Cabenuva (cabotegravir/rilpivirine) is a prescription drug that’s used to treat HIV in certain adults and children. Cabenuva comes as a liquid suspension that’s injected into a muscle by a healthcare professional.
Cabenuva is prescribed to treat HIV in adults and in children ages 12 years and older, in certain situations.
Cabenuva basics
Cabenuva contains two extended-release active drugs:*
- cabotegravir, which is an integrase inhibitor
- rilpivirine, which is a non-nucleoside reverse transcriptase inhibitor (NNRTI)
Cabenuva comes as a liquid suspension that’s injected into your muscle by a healthcare professional. It’s not available as a generic.
* The active drug is the ingredient that makes a medication work. Extended release means the drug is released into your body gradually.
Cabenuva’s cost per month and cost with insurance may vary from one person to the next. Whether you have health insurance or not, cost may be a factor when you’re considering Cabenuva. What you’ll pay for Cabenuva may depend on several things, such as your treatment plan and the cost of visits to your doctor or healthcare professional.
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 Cabenuva when using coupons from the site. See the coupon options below. (Note: Optum Perks coupons cannot be used with insurance copays or benefits.)
- Savings program: If you have questions about how to pay for your prescription, talk with your doctor or pharmacist. A program called ViiV Connect may be available.
You can also check out this article to learn more about saving money on prescriptions.
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Like most drugs, Cabenuva may cause mild to serious side effects. The lists below describe some of the more common ones, but they 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 Cabenuva. They can also suggest ways to help reduce side effects.
Mild side effects
Here’s a list of some of the mild side effects Cabenuva can cause. To learn about other mild side effects, talk with your doctor or pharmacist, or read the drug’s prescribing information.
Mild side effects of Cabenuva that have been reported include:
- bone or muscle pain
- dizziness
- fever
- feeling tired
- headache
- nausea
- problems sleeping
- rash
- reactions at injection sites, such as:
- weight gain*
- mild allergic reaction*
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.
* For more information about this side effect, see the “Side effect focus” section below.
Serious side effects
Serious side effects from Cabenuva can occur, but they aren’t common. If you have serious side effects from this drug, call your doctor right away. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Serious side effects of Cabenuva that have been reported include:
- liver problems
- depression and other mood changes*
- post-injection side effects*
- severe allergic reaction*
* For more information about this side effect, see the “Side effect focus” section below.
Side effect focus
Learn more about some of the side effects Cabenuva may cause.
Post-injection side effects
It’s possible to have a serious reaction that starts within minutes after you receive an injection of Cabenuva. Also called a post-injection reaction, this side effect was very rare in studies.
Symptoms may include:
- back or chest pain
- changes in blood pressure
- feeling anxious
- feeling lightheaded or as if you’re going to pass out
- a numb feeling in your mouth
- abdominal cramps
- trouble breathing, wheezing, or coughing
- sweating
- hives (raised, itchy welts) or another skin rash
- flushing (temporary warmth, redness, or deepening of skin color)
These symptoms typically go away within minutes, but may be severe in some cases.
What might help
You’ll receive Cabenuva injections from a doctor or another healthcare professional. Each dose requires two injections into a muscle of your buttocks. You’ll be monitored for about 10 minutes after your dose for injection reactions. If you have any negative side effects, your doctor can help make you more comfortable. This may include:
- monitoring you and having you lie down if you feel faint
- recommending a medication to help relieve pain or other symptoms
Your doctor or pharmacist can answer any questions you may have about Cabenuva and injection side effects.
Weight gain
Weight gain is a possible side effect of Cabenuva treatment, but it wasn’t significant in the drug’s studies. On average, people who received this drug gained about 2–3 pounds.
What might help
If you have questions or concerns about your weight, talk with your doctor. They can suggest ways to help you manage a weight that’s healthy for you.
Depression and other mood changes
Depression and other mood changes are rare but possibly serious side effects that treatment with Cabenuva may cause.
The following mood changes were reported in people treated with this drug in studies:
- depression
- feeling generally unhappy or uneasy
- mood swings
- negative thoughts
- suicidal thoughts or behaviors
Symptoms of depression or other mood changes Cabenuva may cause can include:
- feeling anxious or restless
- feeling hopeless or sad
- feeling worthless or having low self-esteem
- thoughts of self-harm
What might help
Call your doctor immediately or seek emergency medical help if you notice symptoms of depression or mood changes during your Cabenuva treatment. A doctor can help treat your symptoms and determine whether you should continue using this medication.
