Cabenuva (cabotegravir/rilpivirine)

Medically Reviewed By Dena Westphalen, Pharm.D.

Cabenuva: Overview

Cabenuva is a brand-name prescription medication. It’s approved by the Food and Drug Administration (FDA) to treat HIV. Doctors can prescribe Cabenuva to adults and to children ages 12 years and older who weigh at least 35 kilograms (kg).*

For this use, Cabenuva is prescribed to replace your current HIV treatment regimen. However, for a doctor to prescribe Cabenuva, you must meet the following criteria:

  • Your HIV levels are undetectable.†
  • You don’t have a history of treatment failure‡ with HIV medications.
  • Your HIV must not be resistant to either cabotegravir or rilpivirine, the two active drugs in Cabenuva.       

For details about HIV and how the drug treats it, see the “Cabenuva: Uses” section below.

* One kg is equal to about 2.2 pounds (lb).
† “Undetectable” means the virus can’t be detected with a blood test.
‡ With treatment failure, your HIV levels are detectable despite treatment with HIV medications.

Key points

The following table provides key facts about Cabenuva.

Active drugs cabotegravir/rilpivirine
Drug class • cabotegravir: integrase strand transfer inhibitor (INSTI)
• rilpivirine: non-nucleoside reverse transcriptase inhibitor (NNRTI)
Form extended-release liquid suspension that’s given by intramuscular injection
FDA approval January 2021

Finding a healthcare professional

If you’re interested in receiving this drug, search here to find a doctor who might prescribe it.

Cabenuva: Cost

Like other medications, prices for Cabenuva may vary. The drug’s price will depend on factors such as your insurance coverage.

Cost considerations for Cabenuva

Here’s a list of things to consider when looking into the cost of Cabenuva.

  • Need for prior authorization. Before insurance coverage for Cabenuva is approved, your insurance company may require prior authorization. In this case, your doctor and insurance company will communicate about your prescription for Cabenuva. Then the insurance company will decide if the drug will be covered. To find out if you need prior authorization for Cabenuva, contact your insurance company.
  • Possible cost assistance options. Financial assistance to help lower the cost of Cabenuva is available. The ViiVConnect program for Cabenuva may help reduce its cost. To learn more and see if you’re eligible for support, call 844-588-3288 or visit the manufacturer’s website. Also, check out this article to learn about ways to save on prescription drugs.
  • Availability of a generic form. Cabenuva is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Typically, generics cost less than brand-name drugs.

Cabenuva: Side effects

As with most drugs, it’s possible to have side effects with Cabenuva. These can include some mild side effects but also some serious ones.

To learn more about Cabenuva’s side effects, talk with your doctor or pharmacist. They may also provide information about managing certain side effects of this drug.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you would like to notify the FDA about a side effect you’ve had with Cabenuva, you can do so through MedWatch.

Mild and serious side effects

Mild and serious side effects of Cabenuva are listed in the table below. This table does not include all of Cabenuva’s possible side effects.

Mild side effects* Serious side effects
bone or muscle pain • liver problems, including hepatitis A or B
dizziness • mood changes, including depression, which may lead to thoughts of suicide
• tiredness • post-injection reactions, such as shortness of breath or other trouble breathing and blood pressure changes
fever allergic reaction
headache  
• injection site reactions, such as pain, swelling, or discomfort  
nausea  
• skin rash  
trouble sleeping  
• weight gain  

* This is not a complete list of Cabenuva’s mild side effects. To learn about other mild side effects of this drug, ask your doctor or pharmacist. Or you can view the drug’s prescribing information.
† To learn more about allergic reaction, see below.

Most times, mild side effects of a drug go away within a few days or a couple of weeks. Talk with your doctor or pharmacist if any side effects become severe or don’t go away.

Serious side effects from Cabenuva aren’t common, but they are possible. If you have serious side effects, call your doctor right away. However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Suicide prevention

If you know someone at immediate risk of self-harm, suicide, or hurting another person:

  • Ask the tough question: “Are you considering suicide?”
  • Listen to the person without judgment.
  • Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
  • Stay with the person until professional help arrives.
  • Try to remove any weapons, medications, or other potentially harmful objects.

