Question

Is there a way to remove long-acting HIV drugs in case there are side effects?

29 September 2026. Related: Adherence, All topics, Changing treatment, Injectable ART, Side effects.

Hi there, I am thinking about whether injectable ART would be better for me and one of the things I worry about is what happends if I get side effects? Are there antidotes that would clear these drugs from my body if I have a bad reaction?

Answer

Answer: Simon Collins

Hi there

Thanks, this is a great question.

Although most people use oral HIV meds, some people can use injectable ART.

This mainly involves long-acting cabotegravir (CAB-LA) and long-acting rilpivirine (RPV-LA).

Other injectable HIV meds include lenacapavir (LEN) and ibalizumab, although thes are used in combiantions when there is resistance to oral meds.

The advantages of long-acting meds include less frequent dosing it means the drugs stay in your body for a long time, which could be a problem if you have a bad reaction.

Luckily, these meds are generally well tolerated and most side effects are linked to having the injections.

The longest acting meds – CAB/RPV is given every two months and LEN is given every 6 months – also involve starting with oral dosing. This is to quickly reach the right drug levels but it also has a safety role is checking that there are no serious allergic reactions to the active drugs,

So although there are not antidotes that can quickly remove long-acting drugs, the short time taking oral drugs is a good indication  that there will not be allergic reactions.