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call or text the 988 Suicide and Crisis Lifeline at 988.
- Text HOME to the Crisis Text Line at 741741.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
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 Cabenuva. Allergic reactions weren’t reported during studies of Cabenuva, but they have been reported after the drug was approved.
Symptoms of a mild allergic reaction can include:
- mild skin rash
- itchiness
- flushing (temporary warmth, redness, or deepening of skin color)
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, which can cause trouble breathing
- serious skin rash
It’s important to call your doctor right away if you develop a rash after a dose of Cabenuva. A rash can be a sign of a severe allergic reaction.
If you have a rash along with any other symptoms (such as a fever, muscle or joint pain, tiredness, blisters, or swelling), tell your doctor right away. These can also be symptoms of a severe allergic reaction. Your doctor will likely have you stop treatment with Cabenuva.
Call your doctor right away if you have an allergic reaction to Cabenuva. But if you think you’re having a medical emergency, call 911 or your local emergency number.
Cabenuva is a brand-name medication prescribed for HIV. It can be prescribed for use in adults and in children who are ages 12 years or older and weigh at least 35 kilograms (about 77 pounds).
HIV is a virus that attacks your immune system. It can be contracted through bodily fluids, including blood, semen, breast milk, and vaginal or rectal fluids.
Without treatment, it’s likely to develop into AIDS. This is a condition that causes your immune system to become unable to defend your body against infection. There currently isn’t a cure for HIV. But with proper medical care, such as treatment with Cabenuva, life expectancy for people with HIV is nearly the same as for those without it.
Cabenuva should only be used if HIV:
- has been effectively treated with a stable dosage of other medications
- is at a low or undetectable level in your blood
- is not resistant to either of the drugs in Cabenuva (cabotegravir and rilpivirine)
Your doctor will likely order a blood test to check your HIV levels before prescribing Cabenuva.
Cabenuva contains two extended-release* medications for treating HIV.
- Cabotegravir is an integrase inhibitor. This kind of medication stops HIV from making copies of itself, which lowers the level of the virus in your blood.
- Rilpivirine is a non-nucleoside reverse transcriptase inhibitor (NNRTI). This drug also stops the virus from copying itself, but in a different way than integrase inhibitors.
For about 1 month before starting Cabenuva treatment, you might take cabotegravir (Vocabria) and rilpivirine (Edurant) tablets by mouth. This is sometimes prescribed to make sure your body can tolerate these two drugs before you start receiving Cabenuva injections. For more information, see “How is Cabenuva administered?” below.
* Extended release means the drug is released into your body gradually over time.
The dosage of Cabenuva you receive will be determined by your doctor. Below is some general information about this drug and its dosage.
Form and strength
Cabenuva is a liquid suspension that’s injected into your gluteal (butt) muscle by a healthcare professional. It comes as separate injections of cabotegravir and rilpivirine.
Cabenuva is available in two strengths:
- 400 milligrams (mg) cabotegravir/600 mg rilpivirine
- 600 mg cabotegravir/900 mg rilpivirine
Recommended dosage
You’ll receive Cabenuva injections either once per month or once every other month. Each dose is made up of two injections. You and your doctor will discuss which dosing schedule is best for you.
For about 1 month before starting Cabenuva, your doctor might prescribe cabotegravir (Vocabria) and rilpivirine (Edurant) tablets by mouth once per day. See “How is Cabenuva administered?” below for details.
Children’s dosage
Cabenuva’s dosage for children is the same as in adults (see above). Your child’s doctor will recommend the dosing schedule that’s best for your child.
Questions about Cabenuva’s dosage
Below are answers to some common questions about Cabenuva’s dosage.
- What if I miss a dose of Cabenuva? If you miss an appointment for a Cabenuva injection, contact your doctor right away. They can help schedule a make-up appointment as soon as possible. You can receive Cabenuva injections within 7 days before or 7 days after your scheduled dose, and it will still be effective.
- Will I need to use Cabenuva long term? If you and your doctor agree that Cabenuva is working well for you, you’ll likely use the drug long term.
