Apretude (cabotegravir) is a prescription drug that’s used as preexposure prophylaxis (PrEP) to help prevent HIV. Apretude comes as a long-acting injection given by a healthcare professional.

Apretude is used for PrEP in adults and some children. PrEP is the use of antiretroviral drugs to help prevent HIV. (“Antiretroviral” is a term used to describe HIV medications.) PrEP is used by people who haven’t already been exposed to HIV but have a high risk of contracting it.

To learn more, see the “What is Apretude used for?” section below.

Apretude basics

The active ingredient in Apretude is cabotegravir, which is a kind of drug called an integrase inhibitor. (An active ingredient is what makes a drug work.) Apretude is not available in a generic form.

Keep reading to learn more about Apretude, including its uses, side effects, and more.

Prescription drug prices can vary depending on many factors. These include what your insurance plan covers and the cost of your visit to a healthcare professional to receive injections of the drug.

Here are a few things to consider regarding cost:

  • Cost information and savings coupons: You can visit Optum Perks to get price estimates of what you’d pay for Apretude when using coupons from the site. See the coupon options below. (Note: Optum Perks coupons cannot be used with any insurance copays or benefits.)
  • Savings program: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. The Apretude Savings Program may also be available.

To learn more, you can refer to this Apretude cost article. You can also check out this article to learn more about saving money on prescriptions.

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Apretude is used to prevent HIV in certain people. Keep reading to learn more.

Use for HIV PrEP

Apretude is used for preexposure prophylaxis (PrEP) in adults and children ages 12 years and older who weigh at least 35 kilograms (about 77 pounds).

PrEP is the use of antiretroviral drugs to help prevent HIV. (“Antiretroviral” is a term used to describe HIV medications.) PrEP is used by people who haven’t already been exposed to HIV but have a high risk of contracting it.

Specifically, Apretude is used to treat people who are at risk for contracting HIV-1 through sexual activity. (HIV-1 is the most common type of HIV.)

Your doctor will give you an HIV test before each Apretude injection. They’ll give you Apretude injections only if your HIV test is negative.

This is because Apretude has a boxed warning for the risk of drug resistance when it’s used for PrEP in people with undiagnosed HIV. A boxed warning is the most serious warning from the FDA. To learn more, see the “What should be considered before taking Apretude?” section below.

About HIV

HIV is a virus that affects your immune system. It damages certain cells and makes it more difficult for your body to fight off infections.

HIV can spread between people in various ways, including sexual activity or sharing needles with a person who has HIV.

Apretude lowers your risk of contracting HIV by helping to prevent the virus from entering your body’s cells and making copies of itself.

Like most drugs, Apretude may cause mild or serious side effects. The following lists describe some of the more common side effects that Apretude may cause. These lists don’t include all possible side effects.

Keep in mind that side effects of a drug can depend on:

  • your age
  • other health conditions you have
  • other medications you take

Your doctor or pharmacist can tell you more about the potential side effects of Apretude. They can also suggest ways to help reduce side effects.

Mild side effects

Here’s a list of some of the mild side effects that Apretude can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read Apretude’s prescribing information.

Mild side effects of Apretude that people have reported include:

Mild side effects of many drugs may go away within a few days to a couple of weeks. But if they become bothersome, talk with your doctor or pharmacist.

* To learn more about this side effect, see the “Allergic reaction” section below.

Serious side effects

Serious side effects from Apretude can occur, but they aren’t common. If you have serious side effects from Apretude, call your doctor right away. But if you think you’re having a medical emergency, you should call 911 or your local emergency number.

Serious side effects of Apretude that have been reported include:

* For more information, see the “What should be considered before taking Apretude?” section below.
† To learn more about this side effect, see the “Allergic reaction” section below.

Help is out there

If you or someone you know is in crisis and considering suicide or self-harm, please seek support:

If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.

If you are not in the same household, stay on the phone with them until help arrives.

Allergic reaction

Some people may have an allergic reaction to Apretude. While allergic reaction wasn’t reported in studies of Apretude, it can still happen.

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, usually in your eyelids, lips, hands, or feet. They can also include swelling of your tongue, mouth, or throat, which can cause trouble breathing.

Call your doctor right away if you have an allergic reaction to Apretude. But if you think you’re having a medical emergency, call 911 or your local emergency number.

Find answers to some commonly asked questions about Apretude.

What should I know about alternatives to Apretude, such as Truvada or Descovy?

Below are a few details about alternatives to Apretude.

Apretude is used for preexposure prophylaxis (PrEP). PrEP is the use of antiretroviral drugs to help prevent HIV. It’s used in people who haven’t already been exposed to HIV but have a high risk of contracting it.