If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide

Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 800-273-8255.

Click here for more links and local resources.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Cabenuva. A more severe allergic reaction is rare but possible.

Allergic reactions were not reported in Cabenuva’s clinical studies. However, they have been reported since the drug was approved.

Possible symptoms of mild and serious allergic reactions are listed in the table below.

Mild allergic reaction symptoms Serious allergic reaction symptoms
flushing • swelling under your skin, possibly in your hands, feet, lips, or eyelids
rash • swelling in your throat or mouth
• itching trouble breathing

If you have an allergic reaction to Cabenuva, call your doctor right away. This is important to do because the reaction could become severe.

However, if you’re having a medical emergency or your symptoms feel life threatening, call 911 or a local emergency number.

Cabenuva: Uses

Prescription drugs, such as Cabenuva, are approved by the Food and Drug Administration (FDA) to treat certain conditions.

Using Cabenuva for HIV

Cabenuva is prescribed to treat HIV in adults and in children ages 12 years and older who weigh at least 35 kilograms (kg).*

For this use, Cabenuva is prescribed to replace your current HIV treatment regimen. However, to use Cabenuva, you must meet the following criteria:

  • Your HIV levels are undetectable.†
  • You don’t have a history of treatment failure‡ with HIV medications.
  • Your HIV must not be resistant to either cabotegravir or rilpivirine, the two active drugs in Cabenuva.

* One kg is equal to about 2.2 pounds (lb).
† “Undetectable” means the virus can’t be detected with a blood test.
‡ With treatment failure, your HIV levels are detectable despite treatment with HIV medications.

About HIV

HIV is a virus that attacks your immune system. Left untreated, HIV worsens over time and eventually causes AIDS. This condition prevents your body from fighting off infections. At this time, there is no cure for AIDS.

HIV is most often transmitted through sexual contact. However, it can be passed from person to person through contact with blood or certain other body fluids. HIV does not spread through saliva, sweat, or the sharing of food or drinks.

Symptoms of HIV vary depending on its stage. Some general symptoms include:

Doctors diagnose HIV using a blood test that checks for the virus in your blood. Modern HIV medications work to keep the HIV level undetectable. (“Undetectable” means the virus can’t be detected in your blood using a blood test.)

Cabenuva contains two medications that work to keep your HIV levels undetectable: cabotegravir and rilpivirine. To learn more, see the “Cabenuva: How it works” section below.

Using Cabenuva in children

Cabenuva is prescribed to treat HIV in children ages 12 years and older who weigh at least 35 kilograms (kg). One kilogram is equal to about 2.2 pounds (lb). To learn more, see “Using Cabenuva for HIV” above.

Finding a healthcare professional for Cabenuva

For help finding a healthcare professional for Cabenuva, view our:

Cabenuva: Generic

Cabenuva contains the active drugs cabotegravir and rilpivirine. This combination is only available as a brand-name medication. And it isn’t currently available as a generic drug.

A generic is an identical copy of the active drug found in a brand-name medication. Generics typically cost less than brand-name drugs.

Cabenuva: How it is administered

Your doctor will recommend how you’ll receive Cabenuva. It’s important that you receive doses of the drug exactly as your doctor advises.

Cabenuva comes as extended-release* liquid suspension (type of solution). It’s given as an intramuscular injection. Your doctor or another healthcare professional will give your Cabenuva injections at an office or clinic.

* Extended release means the drug is released into your body gradually.

Cabenuva injection site

Cabenuva should be injected into your buttocks by a healthcare professional.

You’ll receive two injections with each Cabenuva dose:

  • one injection that contains cabotegravir
  • one injection that contains rilpivirine

Your doctor may give both injections into the same side of your buttocks, or they may give one injection into each side.

Questions about receiving Cabenuva

Here’s a list of common questions related to taking Cabenuva.

