Cabenuva is a brand-name intramuscular injection that’s prescribed for HIV. Cabenuva contains the active ingredients cabotegravir and rilpivirine.
You’ll find key information about Cabenuva below.
- Drug classes: integrase strand transfer inhibitor and non-nucleoside reverse transcriptase inhibitor
- Drug form: extended-release liquid suspension that’s given as intramuscular injections by a healthcare professional
- Generic available? no
- Prescription required? yes
- Controlled substance? no
- Year of FDA approval: 2021
As with all medications, the cost of Cabenuva can vary. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use. It will also depend on the cost of visits to your doctor’s office or clinic to receive doses of Cabenuva.
Drug coupons. You can visit Optum Perks for price estimates of Cabenuva. These estimates are based on the use of Optum Perks coupons. Note: Optum Perks coupons cannot be used with insurance copays or benefits.
Financial and insurance assistance. If you need financial support to pay for Cabenuva or help to understand your insurance coverage, help is available.
A program called ViiV Connect is available for Cabenuva. Through this program, you can find information about the Cabenuva Patient Savings Program, copay assistance, insurance coverage, and more. For details and to find out whether you’re eligible for support, call 844-588-3288 or visit the manufacturer’s website.
Generic version. Cabenuva is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.
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Cabenuva can cause mild or serious side effects. The following lists contain some of the key side effects that may occur while taking Cabenuva. These lists do not include all possible side effects.
For more information about the possible side effects of Cabenuva, talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.
Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Cabenuva, you can do so through MedWatch.
Mild side effects
Mild side effects* of Cabenuva can include:
- injection site reactions†
- muscle pain
- mild allergic reaction†
Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or don’t go away, talk with your doctor or pharmacist.
* This is a partial list of mild side effects from Cabenuva. To learn about other mild side effects, talk with your doctor or pharmacist, or view Cabenuva’s prescribing information.
† To learn more about this side effect, see “Side effect details” below.
Serious side effects
Serious side effects from Cabenuva aren’t common, but they can occur. Call your doctor right away if you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
Serious side effects can include:
For more information about each of these side effects, see “Side effect details” below.
Side effect details
Here’s some detail on certain side effects this drug may cause.
Injection site reactions
After Cabenuva injections, some people may experience an injection site reaction. These reactions can be mild or serious, so it’s important to know the symptoms to watch for after your injections.
Injection site reactions occur in the areas where the medication was injected, which is usually in the buttocks. Symptoms may include:
- pain or discomfort
- lumps under the skin
- redness or discoloration
Let your doctor know if you experience any injection site reactions. They may be able to recommend ways to help relieve these reactions, such as icing the injection area after your appointment.
It’s possible to develop a reaction after a dose of Cabenuva. Most post-injection reactions should go away within a few minutes of the injections, but in some cases, these reactions may be more serious. Symptoms of a post-injection reaction may include:
- trouble breathing, which can cause wheezing and coughing
- stomach cramps
- a rash or hives, which can be serious (see below)
- numbness in your mouth
- feeling dizzy
- changes in your blood pressure
- pain, such as back or chest pain
Cabenuva injections are given by a healthcare professional, likely at your clinic or doctor’s office. You’ll be monitored for about 10 minutes after your injection. If you experience any serious post-injection reactions, such as trouble breathing, tell your doctor or healthcare professional right away. They can help treat your symptoms as soon as possible.
If you develop a rash after receiving Cabenuva injections, call your doctor right away. A rash may be a sign of a more serious allergic reaction. See the “Allergic reaction” section below for more details.
Mood changes, such as depression
Cabenuva treatment may cause depression, mood changes, or both in some people. This can include having sudden changes in mood or having negative thoughts. In some serious cases, people taking Cabenuva have reported suicidal thoughts or behaviors.
It’s important to tell your doctor right away if you’re experiencing symptoms of depression or mood changes, including:
- feeling sad or hopeless
- thoughts of harming yourself
Your doctor can help determine whether Cabenuva may be the cause of your depression or mood changes. In some cases, they may recommend a different treatment for you. In other cases, they may monitor your mood more closely to watch for any changes.
If you have a history of depression or mood disorders, tell your doctor before you start Cabenuva treatment. They’ll likely monitor your mood more closely during your treatment.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The 988 Suicide and Crisis Lifeline is available 24 hours a day at 988. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 988.
It’s possible to develop liver problems during treatment with Cabenuva. Throughout your treatment, your doctor will check your liver through blood tests. If they notice any changes, they may recommend a different medication for you.