Two other medications are also approved for PrEP:

  • emtricitabine and tenofovir disoproxil fumarate (Truvada)
  • emtricitabine and tenofovir alafenamide (Descovy)

Apretude is given as an injection into your muscle. You’ll likely receive Apretude injections once every 1 or 2 months. But Descovy and Truvada are taken once per day and come as tablets that you swallow.

If you have questions about other ways that Apretude compares with Truvada and Descovy, talk with your doctor or pharmacist.

How does Apretude compare with Cabenuva?

Apretude and Cabenuva are two drugs that contain cabotegravir as an active ingredient. (An active ingredient is what makes a drug work.) But Cabenuva also contains a second active ingredient called rilpivirine.

Both drugs are given as an injection into your muscle. But Apretude and Cabenuva are used for different reasons:

  • Apretude is used for preexposure prophylaxis (PrEP). PrEP is the use of antiretroviral drugs to help prevent HIV. It’s given to people who haven’t already been exposed to HIV but have a high risk of contracting it.
  • Cabenuva is used to treat HIV in people who already have this condition.

To learn more about how Apretude compares with Cabenuva, talk with your doctor or pharmacist.

Is Apretude used to treat HIV?

No, Apretude is not used to treat HIV.

Apretude is only approved for preexposure prophylaxis (PrEP). PrEP is the use of antiretroviral drugs to help prevent HIV in people who don’t already have this condition. (“Antiretroviral” is a term used to describe HIV medications.)

Your doctor will give you an HIV test before each Apretude injection. They’ll give you Apretude injections only if your HIV test is negative. The drug is not used in people who have HIV.

If you’re found to have HIV while using Apretude, your doctor will stop your Apretude treatment. They’ll have you switch to a different drug that treats this condition.

It’s important to note that Apretude has a boxed warning for the risk of drug resistance when it’s used in people with HIV. To learn more, see the “What should be considered before taking Apretude?” section below.

Your doctor will recommend the dosage of Apretude that’s right for you. Below are commonly used dosages, but your doctor will determine the dosage you receive.

Form and strength

Apretude comes as a long-acting liquid suspension (a type of liquid mixture). The drug may stay in your body for 12 months or longer after stopping treatment. It’s given as an injection into your buttock muscle by a healthcare professional, likely at a doctor’s office or clinic. You won’t give yourself injections of the drug.

Apretude is available in one strength: 600 milligrams (mg) per 3 milliliters (mL) of suspension. This may also be written as 200 mg/mL.

Recommended dosages

Before your first Apretude injection, your doctor may prescribe cabotegravir* tablets for you. If this applies to you, you’ll take the tablets once per day for about 1 month. This will help your doctor determine whether the drug might cause side effects that are severe or bothersome.

If you don’t have severe or bothersome side effects with cabotegravir tablets, your doctor will switch you to Apretude injections. You’ll receive your first Apretude injection within 3 days of your last dose of the tablets.

If you don’t take cabotegravir tablets, your doctor can tell you when you’ll receive your first Apretude injection.

When starting treatment with Apretude injections, you’ll receive 600 mg (one injection) once per month for two doses. After that, you’ll receive one 600-mg injection once every 2 months.

To learn more, you can refer to this Apretude dosage article.

* Cabotegravir is the active ingredient in Apretude. (An active ingredient is what makes a drug work.) In tablet form, the drug is available as the brand-name drug Vocabria.

Questions about Apretude’s dosing

Below are some common questions about Apretude’s dosing.

What if I miss a dose of Apretude? It’s important that you do not miss any doses of Apretude. A missed dose can increase the risk of HIV becoming resistant to the drug. This means Apretude won’t work as well to prevent HIV.

If you miss a dose of Apretude, your risk of contracting HIV also increases.

If you miss an appointment to get your Apretude injection, call your doctor right away to reschedule. What you’ll do about a missed dose depends on how long it’s been since you received your last injection. Your doctor will determine how to adjust your dosing schedule.

Will I need to use Apretude long term? It’s possible. If Apretude works well to prevent HIV without causing bothersome side effects, you’ll likely use it long term.

How long does Apretude take to work? Apretude starts working as soon as you receive a dose. You won’t notice the drug working in your body, but your doctor will give you an HIV test before each Apretude injection. This is to make sure the drug is working to prevent HIV.

Your doctor will explain how Apretude will be administered. They’ll also explain how much you’ll be given and how often.

Receiving Apretude

Apretude comes as a long-acting liquid suspension (a type of liquid mixture). It’s given as an injection into the muscle of your buttocks.

You’ll receive Apretude injections from a healthcare professional, likely at a doctor’s office or clinic. You won’t give yourself injections of the drug.