  • When should I take Cabenuva? You’ll receive Cabenuva injections once each month. Or you may receive them every other month. You and your doctor will decide on the dosing schedule that is best for you.
  • What happens if I miss an appointment to get my Cabenuva injection? If you miss your Cabenuva injection appointment, call your doctor right away. Cabenuva injections have a flexible window of 7 days. This means you can get your injection within 7 days of your scheduled appointment. Your doctor can help you schedule a new appointment within this window. However, missing this 7-day window could result in your doctor having to switch you to a different medication.
  • Do I need to take Cabenuva with food? Cabenuva injections aren’t affected by food. Eating won’t impact how well your body absorbs Cabenuva injections. So you can receive Cabenuva injections with or without food.

Cabenuva: Questions you may have

Here are some common questions about Cabenuva and brief answers to them. If you’d like to know more about these topics, ask your doctor.

Is Cabenuva used for PrEP?

No, Cabenuva is only used to treat HIV. It’s not used for PrEP, which stands for pre-exposure prophylaxis.

With PrEP, certain HIV medications are taken by people at high risk of contracting HIV. PrEP is used for people who don’t have HIV but want to avoid contracting it.

One of the active drugs in Cabenuva, cabotegravir, is also the active drug in Apretude. Apretude is an injection given every other month for PrEP.

To learn more about PrEP, including which medications are approved for this use, such as Apretude, talk with your doctor or pharmacist. However, keep in mind that PrEP is only used for people who aren’t living with HIV. If you already have HIV, your doctor or pharmacist can tell you more about drugs approved for treating HIV, including Cabenuva.

Will I have to store Cabenuva?

No, you shouldn’t have to store Cabenuva.

Cabenuva injections are only given by a healthcare professional, such as your doctor. They’ll obtain and store Cabenuva at their office or clinic. You won’t have to pick up the medication from a pharmacy or store your prescription at home.

Does Cabenuva cure HIV?

No, Cabenuva doesn’t cure HIV. There currently isn’t a known cure for HIV. The virus inserts itself into the DNA of your cells, making it difficult to find a cure.

However, with proper treatment, such as with medications including Cabenuva, someone with HIV can lead a long life.

Talk with your doctor or pharmacist if you’d like to learn more about treatment options for HIV.

Cabenuva: Alternatives

Doctors may prescribe drugs other than Cabenuva for your condition. Certain drugs may work better for you than others.

Cabenuva is used to treat HIV. Here’s a summary of other drugs that doctors sometimes prescribe for this condition.

Your doctor can tell you about other similar drugs, such as bictegravir/emtricitabine/tenofovir alafenamide (Biktarvy).

To learn more about alternatives to Cabenuva, ask your doctor. They can tell you about other medications that could be prescribed for your condition.

Cabenuva: Dosage

Below, you’ll find dosages that are commonly recommended for Cabenuva. However, you should receive the dosage your doctor prescribes for you. They’ll recommend the dosage that’s best for your needs.

Cabenuva’s forms and strengths

Cabenuva is available as follows.

  • Form: extended-release* liquid suspension (type of solution) that’s given by intramuscular injection
  • Strengths:
    • 400 milligrams (mg) cabotegravir/600 mg rilpivirine per 2 milliliters (mL)
    • 600 mg cabotegravir/900 mg rilpivirine per 3 mL

* Extended release means the drug is released into your body gradually.

Cabenuva’s recommended dosages

Recommended dosages for Cabenuva in adults and children are described below.

Cabenuva injections may be given once each month or once every other month. You and your doctor will decide which dosing frequency works best for you.

Before you start Cabenuva injections, your doctor might prescribe cabotegravir (Vocabria) and rilpivirine (Edurant) tablets. These are oral forms of the active drugs in Cabenuva. These drugs may be prescribed to help make sure that you tolerate them before you start Cabenuva treatment. If your doctor prescribes this, you’ll typically take these tablets daily for 28 days. You’ll get your first injected dose of Cabenuva on the day you take the last dose of the tablets.

Adult dosage

The following are recommended dosages for Cabenuva in adults based on the dosing schedules a doctor might prescribe.

