Cabenuva side effects and how to avoid them

Cabenuva is the brand name for an FDA-approved HIV treatment manufactured by ViiV Healthcare. It is a combination of rilpivirine, a non-nucleoside reverse transcriptase inhibitor (NNRTI), and cabotegravir, a human immunodeficiency virus type-1 integrase strand transfer inhibitor (INSTI). It is used to treat patients 18 years of age and older with HIV-1 infection as a replacement for the current antiretroviral treatment in patients who are suppressed on an antiretroviral with no past history of failure of treatment and without resistance to rilpivirine or cabotegravir. While Cabenuva is generally well tolerated, there are some potential side effects that people should be aware of. The most common side effects of Cabenuva include injection site reactions and fatigue. Less common, but more serious side effects, can include depression and mood changes.

Learn more about the side effects of Cabenuva and what you can do to avoid them.

Cabenuva dosage

Cabenuva is available as an intramuscular injection kit that containing rilpivirine extended-release (long-acting) injectable suspension and cabotegravir extended-release injectable suspension in separate single-dose vials. It is available in the following doses:

  • Cabenuva 400 mg/600 mg containing 400 mg/2 mL cabotegravir, and 600 mg/2 mL rilpivirine
  • Cabenuva 600 mg/900 mg containing 600 mg/3 mL cabotegravir, and 900 mg/3 mL rilpivirine

How effective is Cabenuva?

Results show that after almost 1 year of treatment, around 92% of people using Cabenuva maintained an undetectable viral load compared to around 95% of people who carried on using their oral treatment. Cabenuva is considered a safe and well-tolerated treatment option.

What are the possible side effects of Cabenuva?

The most common possible side effects of Cabenuva include:

  • Injection site reactions
  • Fever
  • Tiredness, headache
  • Muscle or bone pain
  • Nausea
  • Problems sleeping
  • Feeling dizzy, lightheadedness
  • Rash

In rare instances, Cabenuva can cause more serious side effects.  These can include:

  • Allergic reactions – symptoms include fever, tiredness, muscle or joint pain, sores in the mouth, and swelling of the face, lips, mouth, or tongue
  • Post-injection reactions include trouble breathing, stomach cramping, sweating, numbing of the mouth, anxiety, feeling warm, feeling light-headed, or faint, and changes in blood pressure
  • Liver problems – those with hepatitis B may have changes in liver test results. Liver problems are also been seen in patients without any previous history of problems with their livers or any other risk factors. Contact your doctor immediately if you notice yellowing of the skin or your eyes, darker urine, lighter-colored stools, nausea, loss of appetite, vomiting, or pain and discomfort in the stomach area on the upper right side region
  • Mood changes, depression, anxiety, suicidal thoughts, or thoughts of self-harm

Your doctor will assess the benefits of using Cabenuva against your risk of side effects. Patients are encouraged to report negative side effects or adverse reactions to Cabenuva to the FDA. Visit, or call 1-800-FDA-1088.

How long do Cabenuva side effects last?

Cabenuva is a long-acting HIV medication that can work for up to 2 months, depending on your treatment plan. It has a half-life of 5 to 11 weeks (half-life is the time it takes for half of the drug to leave your system) but cabotegravir may remain in your body for up to 12 months after your last injection.

Injection-site reactions tend to be mild to moderate and resolve within 3 days, however other more serious side effects may take longer. Speak to your caregiver for medical advice if you are concerned about any of your side effects.

Cabenuva drug interactions

Cabenuva can interact with other medications including:

  • Dexamethasone (in more than 1 dose)
  • Methadone
  • St. John’s wort
  • Antibiotics – azithromycin, clarithromycin, erythromycin, rifabutin, rifampin, rifapentine
  • Seizure medicine – carbamazepine, oxcarbazepine, phenobarbital, phenytoin.

Before taking Cabenuva, be sure to tell your doctor about all of the medications you are taking to ensure they are safe to take at the same time.