- How long does Cabenuva take to work? Cabenuva begins working as soon as you receive a dose. You won’t feel it working, but your doctor will continue to monitor the level of HIV in your blood. This is to make sure it stays low or undetectable throughout your treatment.
- Should I eat before receiving my Cabenuva injection? Cabenuva injections aren’t affected by food. However, if you’re taking cabotegravir and rilpivirine tablets by mouth, it’s important to take these medications with food.
Find answers below to some commonly asked questions about Cabenuva.
Is Cabenuva used for PrEP?
No, Cabenuva is only used for treating active HIV infection in certain people. It isn’t used for preexposure prophylaxis (PrEP). PrEP refers to drugs that help prevent HIV in those who don’t actually have the virus but are at high risk of contracting it.
One of the active drugs in Cabenuva is cabotegravir. This is also the active drug in
Your doctor or pharmacist can tell you more about PrEP, including medications such as Apretude and others approved for this use.
How does Cabenuva work?
How a drug works is referred to as its mechanism of action.
Cabenuva contains two drugs: cabotegravir and rilpivirine, in an extended-release* injection. Each drug has its own mechanism of action:
- Cabotegravir is an integrase inhibitor. This kind of medication blocks an enzyme (a protein that helps with chemical changes in your body) called integrase. Blocking integrase stops HIV from making copies of itself, which lowers the level of the virus in your blood.
- Rilpivirine is a non-nucleoside reverse transcriptase inhibitor (NNRTI). It also stops the HIV virus from copying itself. Rilpivirine blocks an enzyme called reverse transcriptase. Blocking this enzyme keeps HIV from making copies of itself, which helps to lower the level of HIV in your body.
If you’d like to learn more about how Cabenuva works, talk with your doctor or pharmacist.
* Extended release means the drug is released into your body gradually over time.
What should I know about Cabenuva vs. Biktarvy?
Biktarvy and Cabenuva are both prescribed to treat HIV in adults and certain children. But these drugs have some differences:
- Cabenuva can be prescribed for certain children who are ages 12 years or older and weigh at least 35 kilograms (about 77 pounds). Biktarvy can be prescribed for certain children who weigh at least 14 kilograms (about 31 pounds).
- Cabenuva is given as an injection into your muscle, and Biktarvy comes as a tablet that you swallow.
If you’d like to learn more about how Cabenuva and Biktarvy compare, talk with your doctor or pharmacist.
Will I need to store Cabenuva?
No, you won’t need to store Cabenuva.
You’ll receive Cabenuva injections from a healthcare professional, at a location such as a doctor’s office or clinic. They’ll handle and store your Cabenuva prescription, as well as prepare and give you the injections.
Does Cabenuva cure HIV?
No, Cabenuva isn’t a cure for HIV. There currently isn’t a cure for HIV. But with proper medical care, such as treatment with Cabenuva, life expectancy for people with HIV is nearly the same as for those without it.
Talk with your doctor or pharmacist if you’d like to learn more about treatment options for HIV.
Your doctor will explain how Cabenuva will be given to you. They’ll also explain how much you’ll be given and how often.
Receiving Cabenuva
Cabenuva comes as a liquid suspension that’s injected into your gluteal (butt) muscle by a doctor or another healthcare professional. Each Cabenuva dose is made up of two injections. You’ll receive Cabenuva injections at a location such as your doctor’s office or clinic.
Receiving Cabenuva with other drugs
For about 1 month before starting Cabenuva, your doctor might prescribe immediate-release* cabotegravir (Vocabria) and rilpivirine (Edurant) tablets by mouth once per day, with food. Cabotegravir and rilpivirine are the two active drugs† in Cabenuva, but Cabenuva contains them in extended-release form.*
Your doctor might prescribe cabotegravir and rilpivirine tablets to make sure your body can tolerate these drugs before you start receiving Cabenuva injections.
* Immediate release means the drug is released into your body right away after taking a dose. Extended release means it’s released gradually over time.
† An active drug is an ingredient that causes a medication to work.
Questions for your doctorYou may have questions about Cabenuva and your treatment plan. It’s important to discuss all your concerns with your doctor.
Here are a few tips that might help guide your discussion:
- Before your appointment, write down questions such as:
- How will Cabenuva affect my body, mood, or lifestyle?
- Bring someone with you to your appointment if doing so will help you feel more comfortable.