  Starting dosage Maintenance dosage
Once a month one-time injection of 600 mg cabotegravir/900 mg rilpivirine one injection of 400 mg cabotegravir/600 mg rilpivirine, given once a month*
Once every other month one-time injection of 600 mg cabotegravir/900 mg rilpivirine, repeated 1 month later One injection of 600 mg cabotegravir/900 mg rilpivirine, given every other month†

* For this dosing schedule, the maintenance dosage starts 1 month after the starting dosage.
† For this dosing schedule, the maintenance dosage starts 2 months after both the starting doses have been given.

Children’s dosage

Cabenuva is approved to treat HIV in children ages 12 years and older who weigh at least 35 kilograms (kg), or about 77 pounds. The following are recommended dosages for Cabenuva in children based on the dosing schedules a doctor might prescribe. The recommended dosages for children are the same as those for adults, described just above.

Dosage considerations

Below are some things to consider about Cabenuva’s dosage.

  • Missing an injection. If you miss an appointment to get your Cabenuva injection, call your doctor right away to reschedule the appointment. As Cabenuva is injected either once each month or every other month, it’s OK to get your injection within 7 days of your original appointment date. Calling your doctor as soon as possible helps ensure you’re rescheduled to get your injection within this 7-day window. View these medication reminder options to help avoid missing doses. You could also set an alarm, use a timer, or download a reminder app on your phone.
  • Length of treatment. Doctors typically prescribe Cabenuva as a long-term treatment. You’ll likely use it long term if you and your doctor feel it’s safe and effective for your condition.

Cabenuva: Consuming alcohol during treatment

Consuming alcohol during treatment with Cabenuva may be safe. However, this is only the case if your doctor specifically says it’s OK.

There’s no known interaction between treatment with Cabenuva and drinking alcohol. However, both alcohol and Cabenuva and can cause liver problems, including liver damage. Combining the two may raise your risk of this side effect.

If you drink alcohol, talk with your doctor about how much is safe for you to consume during your treatment with Cabenuva.

Cabenuva: Interactions

Cabenuva may interact with other medications, certain supplements, and certain foods.

Different interactions can cause different effects. Some interactions can interfere with a drug’s effectiveness. Others can increase a drug’s side effects or cause them to be severe.

If any of the interactions listed below might pertain to you, talk with your doctor. They can tell you what you need to do to avoid the interaction.

  • Cabenuva and certain seizure medications. The manufacturer of Cabenuva advises that these drugs should not be taken together. Be sure to discuss with your doctor before taking these drugs together. These medications are:
    • phenytoin (Dilantin, Phenytek)
    • carbamazepine (Epitol, Tegretol, others)
    • oxcarbazepine (Trileptal, Oxtellar XR)
  • Cabenuva and certain other medications. As Cabenuva may interact with the following drugs, your doctor may recommend that you don’t take it with these drugs. Examples include:
    • certain antibiotics called macrolides, including azithromycin (Zithromax), clarithromycin, or erythromycin (Eryc, Ery-Tab)
    • the antibiotic rifampin (Rimactane)
    • the corticosteroid dexamethasone (Hemady)
  • Cabenuva and herbs and supplements. Certain herbs and supplements may interact with Cabenuva. Examples include:
    • St. John’s wort
  • Cabenuva and foods. There aren’t any known food interactions with Cabenuva. If you have questions about eating certain foods during treatment with this drug, talk with your doctor or pharmacist.

For information about drug-condition interactions, see the “Cabenuva: Precautions” section below.

Cabenuva: How it works

Cabenuva is used to treat HIV in adults and certain children.

What happens with HIV

HIV is a virus that attacks your immune system. Left untreated, HIV worsens over time and eventually causes AIDS. This condition prevents your body from fighting off infections. At this time, there is no cure for AIDS.

What Cabenuva does for HIV

Cabenuva contains two drugs. Each drug works to target HIV in your body.

