Cabenuva (cabotegravir/rilpivirine) is a prescription drug used to treat HIV in certain adults and adolescents. It’s given as an injection. Cabenuva can cause side effects ranging from mild to serious, including fever and fatigue.
Some people may experience mild to serious side effects during their Cabenuva treatment. Here are a few examples of the drug’s commonly reported side effects:
- injection site reactions*
- fever
- fatigue (low energy)
- headache
- muscle or joint pain
* To learn more about this side effect, see the “Side effects explained” section below.
Mild side effects have been reported with Cabenuva. These include:
- nausea
- headache
- dizziness
- insomnia (trouble sleeping)
- fever
- fatigue
- muscle or joint pain
- injection site reactions*
- skin rash
- mild allergic reaction*
In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bothersome, talk with your doctor or pharmacist. And do not stop taking Cabenuva unless your doctor recommends it.
Cabenuva may cause mild side effects other than those listed above. See the drug’s prescribing information for details.
* To learn more about this side effect, see the “Side effects explained” section below.
Serious side effects have been reported with Cabenuva. These include:
- depression or other mood changes
- liver problems
- post-injection reaction*
- severe allergic reaction*
If you develop serious side effects while taking Cabenuva, call your doctor right away. If the side effects seem life threatening or you think you have a medical emergency, immediately call 911 or your local emergency number.
* To learn more about this side effect, see the “Side effects explained” section below.
Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Cabenuva, visit MedWatch.
Get answers to some frequently asked questions about Cabenuva’s side effects.
How do side effects of Cabenuva compare with those seen with Biktarvy?
Cabenuva and bictegravir sodium/emtricitabine/tenofovir alafenamide (Biktarvy) are both used to treat HIV. Biktarvy comes as an oral tablet, while Cabenuva is given as an injection every 1–2 months.
The table below shows how the side effects of these drugs compare.
| Biktarvy | Cabenuva | |
| Mild side effects | • diarrhea • nausea • headache • fatigue • insomnia | • injection site reactions • fever • fatigue • headache • muscle or joint pain |
| Serious side effects | • liver and kidney problems • depression • lactic acidosis with fatty deposits in the liver • immune reconstitution syndrome (IRIS) • boxed warning: worsening hepatitis B | • depression or other mood changes • liver problems • post-injection reaction • severe allergic reaction |
To learn more about how the side effects of Cabenuva and Biktarvy compare, talk with your doctor or pharmacist.
Does Cabenuva cause long-term side effects?
It’s possible. Long-term side effects include those that may start at any time you’re taking a drug, even if you’ve taken it for a long time. It also includes side effects that may not go away, even after you stop taking the drug.
Side effects reported in Cabenuva’s studies that could be long term included liver problems and elevated liver enzymes (which may be a sign of liver damage).
If you have questions about your risk of long-term side effects with Cabenuva, talk with your doctor or pharmacist.
Learn more about some of the side effects Cabenuva may cause.
Injection site reaction
Receiving Cabenuva may cause a reaction at the injection site. This was a common side effect reported in studies of the drug. Injection site reactions may cause symptoms such as:
- warmth
- swelling
- bruising
- redness
- itching
- pain or tenderness
- hardened lump
What might help
If you have an injection site reaction during your Cabenuva treatment, these tips may help relieve your symptoms:
- applying ice to the site before and after the injection (no longer than 15 minutes at a time)
- asking for a prescription numbing cream to apply to the site before getting the injection
- taking acetaminophen (Tylenol) to help relieve pain from the injection
- avoiding forcefully rubbing the area after an injection
Injection site reactions will likely become less painful over time, but if the symptoms become worse or unmanageable, talk with your doctor or pharmacist.
Post-injection reaction
Some people may have a post-injection reaction after receiving a Cabenuva injection. This was an uncommon side effect reported in studies of the drug. Most of the reactions reported in studies happened within minutes of the injection and went away within minutes.