- If you don’t understand something related to your condition or treatment, ask your doctor to explain it to you.
Remember, your doctor and other healthcare professionals are available to help you. They want you to get the best care possible. So don’t be afraid to ask questions or offer feedback on your treatment.
Taking a medication with certain vaccines, foods, and other things can affect how the medication works. These effects are called interactions.
Before starting Cabenuva treatment, be sure to tell your doctor about all the medications you take, including prescription and over-the-counter kinds. Also describe any vitamins, herbs, or supplements you take. Your doctor or pharmacist can tell you about any interactions these items may cause with Cabenuva.
Interactions with drugs or supplements
Cabenuva can interact with several types of drugs.
Some drugs can increase the risk of HIV becoming resistant to Cabenuva. (With drug resistance, the drug stops working to treat the virus.) Due to this risk, doctors usually will not prescribe Cabenuva with certain drugs, such as:
- certain antiepileptic medications, including:
- carbamazepine (Epitol, Tegretol, others)
- oxcarbamazepine (Trileptal, Oxtellar XR)
- phenobarbital
- phenytoin (Dilantin, Phenytek)
- the antibiotic rifampin (Rimactane)
- the corticosteroid dexamethasone (Hemady)
- the herbal supplement St. John’s wort
Other drugs can also interact with Cabenuva, but may still be prescribed with it. Your doctor may monitor you more closely if you need to take these drugs with Cabenuva. These include:
- certain antibiotics called macrolides, including:
- azithromycin (Zithromax)
- clarithromycin
- erythromycin (Eryc, Ery-tab)
- the opioid methadone (Methadose)
This list does not contain all types of drugs that may interact with Cabenuva. Your doctor or pharmacist can tell you more about these interactions and any others that may occur with Cabenuva.
Cabenuva may not be right for you if you have certain medical conditions or other factors that affect your health. Talk with your doctor about your health history before starting Cabenuva. Factors to consider include those listed below.
- Mental health conditions. Cabenuva can cause depression or other changes in your mood. If you have a mental health condition, including depression, treatment with Cabenuva may make your condition worse. Talk with your doctor to help determine whether treatment with Cabenuva is safe for you.
- Liver problems, including hepatitis B or C. Cabenuva can cause liver problems or make existing liver problems worse. This includes hepatitis B or hepatitis C. If you have a liver condition, talk with your doctor about whether or not Cabenuva is safe for you.
- Allergic reaction. If you’ve had an allergic reaction to Cabenuva or any of its ingredients, your doctor will likely not prescribe it for you. Ask them what other medications might be better treatment options.
There’s no known interaction between Cabenuva and alcohol. But both Cabenuva and excessive alcohol use can cause liver problems or damage. So, drinking too much or too often during your Cabenuva treatment could increase your risk of this side effect.
If you drink alcohol, talk with your doctor about how much is safe to drink during your Cabenuva treatment.
It’s not known whether treatment with Cabenuva is safe during pregnancy. If you’re pregnant or planning to become pregnant, talk with your doctor about safe HIV treatment options.
It’s also not known whether it’s safe to breastfeed during Cabenuva treatment. But the Centers for Disease Control and Prevention (CDC)
Talk with your doctor or pharmacist if you’re considering treatment with Cabenuva. Ask questions that help you feel comfortable about the risks and benefits. Some examples to help you get started are:
- Does Cabenuva cause sexual side effects?
- What should I know about Cabenuva compared with other HIV treatment options?
- Will I have withdrawal symptoms if I stop Cabenuva treatment?
To learn more about Cabenuva’s cost, see this article.
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.
Q:
Will I need to take other HIV medications with Cabenuva?
AnonymousA:
No, you won’t take other HIV medications during your Cabenuva treatment.
Cabenuva is prescribed to replace HIV medications you’re currently taking. Before prescribing Cabenuva, your doctor will test your blood to make sure your HIV level is low or undetectable. This means the level of HIV in the blood is below the level that can be measured by a lab test. Cabenuva is a complete treatment that’s used to keep HIV undetectable.
Other medications for treating HIV come as tablets or capsules you take every day. Cabenuva, on the other hand, is given by injection once monthly or every 2 months. Some people find a once monthly or every other month injection more convenient than taking a pill every day.
The Healthline Pharmacist TeamAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.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.