Interaction Checker
Potential Weak Interaction
Cabotegravir/rilpivirine [long acting] (CAB/RPV LA)
Darunavir + ritonavir (DRV/r)
Quality of Evidence: Very Low
Summary:
Cabenuva (cabotegravir LA, rilpivirine LA) is indicated for use as a complete regimen for the treatment of HIV-1 infection. However, in specific clinical situations where an intensification of HIV treatment is needed, coadministration with darunavir/ritonavir would be possible from a pharmacokinetic standpoint. Cabotegravir is mainly metabolized by UGT1A1 and to a lesser extent by UGT1A9. Induction of UGTs by ritonavir used to boost darunavir is unlikely to cause a clinically relevant decrease of cabotegravir exposure based on drug-drug interaction studies with rifabutin, another moderate inducer. Coadministration of oral rilpivirine (150 mg once daily) and darunavir/ritonavir (800/100 mg once daily) was studied in 14 subjects. Rilpivirine Cmax increased by 79% and AUC and Cmin increased by 130% and 178%, respectively. Darunavir Cmax, AUC and Cmin decreased by 10%, 11% and 11%, respectively. [Note: this interaction study has been performed with a dose higher than the licensed dose for rilpivirine assessing the maximal effect on the co-administered drug]. No dose adjustment of rilpivirine is required. 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.
Description:
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