well to prevent HIV infection. Use other methods along with this medication to reduce your chance of infection. Other things you can do to lower your risk include safe sex practices (e.g., using latex condoms), knowing if your partner(s) are infected with HIV, and getting tested regularly for HIV and other STDs. Taking Vocabria (cabotegravir) on time will also help lower your likelihood of getting infected with HIV.
Before starting Vocabria (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 STDs. You'll also be asked to get an HIV test before starting this medication. Let your provider know if you have symptoms of HIV, including fever, feeling tired, muscle pain, and skin rash, before or during your treatment with Vocabria (cabotegravir).
Serious allergic reaction
Similar medications to Vocabria (cabotegravir) have caused allergic reactions that are sometimes life-threatening. This is why your provider might ask you to take Vocabria (cabotegravir) — the tablet form of cabotegravir — short term before starting the long-acting, injection form to see how you tolerate it. Watch out for signs and symptoms of allergic reactions, such as pink eye, mouth sores, shortness of breath, rash, fever, muscle pain, swelling in your face, or tightness in your throat. Get medical attention right away if an allergic reaction occurs. You'll need to stop taking Vocabria (cabotegravir) so your provider can help with your symptoms.
Liver problems
Risk factor: History of liver problems in people with HIV infection
Rarely, Vocabria (cabotegravir) can cause serious liver problems. Your risk might be higher if you have HIV and have had liver problems in the past. Talk with your provider about your medical history before starting this medication so they can decide how you can safely take Vocabria (cabotegravir).
You’ll need to get blood tests done while you take Vocabria (cabotegravir) so your provider can check your liver health. If you experience signs and symptoms of liver damage, such as upper right stomach pain, yellowing of the skin or whites of the eyes, or dark urine, talk with your provider right away.
Depression and suicidal thoughts
Some people have experienced depression, mood swings, and suicidal thoughts or attempt(s) while taking Vocabria (cabotegravir). If you or your loved ones notice any mood changes, call your provider so they can determine if your symptoms are related to this medication. They'll also decide whether it's still safe for you to continue taking Vocabria (cabotegravir).
Interaction with other medications
Some medications can interfere with how your body removes Vocabria (cabotegravir). This can affect the amount of Vocabria (cabotegravir) in your body, how well it works, and the risk of side effects.
Taking heartburn medications like calcium carbonate (Tums) can cause Vocabria (cabotegravir) to be less effective. If you are planning to take antacids, make sure to take them 2 hours before or 4 hours after taking Vocabria (cabotegravir).
Avoid taking certain medications for seizures (e.g., carbamazepine (Tegretol), phenytoin (Dilantin)) or antibiotics (e.g., rifampin (Rifadin), Priftin (rifapentine)) along with Vocabria (cabotegravir). These medications can lower the amount of Vocabria (cabotegravir) in your body and cause it to be less effective.
Before starting Vocabria (cabotegravir) and also during your treatment, let your provider or pharmacist know what other medications you’re taking or plan to take. They can help make sure all your medications are safe for you.
Vocabria (cabotegravir) dosage forms
Typical dosing for Vocabria (cabotegravir)
This medication is used in people 12 years and older who weigh at least 77 pounds.
Short-term treatment of HIV-1: The typical dose is 30 mg by mouth once a day taken together with one 25-mg Edurant (rilpivirine) tablet and a meal for at least 28 days.
Short-term HIV pre-exposure prophylaxis: The typical dose is 30 mg by mouth once a day for at least 28 days.
Replacing a missed injection of Cabunuva (cabotegravir / rilpivirine) or Apretude (cabotegravir): Your dose of Vocabria (cabotegravir) will depend on how many days you plan to miss your injection by, how often you're getting your injections, and when your last injection was given. Your provider will determine if you're able to take Vocabria (cabotegravir) to make up for a missed dose and how long you should take it. Vocabria (cabotegravir) is only meant to be used for up to 2 months to replace missed injections.
Vocabria (cabotegravir) contraindications
Take certain medications for seizure that cause Vocabria (cabotegravir) to not work as well (e.g., carbamazepine (Tegretol), oxcarbazepine (Trileptal), phenobarbital, phenytoin (Dilantin))
Take certain antibiotics that cause Vocabria (cabotegravir) to not work as well (e.g., rifampin (Rifadin), Priftin (rifapentine))
Unknown or positive HIV status (for PrEP only)
What are alternatives to Vocabria (cabotegravir)?
Short-term treatment of HIV-1 infection in certain people, used in combination with Edurant (rilpivirine) before starting Cabenuva (cabotegravir / rilpivirine)
Short-term HIV pre-exposure prophylaxis (PrEP) before starting Apretude (cabotegravir)
Oral (by mouth) treatment for people who already know they'll miss a Cabenuva (cabotegravir / rilpivirine) or Apretude (cabotegravir) injection
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