Generic Name

Cabotegravir

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Classification

FDA Approved Indications

• Pre-exposure prophylaxis (PrEP) for HIV-1 prevention in at-risk adults and adolescents

Mechanism of Action

Cabotegravir inhibits the HIV integrase enzyme, preventing viral DNA integration into the host cell genome, thereby blocking viral replication.

Dosage and Administration

Adult: 600 mg intramuscularly once every 2 months after initial oral lead-in and injection

Pediatric: Not approved for pediatric use

Geriatric: No specific dosage adjustment identified; use caution in the elderly

Renal Impairment: No dose adjustment required; no specific studies in severe impairment

Hepatic Impairment: Limited data; use with caution

Pharmacokinetics

Absorption: Formulated for intramuscular injection; bioavailability is high

Distribution: Widely distributed; highly protein-bound

Metabolism: Metabolized primarily via glucuronidation and CYP3A4 pathways

Excretion: Excreted mainly in feces; minimal renal excretion

Half Life: Approximately 5.6 to 8.1 weeks

Contraindications

• Hypersensitivity to cabotegravir or any component of the formulation

Precautions

• Use with caution in individuals with history of hypersensitivity reactions
• Potential for weight gain and lipid alterations
• Assess for HBV and HCV co-infections before initiation

Adverse Reactions - Common

• Injection site reactions (Common)
• Headache (Common)
• Insomnia (Common)
• Nausea (Common)

Adverse Reactions - Serious

• Hypersensitivity reactions (Rare)
• Potential drug interactions leading to viral resistance if doses are missed or discontinued improperly (Rare)

Drug-Drug Interactions

• CYP3A inducers (may reduce cabotegravir levels)
• Other drugs affecting integrase inhibitors

Drug-Food Interactions

• No significant food interactions noted

Drug-Herb Interactions

• Limited data; caution advised with herbal supplements

Nursing Implications

Patient/Family Teaching

• Understand the importance of timely injections every 2 months
• Report any adverse reactions or injection site problems immediately
• Use additional protection measures to prevent HIV transmission
• Attend regular follow-up appointments

Special Considerations

Black Box Warnings:

• Potential for hypersensitivity reactions, including hypersensitivity syndrome called DRESS

Genetic Factors: No specific genetic considerations identified

Lab Test Interference: None reported

Overdose Management

Signs/Symptoms: Nausea, dizziness, headache, hypersensitivity reactions

Treatment: Supportive care; no specific antidote; ceasing medication

Storage and Handling

Storage: Store in a refrigerator at 2°C to 8°C (36°F to 46°F); protect from light

Stability: Stable until the expiration date on the label when stored properly