Guides

lenacapavir

28 August 2022. Related: ARVs, Capsid inhibitors, Experimental.

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Lenacapavir is a new type of drug called a capsid inhibitor.

It was approved in the EU and UK in August 2022 as a treatment for HIV multidrug resistance. It has also been submitted to the US FDA.

Lenacapavir is very effective but always needs to be used in combination with other active HIV drugs. Please be very careful to always take theese other meds in your combination,

  • Dosing. Lenacapavir is started by taking a 600 mg oral tablet on day 1 and 2. This is followed by a 300 mg tablet on day 8. Then, on day 15, the recommended standard adult dose is one subcutaneous injection (927 mg) every six months.

  • Lenacapavir can be given with or without food.
  • Side effects. The main side effects are skin reactions from where the drug is injected.
  • Drug interactions. Lenacapavir has some important drug interactions. Because it is such a long-lasting drug, these interactions can continue for a long time after after the last lenacapavir injection (up to nine months). Please see the full prescribing information for details of these and other interactions.
  • The following should NOT be taken with lenacapavir because they generally reduce levels of lenacapavir.
    Some HIV meds: efavirenz, etravirine, nevirapine, atazanavir/cobicistat, and tipranavir/ritonavir.
    Some TB meds: rifampicin, rifabutin.
    Some anticonvulsants: carbamazepine, phenytoin, oxcarbazepine and phenobarbital.
    Some herbal supplements: St. John’s wort.
  • The following drugs can be INCREASED by lenacapavir. They can sometimes be used at a lower doses.
    Some PDE-5 erectile drugs: sildenafil (Viagra), taladafil, vardenafil.
    Ergot derivatives: dihydroergotamine and ergotamine.
    Some corticosteroids: dexamethasone hydrocortisone/cortisone.
    Some other drugs: dioxin, midazolam, triazolam, lovastatin and simvastatin.
  • There are NO interactions with oral contraceptives or with gender affirming hormones.
  • Resistance. Lenacapavir drug resistance can easily develop if not used with other HIV meds, or by using other drugs that reduce drug levels.
  • If lenacapavir is ever discontinued, it is essential that a fully active combination is started within four weeks.
  • Lenacapavir was developed by Gilead Sciences. It is marketed with the trade name Sunlenca.

Further information

The European patient information and detailed Product Information for Sunlenca are available from this link on the European Medicines Agency (EMA) website.

The Patient Information is a simplified summary: what the drug is, why it is used, results from studies and cautions including side effects.