Cabenuva (cabotegravir LA, rilpivirine LA) and Biktarvy (bictegravir, emtricitabine, tenofovir alafenamide) are indicated for use as complete regimens for the treatment of HIV 1 infection and should not be administered with other antiretroviral products. Furthermore, coadministering two integrase inhibitors (i.e., cabotegravir and bictegravir) is unlikely to be of clinical benefit. Residual concentrations of cabotegravir and rilpivirine may remain in the systemic circulation of patients for a prolonged period after discontinuation of intramuscular cabotegravir/rilpivirine but are not expected to affect exposure of antiretroviral drugs.

Coadministration has not been studied but based on metabolism and clearance a clinically significant interaction is unlikely. Studies have shown no evidence that bictegravir solubility is impacted by changes in pH and therefore can be coadministered with PPIs or H2-antagonists without dose adjustment or separation. Emtricitabine and tenofovir alafenamide are not impacted by pantoprazole.