Cabotegravir belongs to a drug class called integrase strand transfer inhibitors (INSTIs). These medications target HIV by blocking the integrase enzyme. (Enzymes are proteins that speed up reactions in your body.) When integrase is blocked, the virus can’t make copies of itself. This stops HIV from growing and spreading.

Rilpivirine belongs to a drug class called non-nucleoside reverse transcriptase inhibitors (NNRTIs). Similar to cabotegravir, rilpivirine and other NNRTIs block HIV from copying itself. However, NNRTIs do this in a different way by blocking a different enzyme called reverse transcriptase. This also stops HIV from growing and spreading.

How long does Cabenuva take to start working?

Cabenuva begins working as soon as you receive your first dose.

Doctors only prescribe Cabenuva if your HIV levels are already undetectable. (“Undetectable” means the virus can’t be detected with a blood test.) Once you receive your first dose, Cabenuva begins working to keep your HIV levels undetectable.

Cabenuva: Using while pregnant

It’s not known whether it’s safe to use Cabenuva while pregnant. If you are pregnant or planning to become pregnant, talk with your doctor about whether Cabenuva is safe for you.

If you and your doctor decide you’ll use Cabenuva while pregnant, consider joining the drug’s pregnancy registry. Pregnancy registries collect information on the safety of using drugs such as Cabenuva during pregnancy. To learn more and sign up, you can call 800-258-4263 or visit the registry website.

Cabenuva and birth control needs

It’s not known whether it’s safe to use Cabenuva during pregnancy. Talk with your doctor about your birth control needs with Cabenuva if you’re sexually active and you or your partner can become pregnant. Your doctor can recommend if you should use birth control with this medication.

Cabenuva: Using while breastfeeding

The Centers for Disease Control and Prevention (CDC) do not recommend breastfeeding a child if you have HIV. This is because HIV may be passed through breast milk.

Cabenuva’s manufacturer also recommends that you don’t breastfeed while using this drug. Instead, talk with your doctor about alternative feeding options for your child.

Cabenuva: Precautions

Tell your doctor about your health history before starting treatment with Cabenuva. Your doctor may not recommend this medication if you have certain factors affecting your health or specific medical conditions.

These factors and conditions include those listed below.

  • Mental health conditions, such as depression. Cabenuva can cause mood changes, including depression. While this is rare, these mood changes can be serious. If you have any mental health conditions, such as depression, receiving Cabenuva could worsen your condition. Or it could cause new mood changes. Talk with your doctor about whether Cabenuva is safe for you to receive.
  • Liver problems, including hepatitis B or C. In rare cases, Cabenuva can cause liver problems, including liver damage, as a side effect. If you have existing liver problems, such as hepatitis B or C, you may be at higher risk of this side effect. Receiving Cabenuva could worsen your liver problems. Your doctor can determine whether taking Cabenuva is safe for you.
  • Allergic reaction. Your doctor will likely not prescribe Cabenuva if you’ve had an allergic reaction to it or any of its ingredients. To find out about other treatment options, talk with your doctor.
  • Pregnancy. If you’d like to learn more information about taking Cabenuva while pregnant, view the “Cabenuva: Using while pregnant” section above.
  • Breastfeeding. If you’d like to learn more information about taking Cabenuva while breastfeeding, view the “Cabenuva: Using while breastfeeding” section above.

To learn more about the effects of Cabenuva that could be harmful, see the “Cabenuva: Side effects” section above.

Cabenuva: Questions for your doctor

If you have questions about Cabenuva, talk with your doctor. They can advise you on whether Cabenuva could be a good treatment option for you.

Here’s a list of questions you may want to ask your doctor:

  • Do any medications I take put me at higher risk of side effects if I use Cabenuva?
  • I’m an older adult. Is Cabenuva safe for me to use?
  • Will I have withdrawal symptoms if I need to stop treatment with Cabenuva?

Your doctor may also tell you about other treatment options for your condition. You may find this article helpful in learning about alternative drugs for HIV. And view our selection of videos on this condition.

Disclaimer: Healthgrades has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.

Medical Reviewer: Dena Westphalen, Pharm.D.
Last Review Date: 2022 Sep 3
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.