INSTI (long-acting injectable)
Cabotegravir
Brand names: Vocabria, Apretude
Adult dose
Dose: Oral lead-in 30mg OD ×4 weeks then IM 600mg q2 monthly (with rilpivirine for HIV; alone for PrEP)
Route: Oral / IM
Frequency: q2 monthly (IM)
Clinical pearls
- Vocabria + rilpivirine LA: virologically suppressed HIV maintenance — every 2 months IM
- Apretude: HIV PrEP — long-acting alternative to oral PrEP per BHIVA
- Specialist HIV centre administration
Contraindications
- Concurrent strong CYP3A4 inducers
- Hypersensitivity
Side effects
- Injection-site reactions (very common)
- Pyrexia
- Fatigue
- Hypersensitivity
- Hepatotoxicity
- Depression
- Headache
Interactions
- Rifampicin / carbamazepine / phenytoin (avoid)
Monitoring
- VL/CD4 (HIV)
- HIV testing 2-monthly (PrEP)
- LFTs
- Mental health
Reference: BNF; BHIVA HIV / PrEP guidelines; EACS; SmPC; https://bnf.nice.org.uk/drugs/cabotegravir/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023