Using Apretude with other prevention methods

Apretude is used for preexposure prophylaxis (PrEP). PrEP is the use of antiretroviral drugs to help prevent HIV. (“Antiretroviral” is a term used to describe HIV medications.)

PrEP is used by people who have not already been exposed to HIV but have a high risk of contracting it. Apretude is used to reduce the risk of contracting HIV through sexual activity.

Using Apretude while practicing other methods of HIV prevention can reduce the risk of HIV even more. Examples of other methods include:

  • limiting the number of sexual partners
  • using latex condoms or dental dams
  • getting HIV tests on a regular basis*

To learn more about using Apretude with other methods of HIV prevention, talk with your doctor.

Note: Your doctor will give you an HIV test before each Apretude injection. They’ll give you Apretude injections only if your HIV test is negative. This is because Apretude has a boxed warning for the risk of drug resistance when it’s used for PrEP in people with undiagnosed HIV. To learn more, see the “What should be considered before Apretude treatment?” section just below.

When considering treatment with Apretude, there are a few things you may want to discuss with your doctor. These include:

  • any medical conditions you have
  • any medications you take
  • your overall health

These factors and others are discussed in more detail below.

Interactions

Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.

Before using Apretude, be sure to tell your doctor about all medications you take, including prescription and over-the-counter types. Also describe any vitamins, herbs, or supplements you use. Your doctor or pharmacist can tell you about any interactions these items may cause with Apretude.

For information about drug-condition interactions, see the “Other Warnings” section below.

Interactions with drugs or supplements

Apretude can interact with several kinds of drugs. These drugs include:

  • certain seizure medications, such as:
    • phenobarbital, phenytoin (Dilantin)
    • carbamazepine (Carbatrol, Epitol, Tegretol)
  • certain antibiotics, such as rifampin (Rifadin, Rimactane), rifapentine (Priftin), and rifabutin (Mycobutin)
  • the opioid drug methadone (Methadose)

This list doesn’t contain all types of drugs that may interact with Apretude. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with Apretude treatment.

Boxed warning: Risk of drug resistance when used for PrEP in people with undiagnosed HIV

Apretude has a boxed warning. This is a serious warning from the Food and Drug Administration (FDA) about drug effects that may be dangerous.

Apretude has a risk of drug resistance when it’s used for preexposure prophylaxis (PrEP) in people with undiagnosed HIV. With HIV drug resistance, HIV medications may not work as well to treat this condition.

For this reason, your doctor will give you an HIV test before each Apretude injection. They’ll give you Apretude injections only if your HIV test is negative.

If you have symptoms of HIV while receiving Apretude injections for PrEP, contact your doctor right away. Possible symptoms include:

If you’re found to have HIV while using Apretude, your doctor will stop your Apretude treatment. They’ll have you switch to a different drug that treats this condition.

Other warnings

Apretude can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Apretude is a good treatment option for you.

Talk with your doctor about your health history before Apretude treatment. Be sure to tell them if any of the following factors apply to you:

Apretude and alcohol

There’s no known interaction between Apretude and alcohol. But drinking alcohol with Apretude may raise your risk of certain side effects. These include nausea, vomiting, dizziness, and headache.

Rarely, Apretude may cause new or worsened liver damage. Drinking large amounts of alcohol can also raise your risk of liver damage. So drinking alcohol during Apretude treatment could raise this risk even more.

If you drink alcohol, talk with your doctor about how much (if any) may be safe to drink during your Apretude treatment.

Pregnancy and breastfeeding

It’s not known whether Apretude is safe to receive while pregnant or breastfeeding. It’s important to note that this drug can stay in your body for 12 months or longer after your last dose. If you have questions about receiving Apretude during pregnancy or while breastfeeding, talk with your doctor.

If you receive Apretude during pregnancy, consider enrolling in the Antiretroviral Pregnancy Registry. (“Antiretroviral” is a term used to describe HIV medications.) This registry collects information about the safety of treatment with certain drugs, such as Apretude, during pregnancy.

To learn more, talk with your doctor. You can also visit the registry’s website or call 800-258-4263.

If you still have questions about Apretude treatment, talk with your doctor or pharmacist. Questions you may want to ask include:

  • How effective is Apretude?
  • Can I drive myself to and from my appointment to receive an Apretude injection?
  • Can I switch to Apretude from another form of HIV preexposure prophylaxis (PrEP)?

To get information on different conditions and tips for improving your health, subscribe to any of Healthline’s newsletters. You may also want to check out the online communities at Bezzy. It’s a place where people with certain conditions can find support and connect with others.

Disclaimer: Healthline 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.