Quick answer: Cabenuva is delivered as two separate injectable suspensionscabotegravir600mg/400mg and rilpivirine900mg/600mggiven either every2months or oncemonthly depending on the kit you receive. Want the details on which kit fits your life, how to prep the shots, and what to watch for if a dose slips? Keep reading; everything you need is right here.
Cabenuva forms & strengths
What are the two dosing kits?
ViiV Healthcare ships Cabenuva in two distinct kits, each with its own strengths:
- 600mg/900mg kit each vial contains 3mL of suspension (cabotegravir600mg+rilpivirine900mg). This is the kit used for the initial "every2month" schedule and for the first monthly shot.
- 400mg/600mg kit each vial holds 2mL (cabotegravir400mg+rilpivirine600mg). It's the continuation kit for a true oncemonthly regimen.
Why do the strengths matter?
The different milligram amounts translate into how often you visit the clinic. The larger 600/900mg dose gives you a twomonth gap between shots, while the smaller 400/600mg dose lets you space them a month apart. Choosing the right kit is a balance of your schedule, transportation options, and how comfortable you feel with a longer interval.
Comparison table
| Kit | Cabotegravir dose | Rilpivirine dose | Volume per vial | Typical schedule |
|---|---|---|---|---|
| 600/900mg | 600mg (3mL) | 900mg (3mL) | 3mL each | Every2months (initiation+continuation) |
| 400/600mg | 400mg (2mL) | 600mg (2mL) | 2mL each | Oncemonthly continuation |
Dosing schedule basics
What is a "Target Treatment Date"?
The Target Treatment Date (TTD) is simply the day of the month you aim to receive each injectionthink of it like a recurring calendar event. The official guidance lets you give or receive the shot 7days from that date. Going beyond that window means you'll need a backup plan, often an oral bridging regimen, to keep the virus suppressed.
Stepbystep timeline
Here's the standard flow for most patients:
- Month0 optional oral leadin (usually dolutegravirbased) to confirm tolerability.
- Day1 first 600/900mg injection (the initiation shot).
- Day+30 second 600/900mg injection (the "loading" dose that builds up drug levels).
- Every2months repeat the 600/900mg kit, or switch to the monthly 400/600mg kit after the initial series if you prefer monthly visits.
Every2month vs. oncemonthly: which feels right?
Both schedules have been shown in the ATLAS and FLAIR clinical trials to keep viral load lowmeaning they're medically "noninferior" to each other. Your decision will likely hinge on a few practical things:
- Travel & time Do you have reliable transport to get to a clinic every two months? If not, a monthly visit might feel less stressful.
- Insurance coverage Some plans reimburse one schedule more favorably than the other.
- Personal rhythm Some folks love the "set it and forget it" vibe of a twomonth gap, while others feel safer checking in each month.
When in doubt, talk to your HIV specialist. They can walk you through a quick decisiontree (see below) and help you pick the kit that matches your lifestyle.
Decisiontree graphic (suggested for full article)
Can you commit to a visit every2months? Yes 600/900mg kit.
Prefer monthly visits? Use 400/600mg kit after the initial 600/900mg dose.
Preparing the injection
What do I need before I start?
Gather these items and keep them on a clean tray:
- Dosing kit (pick the correct strength).
- Two 23gauge1in. needles (or a longer needle if you have a higher BMI).
- Syringes, vial adapters, and a label.
- Nonsterile gloves, alcohol wipes, gauze pads, and a sharps container.
How do I get the injection ready?
It's a fivestep routine that takes less than five minutes once you're familiar with it:
- Temper the vial Remove it from the fridge and let it sit at room temperature for at least 15minutes (the label says 77F).
- Inspect Check the expiration date, look for particles or discoloration.
- Shake Give the vial a good 10second shake. The suspension should look uniformly cloudy, not clumped.
- Draw air, then medication Pull air into the syringe equal to the volume you'll withdraw (no dilution needed).
- Label & inject Write the drug name and the exact time on the syringe. If you can't inject right away, keep the syringe in a cool place and use within 30minutes.
A short video from ViiV's official dosing & administration guide walks through each step, and many clinics will let you watch it on a tablet while you're waiting.
Where should I inject?
Both drugs go into the gluteal muscles, but you must use separate sites (at least 2cm apart). The ventrogluteal area is preferred because it's farther from major nerves and blood vessels. If you're not comfortable finding it, ask the nurse to demonstratemost people feel confident after a single practice run.
Postinjection checklist
- Apply gentle pressure with gauze for ~30seconds.
