Look inside the book: Nursing 2025-2026 Drug Handbook

206 cabotegravir–rilpivirine

• Monitor LFT values during therapy and as clinically indicated. Discontinue cabotegravir if liver toxicity is suspected. • Monitor patient for depressive symptoms, and promptly evaluate for relation to cabotegravir. • Refer to rilpivirine’s prescribing informa tion if rilpivirine is used with cabotegravir. PATIENT TEACHING • Inform patient taking cabotegravir for PrEP that it’s part of an overall HIV-1 infection pre vention strategy that includes adherence to dosing schedule and safer sex practices, in cluding condoms, to reduce risk of STIs. • Tell patient taking cabotegravir for PrEP that testing for HIV-1 is needed before ther apy, before each injection, and if patient is diagnosed with other STIs. • Inform patient that drug isn’t always effec tive in preventing HIV-1 infection. • Advise patient to immediately contact prescriber if signs and symptoms of hyper sensitivity reaction (severe rash, rash with fever, tiredness, muscle or joint aches, blis ters, facial swelling, difficulty breathing, liver problems [jaundice, dark urine, pale-colored stools, nausea, vomiting, right upper abdomi nal pain]) occur. • Inform patient that LFT values and HIV-1 infection testing will be monitored during therapy. • Tell patient to promptly report depressive symptoms to prescriber. • Advise patient to follow testing schedule, take drug as prescribed, and avoid missed doses as doing so increases the risk of acquir ing HIV-1 infection and developing drug re sistance. • Counsel patient of childbearing potential to report pregnancy or plans to become pregnant or breastfeed. cabotegravir–rilpivirine ka-boe-TEG-ra-vir/ril-pi-VIR-een Cabenuva Therapeutic class: Antiretrovirals Pharmacologic class: HIV-1 integrase strand transfer inhibitors/HIV-1 NNRTIs AVAILABLE FORMS Injection (extended-release suspension): 400 mg cabotegravir and 600 mg rilpivirine

single-dose vials (kit); 600 mg cabotegravir and 900 mg rilpivirine single-dose vials (kit) INDICATIONS & DOSAGES ➤ HIV-1 infection to replace current anti retroviral regimen in patients who are virologically suppressed on a stable antire troviral regimen with no history of treat ment failure and no known or suspected resistance to cabotegravir or rilpivirine Adults and adolescents ages 12 and older weighing at least 35 kg: Initially, cabote gravir 30 mg PO daily and rilpivirine 25 mg PO daily for at least 28 days to assess toler ability. On the last day of oral dosing, initi ate injections with cabotegravir 600 mg IM and rilpivirine 900 mg IM as separate gluteal injections. Starting 1 month after initial in jections, give cabotegravir 400 mg IM and rilpivirine 600 mg IM as separate gluteal in jections once monthly. Alternatively, on last day of current an tiretroviral therapy, initiate injections with cabotegravir 600 mg IM and rilpivirine 900 mg IM as separate gluteal injections and repeat monthly. Adjust-a-dose: If switching from monthly to every-2-month regimen, give cabotegravir 600 mg IM and rilpivirine 900 mg IM 1 month after last monthly injection, then every 2 months thereafter. If switching from every-2-month to monthly regimen, give cabotegravir 400 mg IM and rilpivirine 600 mg IM 2 months after last every-2-month injection, then every month thereafter. ADMINISTRATION IM • Complete dose requires an injection of cabotegravir and an injection of rilpivirine during the same visit. Order of injections isn’t important. • Don’t further dilute or reconstitute vials. Don’t mix with other products or diluents. • Before use, remove vials from refrigera tor; allow products to reach room temperature (not to exceed 77 ◦ F[25 ◦ C]) for 15 minutes. • Inspect vials for particulate matter and dis coloration. Don’t use if present. Note cabote gravir vial has a brown tint, which may limit inspection. • Shake vials vigorously until suspension looks uniform before withdrawing into syringes. Small air bubbles are expected and acceptable.

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