If you have a history of liver problems or hepatitis, be sure to tell your doctor before you start Cabenuva treatment. They’ll likely recommend a different treatment option for you.
Symptoms of liver problems may include:
- abdominal pain
- jaundice (yellowing of your skin or whites of your eyes)
- dark urine
If you notice any symptoms of liver problems during your Cabenuva treatment, call your doctor right away. They can help determine what’s causing the symptoms and either treat your condition or have you switch medications.
As with most drugs, some people can have an allergic reaction after taking Cabenuva. Allergic reaction wasn’t reported during clinical trials of Cabenuva. However, it has been reported since the drug was approved.
Symptoms of a mild allergic reaction can include:
A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:
- swelling under your skin, typically in your eyelids, lips, hands, or feet
- swelling of your tongue, mouth, or throat
- trouble breathing
- serious skin rash
If you develop a rash after your dose of Cabenuva, you should tell your doctor right away. A rash may be a sign of a serious allergic reaction.
Also be sure to tell your doctor if you experience a rash with any additional symptoms such as fever, tiredness, muscle or joint pain, blisters, or swelling. These may also be signs of serious allergic reactions. In this case, tell your doctor right away. They will likely have you stop treatment with Cabenuva and try a different medication.
Call your doctor right away if you have an allergic reaction to Cabenuva, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.
The Food and Drug Administration (FDA) approves prescription drugs such as Cabenuva to treat certain conditions. Cabenuva may also be prescribed off-label for other conditions. Off-label drug use means prescribing a drug for a purpose other than what it’s been approved for by the FDA.
Cabenuva is FDA-approved to treat HIV in certain adults and children who are ages 12 years and older and weigh at least 35 kilograms (77 pounds). Specifically, Cabenuva is only prescribed if:
- the HIV has been effectively treated with other medications, and these medications haven’t been recently changed
- you have a low or undetectable level of HIV in your blood
- the HIV doesn’t have any known resistance to cabotegravir or rilpivirine (Cabenuva’s active ingredients)
Your doctor will test your blood to see if you can use Cabenuva. If you have fewer than 50 copies of HIV in one milliliter of blood, Cabenuva may be an option for you.
If you’ve tried other medications for HIV (such as cabotegravir or rilpivirine) but they weren’t safe or effective, your doctor won’t prescribe Cabenuva.
HIV is a virus that attacks your immune system. This causes your body to have less protection from illness or other diseases. With HIV, you have a higher risk of other infections or conditions (such as cancer) that your body may have otherwise been able to fight off.
Although there is no cure for HIV at this time, it’s important to take medications to help prevent it from getting worse or transmitting to others. If HIV goes untreated, it can turn into AIDS, which is a more severe immune system condition.
To learn more about HIV, visit our HIV and AIDS hub.
Effectiveness for HIV
Cabenuva is an effective treatment option for certain people with HIV. The Department of Health and Human Services (HHS) recommends Cabenuva as a treatment option for certain people who need to replace their current HIV treatment. Learn more about the recommendations from the HHS.
For more information on how Cabenuva performed in clinical trials, see its prescribing information.
Cabenuva and children
Cabenuva is approved for use in children with HIV who:
- are ages 12 years and older, and
- weigh at least 35 kilograms (at least about 77 pounds)
Children must also meet the criteria described above, under “Cabenuva for HIV.” For example, they must have a low or undetectable level of HIV.
Cabenuva is a complete treatment regimen for HIV. This means it’s not taken with other HIV treatments. But your doctor might prescribe two drugs before you start your Cabenuva treatment.
Cabenuva injections contain two active ingredients: extended-release* forms of cabotegravir and rilpivirine. Your doctor might prescribe immediate-release* oral forms of cabotegravir (Vocabria) and rilpivirine (Edurant) for you to take before you get your first Cabenuva injection. If prescribed, you’ll take these two drugs by mouth once per day (with food) for at least 28 days before your first Cabenuva injection.
Your doctor might prescribe these drugs to make sure that you don’t have any reactions to the medication.
On the last day that you take Vocabria and Edurant, you’ll get your first injection of Cabenuva.
* Extended release means the drug is released gradually over a certain period of time. Immediate release means the drug is released right away after you take it.
Cabenuva is an injectable drug that’s used in certain adults and children with HIV.
Cabenuva is administered as two injections into your buttock muscle either every month or every 2 months. One injection contains the drug cabotegravir and the other contains the drug rilpivirine. The two injections can be given at the same doctor’s appointment.
You may receive one injection on each side of your buttock muscle, or in some cases, both injections can be given on the same side.
