Cabotegravir (Apretude) is a medicine your doctor can prescribe to help reduce your risk of getting infected with HIV. It’s the first preexposure prophylaxis (PrEP) medication available as a shot, and it’s longer-lasting than similar medications in pill form. PrEP is what doctors call the type of medicine that protects against HIV infection.
Who Can Take Cabotegravir (Apretude)?
It’s approved for adults and teens ages 12 and older who weigh at least 77 pounds (35 kilograms).
How Does Cabotegravir (Apretude) Work?
This is a type of medicine called an antiretroviral. It blocks a substance that the HIV virus needs to copy itself. This stops HIV from getting into your cells and multiplying.
What to Do Before You Take Cabotegravir (Apretude)
You must test negative for HIV before every shot. That’s because it’s possible to have an HIV infection and not know it. If you take this drug when you already have HIV, it could make the virus harder to treat.
If your test is positive, you’ll need other HIV medicines to treat the infection.
Tell your doctor if you’ve had any flu-like symptoms in the last month, which might be signs of a new HIV infection. Symptoms to watch for include:
- Fever
- Joint or muscle aches
- Rash
- Sore throat
- Tiredness
- Vomiting or diarrhea
Also let your doctor know if you’re pregnant or planning to get pregnant while taking this medicine, or if you’re breastfeeding or plan to. Doctors don’t know whether cabotegravir might cause problems during pregnancy or while you’re nursing.
Tell your doctor about all other medicines and supplements you take, including:
- Herbal remedies
- Over-the-counter medicines
- Prescription drugs
- Vitamins and other dietary supplements
Some medicines can interact with this drug and make it less effective.
What to Expect When You Take Cabotegravir (Apretude)
Before you get the first shot, your doctor might recommend that you take a cabotegravir pill for one month to make sure you don’t have any side effects or other problems.
A doctor or nurse will give you the shot into the muscle of your buttock. You get one shot a month for the first 2 months, then one every 2 months after that.
Common Side Effects of Cabotegravir (Apretude)
Some of the more common side effects you might notice when you take this drug are:
- Diarrhea
- Fever
- Headache
- Nausea or vomiting
- Swelling, pain, or itching of your skin where the needle went in
- Tiredness
- Trouble sleeping
Less Common Side Effects of Cabotegravir (Apretude)
They’re not common, but these side effects sometimes happen to people who take this medicine:
Allergic reactions. Rarely, cabotegravir can cause a serious allergic reaction. Your doctor may start you on cabotegravir pills (Vocabria) to see if you have a reaction. That’s because the pills are easy to stop. The shot stays in your system for a while.
Get medical help quickly if you have a rash along with any of these symptoms:
- Blisters in your mouth
- Muscle or joint aches
- Swollen face
- Unusual tiredness
- Trouble breathing
Liver damage. A small number of people who’ve taken the drug have had liver problems. Your doctor may test how well your liver works while you take it and stop prescribing it if you have any signs of liver damage.
Depression. Some people have had feelings of depression or thoughts of suicide while on this drug. Tell your doctor if you’ve ever had depression before you start taking it. Also let your doctor know about any new sadness or other mood changes while you’re on the medication.
Warnings and Safety Issues With Cabotegravir (Apretude)
Cabotegravir shots can lower your risk of HIV. But no form of PrEP works 100% of the time. To make sure you’re protected against the virus:
- Don’t skip doses. Get your shots on the schedule your doctor prescribes.
- Practice safe sex. Use condoms or another barrier method every time you have sex.
- Know your partners’ HIV status. Make sure they’ve been tested, too.
- Protect yourself against other sexually transmitted infections (STIs). People who have STIs like chlamydia and gonorrhea are more likely to also get HIV.
Who Shouldn’t Take Cabotegravir (Apretude)?
Don’t take this drug if you already have an HIV infection or don’t know your HIV status. Taking it when you’re HIV-positive can actually make the virus harder to treat. You’ll need other medicines to treat the infection.
Never take this medicine if you’re allergic to cabotegravir or to any of its ingredients.
Some other drugs might lower the amount of cabotegravir in your body and make the medication less effective. Your doctor should know about any medicines and supplements you take, but that’s especially important for these medicines:
- Carbamazepine (Epitol, Tegretol)
- Oxcarbazepine (Trileptal)
- Phenobarbital
- Phenytoin (Dilantin, Phenytek)
- Rifabutin (Mycobutin)
- Rifampin (Rifaden, Rimactane)
- Rifapentine (Priftin)
How Well Does Cabotegravir (Apretude) Work?
Two clinical trials compared injected cabotegravir with another PrEP drug you take as a pill, called emtricitabine/tenofovir disoproxil fumarate (Truvada).
One study included more than 4,500 cisgender men (those who identify with the gender they were assigned at birth) and transgender women who have sex with men. About half of the group got cabotegravir and the other half got emtricitabine/tenofovir disoproxil fumarate. People who took cabotegravir had a 69% lower risk of HIV infection than those who took the other medication.
The other study included more than 3,200 cisgender women who were randomly assigned to take either cabotegravir shots or emtricitabine/tenofovir disoproxil fumarate. Women who got the shots had a 90% lower risk of HIV infection than those who took the other drug.