Nurses Compass
Drug Guide
Lenacapavir Sodium
Classification
Therapeutic: Antiretroviral Agent for HIV Infection
Pharmacological: Capsid Assembly Inhibitor
FDA Approved Indications
- Treatment of HIV-1 infection in heavily treatment-experienced adults with multidrug-resistant virus
Mechanism of Action
Lenacapavir inhibits HIV by binding to the viral capsid protein, disrupting multiple stages of the viral life cycle, including capsid uncoating, nuclear import, and genome release, thereby preventing replication.
Dosage and Administration
Adult: Initial loading dose of 475 mg IV once, followed by maintenance doses of 927 mg orally every 6 months.
Pediatric: Not approved for pediatric use.
Geriatric: No specific dosage adjustments; assess for comorbidities.
Renal Impairment: No specific dose adjustment recommended; monitor renal function.
Hepatic Impairment: No specific data; caution advised and monitor liver function.
Pharmacokinetics
Absorption: Orally bioavailable with high plasma protein binding.
Distribution: Widely distributed; crosses into tissues including lymph nodes.
Metabolism: Primarily metabolized by esterases, minimal CYP450 involvement.
Excretion: Primarily via feces; negligible renal excretion.
Half Life: Approximately 2 weeks (14 days).
Contraindications
- Known hypersensitivity to lenacapavir or components.
Precautions
- Use cautiously in patients with hepatic impairment, as data are limited.
- Monitor for signs of immune reconstitution inflammatory syndrome (IRIS).
Adverse Reactions - Common
- Nausea (Unknown)
- Diarrhea (Unknown)
- Fatigue (Unknown)
Adverse Reactions - Serious
- Hypersensitivity reactions, including anaphylaxis (Rare)
- Elevated liver enzymes (Rare)
Drug-Drug Interactions
- No well-established interactions; caution with other potent CYP3A inducers/inhibitors due to potential effect on efficacy.
Drug-Food Interactions
- No significant food interactions reported.
Drug-Herb Interactions
- Limited data; consult current guidelines.
Nursing Implications
Assessment: Monitor for adverse reactions, adherence, and viral load suppression.
Diagnoses:
- Risk for medication nonscompliance,
- Potential for adverse drug reactions.
Implementation: Educate patient on dosing schedule and potential side effects.
Evaluation: Assess viral load and CD4 count periodically to evaluate efficacy.
Patient/Family Teaching
- Importance of adherence to dosing schedule.
- Possible side effects and when to report them.
- Need for regular medical follow-up.
Special Considerations
Black Box Warnings:
- None currently specified.
Genetic Factors: No specific genetic testing required.
Lab Test Interference: No specific interference reported.
Overdose Management
Signs/Symptoms: Potential toxicity is unknown; monitor for signs of adverse effects.
Treatment: Supportive care; no specific antidote. Contact poison control.
Storage and Handling
Storage: Store at room temperature (20°C to 25°C). Keep in original container.
Stability: Stable under recommended conditions.