Cabotegravir is an HIV-1 integrase strand transfer inhibitor (INSTI) used for the treatment of HIV-1 infection and pre-exposure prophylaxis (PrEP). As the active ingredient in VOCABRIA (cabotegravir tablets) or APRETUDE (cabotegravir extended-release injectable suspension), it demonstrates good efficacy; however, vigilance regarding its side effects and precautions is required during use.

What Are the Side Effects of Cabotegravir?

Side Effects in HIV-1 Treatment

When cabotegravir is used in combination with EDURANT (rilpivirine), common adverse reactions include:

Systemic reactions: Fatigue, weakness, headache.

Gastrointestinal reactions: Diarrhea, nausea, abdominal distension, abdominal pain.

Neurological reactions: Dizziness, insomnia, abnormal dreams.

Psychiatric symptoms: Anxiety, depression (close monitoring is required).

Side Effects in HIV-1 Pre-Exposure Prophylaxis (PrEP)

Headache (6%), diarrhea (4%), nausea (3%).

Upper respiratory tract infection (2%), drowsiness (2%).

Severe Side Effects of Cabotegravir That Require Vigilance

Hypersensitivity Reactions

Manifestations: Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), angioedema, urticaria, etc.

Management: If symptoms such as rash, fever, or mucosal damage occur, discontinue the drug immediately and seek medical attention.

Hepatotoxicity

Some patients may experience elevated transaminases or hepatitis, especially those with a history of liver disease.

Recommendation: Monitor liver function regularly during medication; discontinue the drug if symptoms such as jaundice or abdominal pain appear.

Mental Health Issues

Depressive symptoms (e.g., low mood, suicidal ideation) are relatively common during HIV-1 treatment.

Note: Enhanced monitoring and timely intervention are necessary for patients with a history of mental illness.

Precautions for Cabotegravir Administration

Absolute Contraindications

Patients with a hypersensitivity to cabotegravir.

Concomitant use with specific antiepileptic drugs or antituberculosis drugs (e.g., rifampicin, carbamazepine).

Administration in Special Populations

Pregnant women: Animal studies have shown that high doses may delay delivery; human data are limited, and the benefits and risks must be weighed.

Lactating women: Breastfeeding should be avoided to prevent the drug from passing through breast milk.

Patients with hepatic or renal impairment: No dose adjustment is required for mild to moderate impairment; caution is needed for severe impairment.

Other Key Matters

HIV-1 testing: Before starting PrEP and every 3 months thereafter, HIV-1 status should be rechecked to avoid accidental use in infected individuals.

Comprehensive prevention: PrEP should be combined with safe sexual practices (e.g., condom use) to reduce the risk of other sexually transmitted infections.