Guides

cabotegravir LA + rilpivirine LA (Vocabria+Rekambys; Cabenuva)

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cab-oh-TEG-ra-veer + ril-PIV-a-reen

Cabotegravir LA is an integrase inhibitor. Rilpivirine LA is an NNRTI. Both drugs are given together as long-acting (LA) injections.

This dual injectable combination was approved in the EU and US in December 2021.

In the UK, NICE is expected to decide on use in England by October 2021.

  • Oral tablets are used for both drugs for the first month of treatment. This is to make sure you can tolerate the active drugs. Ongoing studies are looking at whether this will always be needed.
  • After dosing with oral drugs for one month, injections are given either every month or every two months. Different doses are used for each schedule. A higher dose is sometimes used for the first injection.
  • The injections can be given with or without food.
  • Both injections need to be given by a health professsional at the same clinic visit. The injection should be to different areas of the gluteus muscle (your ass/arse/bottom).
  • Missing a course of injections might need restarting with oral dosing. This depends on the time missed. Oral versions should be provided in case there is a short unplanned delay.
  • These long-acting drugs can take more than a year to leave your body. If for any reason you need to stop CAB/RPV LA, it is essential to switch to an alternative combination. Otherwise drug resistance will develop when drug levels drop to lower levels.
  • Most people reported skin reactions from where the drug was injected. These very usually mild or moderate. Most people in research studies did not stop treatment because of these reactions but about 1 in 100 (1%) did.
  • Other very common or common side effects include headache, tiredness, dizziness and fever. These occurred in more than 1 in 10 people.
  • Drug interactions include with: carbamazepine, oxcarbazepine, phenobarbital, phenytoin (medicines for epilepsy); rifabutin, rifampicin, rifapentine (antibiotics); systemic dexamethasone (a steroid anti-inflammatory and immunosuppressant medicine), except when used as a single dose treatment; St John’s wort (a herbal antidepressant medicine).
  • CAB LA/RPV LA is being marketed by ViiV Healthcare. In the EU the drugs are packaged separately. Cabotegravir has the tradename Vocabria and rilpivirine is called Rekambys.
  • In the US , both drugs are packaged together, with the trade name Cabenuva (for both drugs).

Further information

The European patient information and detailed Product Information for maraviroc are available in PDF format from these links 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.

The Product Information is a detailed technical summary that you can access as a PDF file by clicking the ‘Product Information’ tab. It describes more precisely how the drug works and how it is processed by your body. This includes, for example, reported food interaction studies in terms of calories or fat content. It includes more details of the study results and a full list of side effects and drug interactions.