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GIVE PEOPLE LIVING WITH HIV TWO MONTHS BETWEEN DOSES AFTER INITIATION[1,2]

BEFORE TREATMENT INITIATION[1,2]

  • Ensure patients agree to the required every-2-month dosing schedule and counsel patients about the importance of adherence to scheduled injection visits
  • Set a consistent injection date, the Target Treatment Date, to help keep your patients on track (+/- 7 days)

EVERY-2-MONTH DOSING SCHEDULE[1,2]

FOLLOWING TREATMENT DISCONTINUATION[1,2]

  • It is essential to start alternative ARV therapy no later than 2 months after the final injections (or 1 month if after first initiation injections) in order to minimise the risk of developing viral resistance

Optional oral lead-in

If you would like to assess tolerability, prescribe 2 tablets (1 cabotegravir and 1 rilpivirine tablet) to be taken once daily with a meal for 1 month (at least 28 days).[1,2]

EVERY-2-MONTH DOSING WITH OPTIONAL ORAL LEAD-IN[1,2]

  • When given the choice in SOLAR, more participants and physicians chose to start with injections (279/454) than via oral tablets (175/454)[3]

Manage missed injections

  • If a patient plans to miss a scheduled injection visit by more than 7 days, oral bridging may be utilised with oral CAB (30 mg) + RPV (25 mg) once daily (with a meal) or any other fully suppressive oral ARV regimen, however, limited data is available on oral bridging with other fully suppressive antiretroviral therapy (ART) (mainly INI-based), for up to 2 consecutive months[1,2]
  • For durations greater than 2 months, an alternative oral regimen is recommended[1,2]
  • The first dose of oral therapy should be taken on the treatment target date of VOCABRIA + REKAMBYS injections (+/- 7 days), i.e. 2 months (+/- 7 days) after the last injection dose. The injections should be restarted on the last day of oral therapy[1,2]

RESTARTING AFTER PLANNED MISSED INJECTIONS[1,2]

  • Adherence to scheduled injection visits is important[1,2]
  • Clinically reassess the patient to determine whether long-acting treatment remains appropriate[1,2]

RESTARTING AFTER UNPLANNED MISSED INJECTIONS[1,2]

Important drug interactions[1,2,4–6]

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ARV=antiretroviral; CYP3A=cytochrome P450 3A; GI=gastrointestinal; IM=intramuscular; OAT=organic anion transporter.

References:

  1. VOCABRIA Summary of Product Characteristics. ViiV Healthcare.
  2. REKAMBYS Summary of Product Characteristics. Janssen.
  3. Ramgopal MN, Castagna A, Cazanave C, et al. Efficacy, safety and tolerability of switching to long-acting cabotegravir + rilpivirine versus continuing bictegravir/emtricitabine/tenofovir alafenamide in virologically suppressed adults with HIV, 12 month results (SOLAR): A randomised open-label, phase 3b non-inferiority trial. The Lancet HIV. 2023. Published Online 8th August 2023. 
  4. EDURANT Summary of Product Characteristics. Janssen.
  5. Antzelevitch C, Sun ZQ, Zhang ZQ, et al. Cellular and ionic mechanisms underlying erythromycin-induced long QT intervals and torsade de pointes. J Am Coll Cardiol. 1996;28(7):1836−1848.
  6. Vieweg WVR, Hancox JC, Hasnain M, et al. Clarithromycin QTc interval prolongation and torsades de pointes: the need to study case reports. Ther Adv Infect Dis. 2013;1(4):121−138.

REKAMBYS (rilpivirine long-acting injection), including the trademark, is owned by the Janssen Pharmaceutical Companies and used under license by the ViiV Healthcare group of companies. All other trademarks are owned by the ViiV Healthcare group.

PM-GB-CBR-WCNT-240002 | February 2024

Prescribing Information

Adverse event reporting

Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard or search for MHRA Yellowcard in the Google Play or Apple App store. Adverse events should also be reported to GlaxoSmithKline on 0800 221441.

If you are from outside the UK, you can report adverse events to GSK/ViiV by selecting your region and market, here.