Cabenuva is administered as an intramuscular injection, usually by a healthcare provider, in a clinical or medical setting. It is not taken orally. The usual dosing schedule for Cabenuva is:

Induction phase: A patient will receive monthly injections of both cabotegravir and rilpivirine for the first two months. During this phase, the doses are usually higher to rapidly suppress viral replication.

Maintenance phase: After the induction phase, patients are transitioned to monthly or every-two-months injections depending on their individual needs and response to treatment.

The exact timing of doses may vary based on the patient’s response to the medication and the recommendation of their healthcare provider.

Cabenuva works by acting on the mechanisms of its two ingredients, cabotegravir and rilpivirine, targeting multiple stages of the HIV lifecycle:

Cabotegravir: It acts by interrupting the HIV integrase enzyme responsible for the entry of viral genetic material in the DNA of the host cell. Without this stage, the virus cannot undergo replication, thus reducing its load.

Rilpivirine: It is an inhibitor of the reverse transcriptase enzyme of the HIV virus, which transcribes the viral RNA into DNA. Rilpivirine, through its action, blocks this enzyme, preventing the multiplication and further transmission of the virus.

This dual activity will ensure that HIV replication is suppressed from two sides, making it a stronger and more long-lasting therapy than many monotherapies.

Like any medicine, Cabenuva can cause side effects, but not everyone will experience them. Common side effects that have been reported with cabotegravir injection are:

Injection site reactions: Pain, redness, swelling, or hard lumps at the injection site are common. These usually resolve on their own, but may require management with a cold compress or over-the-counter pain relievers.

Fever or chills: Some patients may experience flu-like conditions after their injection, and this is usually after their first few doses.

Headache and dizziness: Some patients complain of developing headaches or dizziness soon after the beginning of their treatment.

Fatigue or tiredness: Fatigue is another commonly reported condition, which may occur due to the initial phases of treatment.

Mood changes or depression: Less frequently, some patients may present with mood swings, irritability, or depression when on Cabenuva treatment, most likely due to the presence of rilpivirine.

HIV resistance testing: It must be ensured that patients with HIV are tested for the resistance of the virus because if a patient has been infected with a drug-resistant strain of HIV, his treatment will not work adequately.

Pre-existing medical condition: Cabenuva must be used with extreme precaution in patients with known cases of liver disease or significant liver damage because it worsens the liver problem.

Pregnancy and breastfeeding: Safety in pregnancy and lactation has not been established for Cabenuva. Therefore, use only if the potential benefits justify the risks for patients during pregnancy. In addition, advise HIV-infected mothers not to breastfeed their infants to prevent postnatal transmission of the virus.

Drug interactions: Cabenuva may interact with other drugs, such as some antiepileptic drugs, antifungals, and drugs for tuberculosis or hepatitis. Patients should notify their healthcare providers of all the drugs they are on.

1. CYP3A4 Inhibitors: Medications like ketoconazole or ritonavir, which inhibit the CYP3A4 enzyme, can increase Cabenuva’s drug concentrations, potentially raising the risk of side effects such as nausea or dizziness.
2. CYP3A4 Inducers: Drugs like rifampin or phenytoin may reduce the effectiveness of Cabenuva by decreasing its plasma levels, potentially leading to suboptimal viral suppression.
3. Other Antiretrovirals: Co-administration with other antiretrovirals, particularly non-nucleoside reverse transcriptase inhibitors (NNRTIs), may alter the pharmacokinetics of Cabenuva, requiring careful monitoring and dose adjustments.
4. Hormonal Contraceptives: Although Cabenuva does not directly affect hormonal contraceptives, some antiretrovirals may impact contraceptive effectiveness, so additional contraceptive measures may be needed.

These interactions emphasize the need for careful monitoring and adjustments when combining Cabenuva with other medications.

Induction phase: Cabenuva is administered as two injections, namely cabotegravir and rilpivirine, once a month for two consecutive months.

Maintenance phase: After the induction phase, patients are transitioned to monthly or every two months injections, based on individual response and recommendations from the healthcare provider. The frequency of injections can be adjusted according to clinical considerations and patient needs.

Cabenuva is a prescription drug that needs to be prescribed by an experienced healthcare provider in HIV treatment. Prescription will be according to the patient’s health profile, HIV resistance patterns, and treatment history.

Patients will be screened for resistance to HIV, liver function tests, and other assessments before cabenuva is initiated; they should be appropriate for the therapy. It requires administration in a healthcare facility, where the patient should be monitored for immediate effects or reactions.

1. What is Cabenuva?
   Cabenuva is a long-acting injectable medication used for the treatment of HIV-1 infection in adults.

2. What are the active ingredients in Cabenuva?
   Cabenuva contains two active ingredients: cabotegravir and rilpivirine.

3. How does Cabenuva work?
   Cabenuva works by blocking HIV integrase and non-nucleoside reverse transcriptase, preventing the virus from replicating in the body.

4. Who is a candidate for Cabenuva treatment?
   Candidates for Cabenuva include adults with HIV-1 who are virally suppressed on a stable antiretroviral regimen and have no history of virologic failure.

5. How often is Cabenuva administered?
   Cabenuva is administered as an intramuscular injection once a month or once every two months, depending on the prescribed regimen.

6. What are the common side effects of Cabenuva?
   Common side effects include injection site reactions, headache, fatigue, fever, and nausea.

7. How is Cabenuva administered?
   Cabenuva is administered by a healthcare professional through an intramuscular injection, typically in the gluteal muscle.

8. Can Cabenuva be used in combination with other medications?
   Yes, Cabenuva can be used in combination with other antiretroviral medications as part of an HIV treatment regimen if necessary.

9. What should I do if I miss a dose of Cabenuva?
   If a dose is missed, it should be administered as soon as possible, but consult your healthcare provider for guidance on when to schedule the next dose.

10. Is Cabenuva safe for pregnant or breastfeeding women?
    The safety of Cabenuva during pregnancy or breastfeeding should be discussed with a healthcare provider, as it may have implications for the baby.

11. Can Cabenuva cause allergic reactions?
    Yes, some individuals may experience allergic reactions, including rash, itching, or swelling. Seek medical help if you experience severe allergic symptoms.

12. How is the effectiveness of Cabenuva monitored?
    Effectiveness is monitored through regular viral load tests to ensure the HIV viral load remains undetectable.

13. What are the potential drug interactions with Cabenuva?
    Cabenuva can interact with certain medications, including anticonvulsants and some antibiotics; always inform your doctor of all medications you are taking.

14. Are there any long-term effects of using Cabenuva?
    Long-term studies are ongoing, but patients should regularly consult their healthcare provider to monitor for any potential long-term effects.

15. Is there a risk of developing resistance to Cabenuva?
    Yes, if Cabenuva is not taken as prescribed, there is a risk of developing resistance to the medications in the regimen.

16. What lifestyle changes can support effective treatment with Cabenuva?
    Maintaining a healthy lifestyle through proper nutrition, regular exercise, and adherence to medication schedules can support treatment effectiveness.

17. Can Cabenuva be used in individuals with other health conditions?
    Individuals with other health conditions should discuss their medical history with their doctor, as this may affect treatment decisions.

18. What storage conditions are recommended for Cabenuva?
    Cabenuva should be stored in the refrigerator and protected from light; do not freeze it.

19. Is Cabenuva covered by health insurance?
    Coverage can vary by insurance plan; patients should check with their insurance provider for specific details regarding coverage and costs.

20. What should I do if I have other questions or concerns about Cabenuva?
    Consult your healthcare provider or pharmacist for personalized advice and information regarding Cabenuva and its use in your treatment plan.