- Do not massage the site; that can affect drug absorption.
- Observe the patient (or yourself) for 10minutes for any immediate reaction.
Missed or delayed doses
What if I'm more than 7days late?
First, stay calmyou're not alone. The guidelines give two clear options:
- Oral bridging Switch to a fully suppressive oral regimen (often a oncedaily integrase inhibitor plus two NRTIs) until you can get back on schedule.
- Reinitiate If you're over a month behind, you may need to repeat the initiation series (two shots one month apart) before returning to your regular schedule.
Both paths protect you from viral rebound and resistance. Your provider can write the bridging prescription on the spot, so you never run out of coverage.
How long do the drugs stay in my body?
Cabotegravir and rilpivirine have long halflives; they can be detectable up to a year after the final injection. That's part of why the "missed dose" rules are strictthere's still drug hanging around, but not enough to guarantee full suppression.
Misseddose flowchart (suggested for full article)
Late 7days take the next scheduled injection.
Late 830days start oral bridging until the next injection.
Late >30days repeat initiation series.
Safety & side effects
What are the most common reactions?
In clinical studies, about 210% of patients reported these:
- Injectionsite pain or tenderness (usually mild and resolves in a day).
- Lowgrade fever or chills.
- Headache, fatigue, or mild rash.
Most side effects are shortlived and don't require any extra medication. A cold compress can help with soreness, and staying hydrated often eases the headache.
What are the rare but serious warnings?
While uncommon, you should be aware of the following:
- Hypersensitivity reactions Includes skin rash, fever, and in extreme cases, DRESS (Drug Reaction with Eosinophilia and Systemic Symptoms). If you notice a spreading rash or feel unwell after an injection, call your clinic right away.
- Postinjection bronchospasm Rarely, patients have reported shortness of breath within minutes of the shot. Clinics keep an epinephrine autoinjector on hand just in case.
- Liver enzyme elevations Your provider will check labs at baseline and periodically; significant changes would prompt a medication review.
Safety checklist (downloadable PDF suggested for full article)
- Keep a symptom diary for the first two weeks.
- Know the emergency contact number of your clinic.
- Bring a list of all medicines you're taking to each visit.
Bottom line insights
Cabenuva offers a gamechanging option for people living with HIV who want to swap daily pills for a shot every month or every two months. The key to success lies in three things:
- Choose the right kit 600/900mg for the longer interval, 400/600mg for monthly dosing.
- Stick to the schedule Aim for your Target Treatment Date, and use the 7day window wisely.
- Follow preparation and safety steps Proper shaking, site selection, and postinjection monitoring keep you on track and minimize side effects.
If a dose slips, remember you have builtin safety nets (oral bridging or reinitiation) that protect you from viral rebound. And always keep the conversation open with your healthcare team; they're there to help you navigate any hiccup.
Got questions about your personal dosing plan? Want to share how the monthly schedule works for you? Drop a comment below or reach out to your provideryour experience might be the exact tip someone else needs. Together, we can make longacting therapy feel like just another friendly routine.
FAQs
What is the difference between the 600/900 mg and 400/600 mg Cabenuva kits?
The 600 mg / 900 mg kit contains larger doses and is used for the every‑2‑month schedule (or the first monthly loading dose). The 400 mg / 600 mg kit has lower doses and is intended for a true once‑monthly continuation regimen.
How often should I receive Cabenuva injections?
After the initial lead‑in oral dose, you get a 600/900 mg injection, a second identical dose 30 days later, and then continue either every 2 months with the same kit or switch to monthly 400/600 mg injections depending on your chosen schedule.
What should I do if I miss my scheduled Cabenuva dose?
If you’re ≤ 7 days late, take the next dose as soon as possible. Between 8–30 days, start an oral bridging regimen until you can inject. If > 30 days have passed, repeat the initiation series (two shots one month apart) before returning to regular dosing.
How do I properly prepare and administer a Cabenuva injection at the clinic?
Remove the vial from refrigeration, let it warm to room temperature (≥ 15 min), inspect, shake for 10 seconds, draw the full volume with a syringe, label, and inject each component into separate gluteal sites (at least 2 cm apart), preferably the ventrogluteal area.
What side effects are common with Cabenuva and when should I seek medical help?
Typical reactions include mild injection‑site pain, low‑grade fever, headache, or fatigue, which usually resolve quickly. Seek immediate care for severe rash, fever, shortness of breath, or signs of hypersensitivity such as swelling or difficulty breathing.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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