Home Drug Guide Cabotegravir

Drug Guide

Generic Name

Cabotegravir

Brand Names Apretude

Classification

Therapeutic: Antiretroviral Agent

Pharmacological: Integrase Strand Transfer Inhibitor

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

Assessment: Monitor injection site for reactions; assess HIV status and possible co-infections

Diagnoses:

  • Risk for HIV transmission
  • Risk for adverse drug reactions

Implementation: Administer injection as scheduled; provide pre-injection assessment and post-injection site care

Evaluation: Assess adherence, injection site reactions, and patient understanding

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

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.