Injectable PrEP

Cabotegravir is a form of HIV PrEP which is injected into the muscle. It is available on the NHS but only suitable in certain circumstances. Each case needs to be approved by the PrEP multidisciplinary team. Please discuss with an Umbrella clinician if you feel you may benefit from this treatment.

Efficacy

Studies have shown Cabotegravir PrEP to be over 99% effective. There is a small chance of acquiring HIV even if you attend for all of your injections on time.

It takes seven days from the first injection for Cabotegravir levels to reach protective levels in the body.

Dosing

The first two injections are given 4 weeks apart and the following injections will be given every eight weeks. These injections can only be given in certain Umbrella clinics. It is extremely important that you can commit to attending for these injections regularly and on time. We strongly advise you not to miss your injection appointments.

What happens if I miss my injection?

If you know that you cannot make it to an injection appointment, please inform the clinic as early as possible. If you miss your planned injection, you have a seven-day window period to get your injection. If you cannot attend within this seven day window, we will advise you to take oral Cabotegravir tablets daily, until you attend for the next injection. There is a maximum duration of two months of oral Cabotegravir. Beyond this, we would recommend you switch to an oral form of PrEP in the long term.

If you have missed your injection and not taken oral Cabotegravir, we strongly advise you do not have unprotected sex. If you have had unprotected sex in this scenario, please seek urgent medical advice about whether post-exposure prophylaxis (PEPSE) is required.

Side effects

The most common side effect is injection site reactions (redness and / or swelling at the site of the injection). These tend to reduce over time with each injection. Other common side effects include nausea, vomiting, headache and rash.

You can use over the counter paracetamol, ibuprofen and anti-sickness medications as needed.

There is no need to monitor kidney or liver function.

Stopping injectable PrEP

It is important you let your Umbrella doctor or nurse know that you are thinking about stopping PrEP, as Cabotegravir can remain in the blood at levels that do not offer protection from HIV for up to 12 months.

Upon stopping Cabotegravir, we may offer you an alternative form of PrEP, condoms, and further HIV tests.