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HIV-1 capsid inhibitor (long-acting)

Lenacapavir

Brand names: Sunlenca

Adult dose

Dose: Initiation: 600mg PO days 1–2, 300mg PO day 8, then 927mg SC every 6 months
Route: SC/PO
Frequency: every 6 months (after loading)

Clinical pearls

  • Heavily treatment-experienced multidrug-resistant HIV-1
  • Twice-yearly SC dosing — major adherence advantage

Contraindications

  • Concurrent strong CYP3A4 inducers (rifampicin, carbamazepine, phenytoin, St John's wort)

Side effects

  • Injection site reactions (nodule, induration)
  • Nausea

Interactions

  • Strong CYP3A4 modulators
  • Rifabutin

Monitoring

  • Viral load
  • CD4

Reference: BNF; NICE TA942; BHIVA; SmPC; https://bnf.nice.org.uk/drugs/lenacapavir/. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.