Cabotegravir/rilpivirine: Difference between revisions

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(Created page with "* 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 ** 600 mg/900 mg IM on week 1 followed by 400 mg/600 mg every 4 weeks ** 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) * Injectio...")
 
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* Studied after viral suppression with oral CAB/RPV, but this is not likely to be necessary
* Studied after viral suppression with oral CAB/RPV, but this is not likely to be necessary
* Dosing
* Dosing
** 600 mg/900 mg IM on week 1 followed by 400 mg/600 mg every 4 weeks
** '''Monthly:''' 600 mg/900 mg IM on week 1 followed by 400 mg/600 mg every 4 weeks
** 600 mg/900 mg IM every 4 weeks for 2 doses followed by every 8 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
** 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)
** If they are going to miss a dose, they should get bridge oral dosing (preference for oral CAB/RPV, but can be anything)

* Injections
* Injections
** May need long needle to reach muscle in obese patients
** May need long needle to reach muscle in obese patients
** Often given as <u>r</u>ilpivirine into <u>r</u>ight buttock and cabotegravir into left
** Often given as [[rilpivirine]] into right buttock (R in R) and [[cabotegravir]] into left
* Virologic failures
* Virologic failures
** Occur despite perfect adherence
** Occur despite perfect adherence
** Increased if rilpivirine RAMs, low 8-week trough levels, HIV-1 subtype A6 and A3, and with elevated BMI
** 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 hepatitis B coinfection
* 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
** Use with caution if risk factors for virologic failure; may warrant closer monitoring



Latest revision as of 18:55, 2 July 2024

  • 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