What is Cabotegravir: Uses, Dosage, Side Effects and More

Cabotegravir is a prescription medication designed to help prevent HIV infection in people who are at high risk of getting the virus. This oral medication belongs to a class of drugs called integrase inhibitors, which work by blocking HIV from multiplying in your body if you're exposed to it.

Think of cabotegravir as a protective shield that you take daily to reduce your chances of contracting HIV. It's part of what doctors call pre-exposure prophylaxis, or PrEP, which means taking medicine before potential exposure to prevent infection.

What is Cabotegravir Used For?

Cabotegravir is specifically approved for HIV prevention in adults and adolescents who weigh at least 35 kilograms (about 77 pounds). Your doctor will prescribe this medication if you're at substantial risk of getting HIV through sexual contact or injection drug use.

The medication is particularly helpful for people who have HIV-negative partners, engage in condomless sex, have multiple sexual partners, or share injection equipment. It's also used as a lead-in treatment before starting long-acting injectable cabotegravir shots.

This isn't a treatment for people who already have HIV. If you're HIV-positive, your doctor will recommend different medications specifically designed to treat the infection rather than prevent it.

How Does Cabotegravir Work?

Cabotegravir works by blocking an enzyme called integrase that HIV needs to reproduce inside your cells. When HIV enters your body, it tries to insert its genetic material into your healthy cells to make copies of itself.

This medication essentially puts up a roadblock at that crucial step. Even if HIV manages to get into your cells, cabotegravir prevents it from integrating its genetic code, which stops the virus from multiplying and establishing infection.

The drug is considered moderately potent and highly effective when taken consistently. Studies show it can reduce your risk of getting HIV by more than 90% when used as directed, making it one of the most effective prevention tools available.

How Should I Take Cabotegravir?

Take cabotegravir exactly as your doctor prescribes it, typically once daily with or without food. You can take it with water, juice, or milk - whatever feels most comfortable for you.

Timing matters more than what you eat with it. Try to take your dose at the same time each day to maintain steady levels in your bloodstream. Many people find it helpful to set a daily alarm or link it to another daily habit like brushing their teeth.

You don't need to worry about specific food restrictions, but taking it with a meal can help reduce any stomach upset if you experience that side effect. If you have trouble swallowing pills, you can discuss alternatives with your healthcare provider.

How Long Should I Take Cabotegravir For?

You'll typically take oral cabotegravir for about one month as a lead-in period before transitioning to long-acting injectable cabotegravir shots. This oral phase helps your doctor make sure you tolerate the medication well before committing to the longer-lasting injection.

Some people may stay on the oral form longer if they're not ready for injections or if their doctor wants to monitor how they respond to the medication. Your healthcare provider will work with you to determine the best timeline based on your individual situation.

The key is maintaining continuous protection, so you'll need to keep taking the oral form until you receive your first injection. There should be no gaps in your medication schedule to ensure ongoing HIV prevention.

What Are the Side Effects of Cabotegravir?

Most people tolerate cabotegravir well, but like any medication, it can cause side effects. The good news is that serious side effects are uncommon, and many mild side effects improve as your body adjusts to the medication.

Here are the most common side effects you might experience:

• Headache
• Nausea or stomach upset
• Diarrhea
• Fatigue or feeling tired
• Dizziness
• Trouble sleeping
• Decreased appetite

These symptoms are usually mild and tend to get better within the first few weeks of treatment. If they persist or become bothersome, talk to your healthcare provider about ways to manage them.

Less common but more serious side effects can include liver problems, severe allergic reactions, or significant mood changes. While these are rare, it's important to know what to watch for so you can get help quickly if needed.

Contact your doctor immediately if you experience yellowing of your skin or eyes, severe stomach pain, unusual bleeding, difficulty breathing, or thoughts of harming yourself. These symptoms require prompt medical attention.

Who Should Not Take Cabotegravir?

Cabotegravir isn't right for everyone, and your doctor will carefully review your medical history before prescribing it. You shouldn't take this medication if you're allergic to cabotegravir or any of its ingredients.

People who already have HIV should not use cabotegravir for prevention, as it's not strong enough as a single medication to treat existing infection. Your HIV status must be confirmed negative before starting this medication.

Here are other situations where cabotegravir may not be appropriate:

• Severe kidney problems
• Significant liver disease
• Taking certain medications that interact with cabotegravir
• Pregnancy (safety data is limited)
• Breastfeeding
• History of severe depression or suicidal thoughts

Your doctor will also consider your ability to take the medication consistently, as irregular use can lead to drug resistance and reduced effectiveness. They'll want to ensure you're committed to daily dosing before prescribing cabotegravir.

Cabotegravir Brand Name

The brand name for oral cabotegravir is Vocabria. This is the name you'll see on your prescription bottle and pharmacy labels when you pick up your medication.

Vocabria is manufactured by ViiV Healthcare and is the same active ingredient found in the injectable form called Apretude. Both contain cabotegravir, but they're formulated differently for oral versus injection use.

When talking to your healthcare provider or pharmacist, you can refer to your medication as either cabotegravir or Vocabria - they'll understand you're talking about the same drug.

Cabotegravir Alternatives

If cabotegravir isn't right for you, there are other effective HIV prevention options available. The most commonly used alternative is a daily pill called Truvada, which contains two medications: emtricitabine and tenofovir.

Descovy is another daily PrEP option that contains emtricitabine and a newer form of tenofovir. This version may be easier on your kidneys and bones compared to Truvada, making it a good choice for some people.

Beyond daily pills, you might consider the injectable form of cabotegravir (Apretude) given every two months, or event-driven PrEP where you take medication only around times of potential HIV exposure. Your doctor can help you choose the best option based on your lifestyle and medical needs.

Is Cabotegravir Better Than Truvada?

Both cabotegravir and Truvada are highly effective at preventing HIV, but they work differently and may suit different people better. Cabotegravir offers the advantage of potentially transitioning to injections every two months, which some people find more convenient than daily pills.

Truvada has been available longer and has more extensive real-world data supporting its effectiveness. It's also generally less expensive and more widely available than cabotegravir.

The "better" choice depends on your individual circumstances, including your medical history, lifestyle preferences, insurance coverage, and how well you tolerate each medication. Some people prefer the newer option of cabotegravir, while others are comfortable with the proven track record of Truvada.