Cabenuva warnings & precautions

You should not use Cabenuva if you:

  • Are allergic to the active ingredients in the Cabenuva injection kit
  • Have previously had an allergic reaction to cabotegravir and/or rilpivirine
  • Are coadministered with drugs where significant decreases in cabotegravir
    and/or rilpivirine plasma concentrations may occur, which may result in
    loss of virologic response

Talk to your doctor before using Cabenuva if you:

  • Are taking any of the medications that could interact with Cabenuva
  • Have had an allergic reaction or a skin rash to drugs containing cabotegravir or rilpivirine in the past
  • Have liver problems, or hepatitis B infection now or in the past
  • Have mental health problems
  • Are pregnant or are planning to become pregnant
  • Are breastfeeding or are planning to breastfeed. It is unknown if Cabenuva passes into breast milk

You should always check with your doctor or pharmacist before taking any medication, including Cabenuva, to make sure it is safe for you.

Does Cabenuva cause weight gain?

Weight gain is a side effect of Cabenuva. On average, those who receive this drug gain around 2 to 3 pounds. Weight gain is not significant but if you are concerned talk to your doctor for medical advice.

How much does Cabenuva cost per month?

As a guide, Cabenuva intramuscular suspension, extended-release (200 mg-300 mg/mL) will typically cost around $4,150 for a supply of 4 milliliters.

Who should get Cabenuva?

Cabenuva is indicated for the treatment of HIV in individuals 12 years of age or older weighing a minimum of 77 pounds.

What is the best time to take Cabenuva?

Before using Cabenuva, you will have to take one Vocabria tablet and one Edurant tablet once a day for 28 days to assess your tolerability to these medicines.

The recommended dosing schedule is to initiate injections of Cabenuva (600 mg of cabotegravir and 900 mg of rilpivirine) on the last day of the oral lead-in and continue with injections of Cabenuva (400 mg of cabotegravir and 600 mg of rilpivirine) as monthly injections thereafter. A healthcare provider will inject Cabenuva as 2 injections (cabotegravir and rilpivirine), one into each side of your buttocks.

You are advised to read the complete medication guide provided with this medicine for the full drug information and patient information, and always speak with a healthcare professional for medical advice about any changes to your dose so they can monitor and evaluate your condition.

What can happen with Cabenuva?

Cabenuva can cause common side effects such as injection site reactions (pain, tenderness, hardened mass or lump, swelling, redness, itching, bruising, and warmth), fever, fatigue, headaches, sleep problems, dizziness, and rashes. It can also cause more serious side effects such as allergic reactions and liver problems. Talk to your doctor if you have concerns about taking Cabenuva.

How to avoid Cabenuva side effects

The best way to avoid side effects is to take Cabenuva as directed by your doctor. Follow your doctor’s instructions carefully and do not take more or less than prescribed.

If you experience any side effects, talk to your doctor or pharmacist. They may be able to recommend ways to help reduce or prevent some of the side effects.

1. Stick to the recommended dosage

Take your prescribed dose of Cabenuva that has been recommended by your doctor. Do not take more or less than prescribed.

2. Monitor your blood sugar levels

If you have diabetes, it is important to monitor your blood sugar levels closely while taking Cabenuva. Check your blood sugar levels as directed by your doctor and report any changes to your doctor immediately.

3. Drink plenty of fluids

Drink eight to 10 glasses of water or fluids every day to help prevent dehydration, which can make side effects worse.

4. Avoid alcohol

There are no known interactions between alcohol and Cabenuva, however you should limit your alcohol consumption as excessive intake of alcohol could make the side effects of Cabenuva worse.

5. Don’t skip meals

Eating regular meals and snacks will help to prevent low blood sugar levels (hypoglycemia).

6. Check your feet

If you have diabetes, check your feet for any cuts, sores, or redness regularly. Tell your doctor if you experience any problems with your feet while taking Cabenuva.

7. Know the signs and symptoms of Cabenuva side effects

Signs and symptoms of side effects include liver problems and allergic reactions. If you experience any of these side effects speak to your doctor for medical advice.

8. Tell your doctor about all medications you’re taking

Be sure to tell your doctor about all other medications you’re taking, including over-the-counter drugs, vitamins, and herbal supplements, as they can interact with Cabenuva.

9. Get regular medical check ups

It is important to get regular medical check ups and monitor your medical conditions. Your doctor will monitor your side effects and may adjust your dose of Cabenuva as needed.

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  1. FDA - highlights of prescribing information for Cabenuva

  2. - Cabenuva

The content on this website is intended for information purposes only. It does not constitute medical advice. The information on this website should not be relied upon and is not a substitute for professional medical advice. You should always speak to your doctor regarding the risks and benefits of any treatment.