When it’s given
If your doctor prescribes cabotegravir (Vocabria) and rilpivirine (Edurant) oral tablets, you’ll get your first injection of Cabenuva on the last day that you take the tablets. (See the “Cabenuva use with other drugs” section above to learn more.) Then you’ll receive Cabenuva injections once per month or every 2 months.
You can get your injections within a 7-day time frame of when they’re due. That means you can get your dose of Cabenuva anytime 7 days before or 7 days after when you’re due for your injection, and the medication will still be effective.
Cabenuva works to decrease the amount of HIV in your blood, so it’s important to get your injections as prescribed. Missing an appointment can cause the HIV levels in your blood to become very high. This can cause HIV to get worse or become transmittable to others.
Taking Cabenuva with food
The manufacturer of Cabenuva hasn’t given specific recommendations about whether you should eat before receiving a Cabenuva injection. If you have questions about whether you should eat before an injection appointment, talk with your doctor.
Note: If your doctor prescribes cabotegravir and rilpivirine oral tablets, you should take those with food.
The typical Cabenuva dosage your doctor will prescribe is two injections received at the same visit.
The following information describes dosages that are commonly used or recommended. But be sure to take the dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.
Drug form and strengths
Cabenuva comes as an extended-release suspension that’s given as intramuscular injections by a healthcare professional. It comes in a dosing kit that contains one dose of cabotegravir and one dose of rilpivirine. The drug comes in two strengths:
- 400 milligrams (mg) cabotegravir/600 mg rilpivirine
- 600 mg cabotegravir/900 mg rilpivirine
Cabenuva injections are extended release. This means they’re released over a certain period of time instead of being released into the body all at once.
Dosage for HIV
Cabenuva is given as two injections into the buttock muscles, either once per month or once every 2 months* as follows:
- Monthly injections: Your first dose will be a higher dose of medication. You’ll receive one injection containing 600 mg of cabotegravir and a second injection with 900 mg of rilpivirine. Then after your first dose, you’ll usually get one injection containing 400 mg of cabotegravir and a second injection with 600 mg of rilpivirine per month.
- Injections every 2 months: If you receive Cabenuva injections every other month, you’ll receive your first two doses 1 month apart. After this, you’ll receive your doses every 2 months. Each dose will consist of 600 mg of cabotegravir and a second injection with 900 mg of rilpivirine.
Cabenuva may be given as one injection on each side of your buttock muscle, or in some cases, it can be given on the same side. You will get both injections at the same appointment.
Before you start your Cabenuva treatment, you might take Cabenuva’s active drugs as oral tablets for 1 month. See the “Cabenuva use with other drugs” section above to learn more.
* If you’re switching from monthly injections to injections every 2 months: 1 month after your last monthly dose, you’ll receive a dose of 600 mg cabotegravir/900 mg rilpivirine. And then 2 months later you’ll continue with this higher dose every 2 months. Your doctor will schedule any dosage changes as needed.
Cabenuva’s recommended dosages for children are the same as those for adults, described just above.
What if I miss a dose?
Cabenuva works to decrease the amount of HIV in your blood, so it’s important to get your injections as prescribed. Missing a dose can cause the HIV levels in your blood to become very high. This can cause HIV to get worse or become transmittable to others.
You can get your injections within a 7-day time frame of when they’re due. That means you can get your dose of Cabenuva anytime 7 days before or 7 days after when you’re due for your injection, and the medication will still be effective.
If you need to reschedule your appointment for more than 7 days after your recommended due date, talk with your doctor. They may recommend that you switch back to the tablet forms of the medications cabotegravir (Vocabria) and rilpivirine (Edurant) to replace Cabenuva for up to 2 months.
If you miss a dose, your doctor may discuss whether Cabenuva is still a good treatment option for you. If you’ve missed your dose of Cabenuva for 2 months or less, your doctor will likely recommend making an appointment to get your dose as soon as possible.
If you’ve missed more than two doses in a row, your doctor will likely give you the initial dose of 600 mg of cabotegravir and 900 mg of rilpivirine. Then you’ll likely continue treatment with the dosage your doctor has prescribed.
To help make sure that you don’t miss a dose, you could set a calendar reminder or download a reminder app on your phone.
Will I need to use this drug long term?
Cabenuva is meant to be used as a long-term treatment. If you and your doctor determine that Cabenuva is safe and effective for you, you’ll likely take it long term.
Cabenuva can interact with several other medications. It can also interact with certain supplements. The drug is not known to interact with any foods.
