Version June 2024
| Schedule | Induction dosing | Maintenance dosing | Missed injections without oral therapy bridge¶ | |||
| First dose (week 0)* | Week 4 | Week 8 | Week 12 | After week 12 | ||
| Every 4 weeksΔ | Cabotegravir (600 mg [3 mL]) and rilpivirine (900 mg [3 mL]) intramuscularly | Cabotegravir (400 mg [2 mL]) and rilpivirine (600 mg [2 mL]) intramuscularly | Cabotegravir (400 mg [2 mL]) and rilpivirine (600 mg [2 mL]) intramuscularly | Cabotegravir (400 mg [2 mL]) and rilpivirine (600 mg [2 mL]) intramuscularly | Cabotegravir (400 mg [2 mL]) and rilpivirine (600 mg [2 mL]) are administered intramuscularly every 4 weeks thereafter | After confirmation that resumption of cabotegravir-rilpivirine treatment is clinically appropriate◊:
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| Every 8 weeks§ | Cabotegravir (600 mg [3 mL]) and rilpivirine (900 mg [3 mL]) intramuscularly | Cabotegravir (600 mg [3 mL]) and rilpivirine (900 mg [3 mL]) intramuscularly | No injection | Cabotegravir (600 mg [3 mL]) and rilpivirine (900 mg [3 mL]) intramuscularly | Cabotegravir (600 mg [3 mL]) and rilpivirine (900 mg [3 mL]) are administered intramuscularly every 8 weeks thereafter | After confirmation that resumption of cabotegravir-rilpivirine is clinically appropriate◊:
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Cabotegravir and rilpivirine are provided as a kit containing two extended-release injections for either once every four- or once every eight-week intramuscular administration by a health care provider for treatment of HIV-1 infection in adult and adolescent patients aged ≥12 years and weighing ≥35 kg. For considerations for patient selection and other details of clinical use, refer to the UpToDate topic review on switching antiretroviral therapy for adults with HIV-1 and a suppressed viral load.
Cabotegravir and rilpivirine injections should be administered at separate gluteal sites, either on opposite sides or at least 2 cm apart on the same side, at the same clinic visit. It is acceptable to administer the injectables within seven days before or after a scheduled dosage.ART: antiretroviral therapy.
* If there is concern about the tolerability of the injectable regimen, patients can receive oral cabotegravir (30 mg) plus oral rilpivirine (25 mg) once daily with food for one month prior to initiating the long-acting injectable formulation. The last doses of oral cabotegravir and rilpivirine should be taken on the same day that cabotegravir-rilpivirine injections are started.
¶ If a patient plans to miss a scheduled injection visit by more than seven days, bridge with daily oral cabotegravir plus oral rilpivirine, or any other fully suppressive oral ART regimen, for up to two months until the day the injection dosing is restarted.
Δ To switch from an every four-weeks to an every eight-weeks schedule: Administer cabotegravir 600 mg (3 mL) and rilpivirine 900 mg (3 mL) four weeks after the last monthly injection and then cabotegravir 600 mg (3 mL) and rilpivirine 900 mg (3 mL) once every eight weeks thereafter.
◊ If the patient misses or delays a dose of injectable therapy by more than seven days and did not take an oral ART bridge, we determine appropriateness of resumption of cabotegravir-rilpivirine injections by reassessing clinical symptoms, consider checking a viral load, and, if a viral load result is greater than 200 to 500 copies/mL, perform a genotypic resistance test (including integrase resistance).
§ To switch from an every eight-weeks to an every four-weeks schedule: Administer cabotegravir 400 mg (2 mL) and rilpivirine 600 mg (2 mL) eight weeks after the last every eight-week continuation injection, and then continue cabotegravir 400 mg (2 mL) and rilpivirine 600 mg (2 mL) every four weeks thereafter.آیا می خواهید مدیلیب را به صفحه اصلی خود اضافه کنید؟