Post-injection reactions may cause symptoms such as:
- trouble breathing
- abdominal cramps
- feeling faint or lightheaded
- sweating
- feeling warm
- pain in the back and chest
- feeling anxious
- numbness in the mouth
- skin rash
- blood pressure changes
What might help
If you experience a post-injection reaction during your Cabenuva treatment, your doctor will have medications on hand to treat low blood pressure, trouble breathing, and pain. If you have concerns about the risk of a post-injection reaction, discuss this with your doctor before getting the injection.
Allergic reaction
Like most drugs, Cabenuva can cause an allergic reaction in some people.
Symptoms can be mild to serious and can include:
After Cabenuva was approved, there have been rare rare reports of a severe allergic reaction known as drug reaction with eosinophilia and systemic symptoms (DRESS) in people receiving the drug. DRESS may begin 2–8 weeks after starting Cabenuva. Symptoms to look for include:
- widespread body rash
- swelling of lymph nodes
- high fever
- facial swelling
DRESS is a potentially life threatening condition that requires immediate medical attention.
What might help
If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:
- an oral antihistamine, such as Benadryl (diphenhydramine)
- a product you apply to your skin, such as hydrocortisone cream
If your doctor confirms you’ve had a mild allergic reaction to Cabenuva, they’ll decide if you should continue taking it.
If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.
If your doctor confirms you’ve had a serious allergic reaction to Cabenuva, they may have you switch to a different treatment.
Keeping track of side effectsDuring your Cabenuva treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.
Your side effect notes can include things such as:
- what dose of the drug you were taking when you had the side effect
- how soon you had the side effect after starting that dose
- what your symptoms were
- how your symptoms affected your daily activities
- what other medications you were taking
- any other information you feel is important
Keeping notes and sharing them with your doctor will help them learn more about how Cabenuva affects you. They can then use this information to adjust your treatment plan if needed.
Below is important information you should consider before starting Cabenuva treatment.
Warnings
Cabenuva can sometimes cause harmful effects in people who have certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Cabenuva is a good treatment option for you.
Talk with your doctor about your health history before starting Cabenuva treatment. Be sure to tell them if any of the following factors apply to you:
- liver problems, especially hepatitis B or C
- taking other prescription or over-the-counter medications, herbs, supplements, or vitamins, especially:
- history of mental health conditions, especially depression or suicidal thoughts
- previous allergic reaction to Cabenuva
- pregnancy
- breastfeeding
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call or text the 988 Suicide and Crisis Lifeline at 988.
- Text HOME to the Crisis Text Line at 741741.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
Alcohol and Cabenuva
There are no known interactions between alcohol and Cabenuva. However, Cabenuva can cause liver problems. Excessive alcohol use can also cause liver problems. So your risk of liver problems may be higher if you drink too much during your Cabenuva treatment.
If you have questions about consuming alcohol during Cabenuva treatment, talk with your doctor or pharmacist.
Pregnancy and breastfeeding with Cabenuva
Before starting Cabenuva treatment, talk with your doctor if you’re pregnant, breastfeeding, or planning to become pregnant or to breastfeed.
Pregnancy
It’s not known whether it’s safe to use Cabenuva while pregnant. This drug’s use during pregnancy hasn’t been studied. However, a drug in the same class as cabotegravir (one of the active ingredients in Cabenuva) was shown to cause fetal harm when used in early pregnancy.
If you’re pregnant or planning to become pregnant, talk with your doctor about safe HIV treatment options.
If you receive this drug while pregnant, consider signing up for the Antiretroviral Pregnancy Registry. A pregnancy registry collects information about the safety of certain drugs when used during pregnancy. You can learn more on the website or by calling 800-258-4263.
Breastfeeding
It isn’t known whether Cabenuva passes into breast milk or is safe to use while breastfeeding. But the Centers for Disease Control and Prevention (CDC)
Like most drugs, Cabenuva can cause side effects that range from mild to serious. However, most are temporary and go away after a few days to weeks. If you have questions about side effects that Cabenuva can cause, talk with your doctor.
Examples of questions to help get you started include:
- Will Cabenuva cause me to gain weight?
- How long will it take for side effects of Cabenuva to go away?
- Do Cabenuva injections cause permanent muscle damage and long lasting pain?
- Can I develop drug resistance to Cabenuva?
To learn more about Cabenuva, see these articles:
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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.