Different interactions can cause different effects. For instance, some interactions can interfere with how well a drug works. Other interactions can increase side effects or make them more severe.
Cabenuva and other medications
Below is a list of medications that can interact with Cabenuva. This list does not contain all drugs that may interact with Cabenuva.
Before starting Cabenuva, talk with your doctor and pharmacist. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.
If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.
Other HIV medications. You shouldn’t use any other HIV medications during your Cabenuva treatment. Cabenuva is considered a complete treatment, which means it can be used alone. Before starting Cabenuva, talk with your doctor about how to stop your other HIV treatments before starting Cabenuva. Examples of other HIV medications include:
- bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy)
- dolutegravir/lamivudine/abacavir (Triumeq)
- efavirenz/emtricitabine/tenofovir disoproxil fumarate (Atripla)
- rilpivirine/emtricitabine tenofovir alafenamide (Odefsey)
- darunavir/cobicistat/emtricitabine/tenofovir alafenamide
Drugs that affect your heart rhythm. Taking Cabenuva with drugs that may affect your heart rhythm can cause an irregular heart rhythm, such as long QT syndrome. In some cases, your doctor may monitor you more closely for side effects during your Cabenuva treatment. In other cases, they may recommend a different medication that doesn’t interact with Cabenuva.
- azithromycin (Zithromax)
- erythromycin (Eryc)
- ciprofloxacin (Cipro)
- escitalopram (Lexapro)
- fluconazole (Diflucan)
- haloperidol (Haldol)
Anticonvulsants. You should not use Cabenuva if you’re taking certain anticonvulsant medications (a type of seizure medication). Examples of anticonvulsants include:
- carbamazepine (Tegretol)
- oxcarbazepine (Trileptal)
- phenytoin (Dilantin)
Antibiotics. Certain antibiotics may interact with Cabenuva.
Examples of antibiotics that should not be taken with Cabenuva include:
- rifampin (Rimactane, Rifadin)
- rifapentine (Priftin)
- rifabutin (Mycobutin)
Examples of other antibiotics that can interact with Cabenuva include:
- azithromycin (Zithromax)
- erythromycin (Eryc)
Dexamethasone. You shouldn’t take more than one dose of dexamethasone during your Cabenuva treatment. If you need to take dexamethasone, tell your doctor that you’re using Cabenuva. If you need more than one dose, they may recommend a different steroid medication for you.
Methadone. If you’re taking methadone, tell your doctor before you start Cabenuva. In some cases, your doctor may need to change your methadone dosage during your Cabenuva treatment.
Cabenuva and herbs and supplements
During your Cabenuva treatment, you shouldn’t take St. John’s wort. This herb decreases the amount of rilpivirine in your body. Rilpivirine is one of the drugs in Cabenuva. So taking St. John’s wort with Cabenuva may make Cabenuva less effective. Your doctor will likely recommend that you stop taking St. John’s wort when you start your Cabenuva treatment.
Cabenuva and foods
There aren’t any foods that have been specifically reported to interact with Cabenuva. If you have any questions about eating certain foods with Cabenuva, talk with your doctor.
Cabenuva is a prescription drug that’s used to treat HIV in certain adults and children.
HIV is a virus that attacks your immune system. This causes your body to have less protection from illness or other diseases.
Although there is no cure for HIV at this time, it’s important to take medications to help prevent it from getting worse. If HIV goes untreated, it can turn into AIDS, which is a more severe immune system condition.
What Cabenuva does
Cabenuva contains two extended-release active drugs: cabotegravir and rilpivirine. Extended release means that these drugs are released over a certain period of time instead of being released into the body all at once.
Cabotegravir and rilpivirine work to attack HIV and help prevent the virus from getting worse. Both of these drugs block the HIV virus from replicating in your body by blocking an enzyme (a type of protein). This decreases the symptoms you experience from HIV.
Cabotegravir belongs to a group of medications called integrase strand transfer inhibitors. Rilpivirine belongs to a group of drugs called non-nucleoside reverse transcriptase inhibitors.
How long does it take to work?
Cabenuva is a long-acting medication, so it may take some time to begin working. But it’s unlikely that you’ll notice the drug working in your body.
The medication will start working a few days after your injection. It will continue to keep the levels of HIV in your blood low or undetectable.
It’s not known whether Cabenuva is safe to take while pregnant. At this time, there isn’t enough data on the safety of Cabenuva during pregnancy.
Cabenuva contains the active drugs cabotegravir and rilpivirine. A medication similar to cabotegravir, called dolutegravir, may be associated with a risk of congenital anomalies for a fetus (commonly called birth defects) if used during pregnancy.
