Cabotegravir/rilpivirine
From IDWiki
- Long-acting injectable medication used to treat HIV
- Studied after viral suppression with oral CAB/RPV, but this is not likely to be necessary
- Dosing
- Monthly: 600 mg/900 mg IM on week 1 followed by 400 mg/600 mg every 4 weeks
- Every 2 monthly: 600 mg/900 mg IM every 4 weeks for 2 doses followed by every 8 weeks
- Can be given ±1 week of target date
- If they are going to miss a dose, they should get bridge oral dosing (preference for oral CAB/RPV, but can be anything)
- Injections
- May need long needle to reach muscle in obese patients
- Often given as rilpivirine into right buttock (R in R) and cabotegravir into left
- Virologic failures
- Occur despite perfect adherence
- Increased if rilpivirine RAMs, low 8-week trough levels, HIV-1 subtype A6 and A3, and with elevated BMI
- Contraindications: anticoagulation (given risk of IM bleeding), buttock implants, drug-drug interactions, and HIV-hepatitis B coinfection
- Use with caution if risk factors for virologic failure; may warrant closer monitoring
