Cabotegravir is an HIV-1 integrase strand transfer inhibitor (INSTI) used for the treatment of HIV-1 infection and pre-exposure prophylaxis (PrEP) against HIV-1. As the main active ingredient in VOCABRIA (cabotegravir tablets) or APRETUDE (cabotegravir extended-release injectable suspension), it demonstrates good efficacy. However, caution must be exercised regarding its side effects and precautions during use.

What Are the Side Effects of Cabotegravir?

Side Effects in HIV-1 Treatment

When cabotegravir is used in combination with EDURANT (rilpivirine), common adverse reactions include:

Systemic reactions: Fatigue, weakness, headache.

Digestive system reactions: Diarrhea, nausea, abdominal distension, abdominal pain.

Nervous system reactions: Dizziness, insomnia, abnormal dreams.

Psychiatric symptoms: Anxiety, depression (close monitoring is required).

Side Effects in HIV-1 Pre-Exposure Prophylaxis (PrEP)

Headache (6%), diarrhea (4%), nausea (3%).

Upper respiratory tract infection (2%), drowsiness (2%).

Serious Side Effects of Cabotegravir That Require Vigilance

Hypersensitivity Reactions

Manifestations: Stevens-Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN), angioedema, urticaria, etc.

Management: If symptoms such as rash, fever, or mucosal damage occur, discontinue the drug immediately and seek medical attention.

Hepatotoxicity

Some patients may experience elevated transaminases or hepatitis, especially those with a history of liver disease.

Recommendation: Monitor liver function regularly during medication use; discontinue the drug if symptoms such as jaundice or abdominal pain appear.

Mental Health Issues

Depressive symptoms (e.g., low mood, suicidal tendencies) are relatively common during HIV-1 treatment.

Caution: Enhanced monitoring and timely intervention are required for patients with a history of mental illness.

Precautions for Cabotegravir Administration

Absolute Contraindications

Patients allergic to cabotegravir.

Concomitant use with specific anticonvulsants or antituberculosis drugs (e.g., rifampicin, carbamazepine).

Medication for Special Populations

Pregnant women: Animal studies have shown that high doses may delay childbirth; human data are limited, and the benefits and risks must be weighed.

Lactating women: Breastfeeding should be avoided to prevent the drug from passing through breast milk.

Patients with hepatic or renal impairment: No dosage adjustment is needed for mild to moderate impairment; caution is required for severe impairment.

Other Key Precautions

HIV-1 testing: Before initiating PrEP and every 3 months thereafter, recheck HIV-1 status to avoid accidental use in infected individuals.

Comprehensive prevention: PrEP must be combined with safe sexual practices (e.g., condom use) to reduce the risk of other sexually transmitted infections.