In animal studies, cabotegravir was associated with an increased risk of death in the animals’ offspring. It’s important to note that animal studies don’t always predict what will happen in humans.
Cabenuva can remain in your body for 12 months or longer after your dose. So if you’re planning to become pregnant in the next year, talk with your doctor about the best plan for HIV treatment. They may monitor you more often throughout your pregnancy, or they may recommend a different treatment than Cabenuva.
If you do use Cabenuva during pregnancy, consider enrolling in the Antiretroviral Pregnancy Registry. This registry gathers information about the use of certain HIV drugs during pregnancy. Your doctor can enroll you in the pregnancy registry by calling 800-258-4263 or by visiting the registry website.
It’s not known whether Cabenuva is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs during Cabenuva treatment.
For more information about taking Cabenuva during pregnancy, see the “Cabenuva and pregnancy” section above.
It’s unknown whether it’s safe to breastfeed during Cabenuva treatment. No animal or human studies have looked at whether this drug passes into breast milk or if it would have any effect on a child who is breastfed.
Here are answers to some frequently asked questions about Cabenuva.
Why might I need to take HIV medications by mouth before starting and after stopping Cabenuva?
Cabenuva injections contain two drugs: cabotegravir and rilpivirine. Before you get your first Cabenuva injection, your doctor might prescribe these two drugs for you to take by mouth once per day, for at least 28 days.
Taking these drugs by mouth before getting Cabenuva injections helps make sure you don’t have any reactions to the medications. This is important, as Cabenuva can stay in your body for up to 12 months.
But even though Cabenuva can remain in your body for up to 12 months, the amount of medication decreases over time. So if you stop taking Cabenuva, you should start taking another HIV medication by mouth after 1 month. This is to ensure that the HIV continues to be treated.
If you miss an appointment to receive a Cabenuva injection, your doctor may recommend that you take cabotegravir (Vocabria) and rilpivirine (Edurant) by mouth. You can substitute injections with Vocabria and Edurant for up to 2 months.
If you have any questions about other drugs you’ll take before or after Cabenuva, talk with your doctor or pharmacist.
Will I need to have lab tests or other monitoring done during my Cabenuva treatment?
Yes, your doctor will monitor you throughout your Cabenuva treatment for:
- The level of HIV in your blood. This determines how well the medication is working for you.
- Symptoms of liver problems. They’ll check your liver function through blood tests, because Cabenuva can cause liver problems.
- Other side effects of the drug, such as depression or changes in mood.
After each injection, you’ll also be monitored for about 10 minutes to make sure you don’t experience any post-injection reactions. For more information about side effects that Cabenuva may cause, see the “Cabenuva side effects” section above.
Should I take other HIV medications during Cabenuva treatment?
No, you should not take other HIV medications with Cabenuva, unless directed by your doctor. Cabenuva is considered a complete treatment, which means it works by itself to treat HIV. So you don’t need to take any other HIV medications along with Cabenuva.
If Cabenuva isn’t working for you, your doctor may switch you to another medication for HIV. If you have any questions about your treatment plan, talk with your doctor or pharmacist.
Before starting Cabenuva, talk with your doctor about your health history. Cabenuva may not be right for you if you have certain medical conditions or other factors affecting your health. These include:
- Liver problems. Cabenuva may cause liver problems. If you have a history of liver problems, such as hepatitis, be sure to tell your doctor before starting Cabenuva. Cabenuva treatment can make your liver problems worse. Your doctor may monitor your liver function more closely during your Cabenuva treatment, or they may recommend a different treatment for HIV.
- Depression or mood problems. Cabenuva can cause depression or changes in your mood. If you have a history of depression or other mental health conditions, Cabenuva may make your condition worse. Before starting Cabenuva, talk with your doctor about any mental health concerns you have. Your doctor may monitor your mental health more closely during your Cabenuva treatment, or they may recommend a different treatment option for you.
- Allergic reaction. If you’ve had a rash or an allergic reaction to Cabenuva or any of its ingredients, you should not take Cabenuva. Ask your doctor which other medications may be better options for you.
- Pregnancy. It’s not known whether Cabenuva is safe to use during pregnancy. For more information, see the “Cabenuva and pregnancy” section above.
- Breastfeeding. You should not breastfeed if you have HIV. For more information, see the “Cabenuva and breastfeeding” section above.
Note: For more information about the potential negative effects of Cabenuva, see the “Cabenuva side effects” section above.
Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.