Cabenuva Interactions: Alcohol, Medications, and Others

Does Cabenuva interact with other drugs?

Before you start using Cabenuva, tell your doctor and pharmacist about any prescription, over-the-counter, or other drugs you take. Sharing this information with them may help prevent possible interactions.

The following table lists drugs that may interact with Cabenuva. Keep in mind that this table does not include all drugs that may interact with Cabenuva. For more information about some of these interactions, see the “Drug interactions explained” section.

If you have questions about drug interactions that may affect you, talk with your doctor or pharmacist.

Are there other interactions with Cabenuva?

Cabenuva can interact with certain supplements and foods. Below is a list of common substances and whether they interact with Cabenuva.

Note: Although vitamins, alcohol, vaccines, and lab tests have not been reported to interact with Cabenuva, more interactions may be reported in the future.

Before you start a new medication or supplement, be sure to tell your doctor or pharmacist about all medications you currently take. They’ll let you know about any interactions you need to be aware of.

When should I avoid Cabenuva?

Certain health conditions or other factors could raise your risk of harm if you take Cabenuva. In such cases, your doctor may not prescribe Cabenuva for you. These are known as contraindications. The contraindications of Cabenuva are:

If you take certain medications or the supplement St. John’s wort: Certain products can decrease the level of Cabenuva in your body, making it less effective. These include:

• the seizure medications carbamazepine (Tegretol, others), oxcarbazepine (Trileptal), phenytoin (Dilantin), and phenobarbital
• the antibiotic medications rifampin (Rimactane), rifabutin, and rifapentine (Priftin)
• the corticosteroid medication dexamethasone, except for dexamethasone as a single-dose treatment
• the herbal supplement St. John’s wort, which helps manage symptoms of depression

Making Cabenuva less effective can cause HIV to become resistant to Cabenuva. This means the drug will no longer work to treat HIV. Due to this risk, your doctor won’t prescribe Cabenuva with any of the products listed above. They can advise you on alternatives to Cabenuva or the other products.

If you’ve had an allergic reaction: If you’ve ever had an allergic reaction to Cabenuva or any of its ingredients, your doctor likely won’t prescribe Cabenuva for you. This is because receiving the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better options for you.

Before you start using Cabenuva, talk with your doctor if any of the factors mentioned here apply to you. Your doctor can determine whether Cabenuva is safe for you to take.

Drug interactions explained

Learn more about certain drug interactions that can occur with Cabenuva.

Interaction with certain antidepressants

Cabenuva can interact with certain antidepressants. These are prescribed to help treat depression and certain other mental health conditions.

Cabenuva can cause long QT syndrome as a side effect. Antidepressants also can cause this side effect. So using these medications together can raise this risk further.

Some antidepressants that may interact with Cabenuva are:

• citalopram (Celexa)
• fluoxetine (Prozac)
• amitriptyline
• venlafaxine (Effexor XR)
• mirtazapine (Remeron)

What you can do

If you use Cabenuva with an antidepressant that can cause long QT syndrome, your doctor may adjust your antidepressant dosage. They’ll usually prescribe a dosage of the antidepressant that’s lower than usual. You should not take a dose of either medication higher than what your doctor prescribes.

Or if you’re prescribed Cabenuva, your doctor might discuss switching to an antidepressant that doesn’t cause long QT syndrome.

Your doctor may order certain tests if you use Cabenuva and an antidepressant that causes long QT syndrome together. They’ll likely test your heart rhythm regularly with an electrocardiogram (EKG). An EKG can detect changes to your heart rhythm.

Long QT typically doesn’t cause symptoms. But in rare cases, you could feel symptoms like fainting for no apparent reason or a fluttering feeling in your chest. If you have these symptoms, notify your doctor immediately.

Interaction with certain antipsychotic medications

Cabenuva can interact with certain antipsychotics. These are prescribed for certain mental health conditions, such as schizophrenia. Some are also used for other purposes, including to treat nausea and vomiting caused by chemotherapy.

Cabenuva and certain antipsychotics can cause long QT syndrome as a side effect when used on their own. But when used together, this risk may increase.

Some antipsychotic medications that may interact with Cabenuva are:

• thioridazine
• ziprasidone (Geodon)
• chlorpromazine
• paliperidone (Invega)
• quetiapine (Seroquel)

What you can do

If you use Cabenuva with an antipsychotic that can cause long QT syndrome, your doctor may adjust your antipsychotic dosage. They may prescribe a dosage that’s lower than usual. You should not take a dose of either medication that’s higher than what your doctor prescribes.

It’s likely that they’ll also order an electrocardiogram (EKG) to be performed regularly throughout treatment. An EKG will monitor and detect changes to your heart rhythm.

Long QT syndrome typically doesn’t cause symptoms. But in rare cases, you could feel symptoms such as fainting for no apparent reason or a fluttering feeling in your chest. If you have these symptoms, notify your doctor immediately.

Your doctor might discuss switching to an antipsychotic that doesn’t cause long QT syndrome if you’re prescribed Cabenuva. While most antipsychotics have some risk of causing long QT syndrome, the risk varies with individual medications.

Interaction with lithium

Cabenuva can interact with lithium, which is prescribed to treat bipolar disorder.

Cabenuva can cause long QT syndrome as a side effect. Lithium also can cause this side effect if blood levels of the medication become too high. Using Cabenuva and lithium together may raise your risk of long QT syndrome.

What you can do

If you use Cabenuva with lithium, your doctor may prescribe a dosage of lithium that’s lower than usual. Your doctor also may check the level of lithium in your blood frequently. With or without Cabenuva, doctors usually order periodic tests to check the level of lithium in the blood. This is because a level of lithium in the blood that’s too high can cause lithium toxicity.

Lithium is a narrow therapeutic index medication. This means the medication has a narrow window between an effective level and a harmful level in the body. Checking it periodically helps your doctor know whether lithium is at an effective level. If the level is too low or too high, they can adjust your lithium dosage. Lithium is unlikely to cause long QT syndrome when levels are below the harmful range.

If you have questions about using Cabenuva with lithium, talk with your doctor or pharmacist.

Does my health history affect whether I should use Cabenuva?

Certain medical conditions or other health factors may raise the risk of interactions with Cabenuva. Before using Cabenuva, talk with your doctor about your health history. They’ll determine whether Cabenuva is right for you.

Health conditions or other factors that might interact with Cabenuva include:

Liver condition: Liver damage has been reported as a side effect of Cabenuva. If you have a liver condition such as fatty liver, Cabenuva could worsen it. You also may be at higher risk of new liver side effects. If your doctor prescribes Cabenuva to you, they’ll likely want to order liver function tests frequently. This will allow them to check the health of your liver throughout treatment.

Depression or suicidal thoughts: Depression and suicidal thoughts and behaviors are known side effects of Cabenuva. If you have depression or other mental health conditions, let your doctor know. Then before prescribing Cabenuva, your doctor will discuss the risks and benefits of treatment with you. During Cabenuva treatment, if you experience new or worsening mental health symptoms, notify your doctor immediately.

Severe kidney condition: If you have a severe kidney condition, your doctor may want to monitor you closely for Cabenuva side effects if they prescribe the medication to you. This includes end stage renal (kidney) disease. Your body relies on your kidneys to remove Cabenuva, but a severe kidney condition can impair this action. This can increase the amount of Cabenuva in your body, which raises the risk of side effects.

Pregnancy: It’s not known whether Cabenuva is safe to use during pregnancy. If you’re pregnant or may become pregnant, talk with your doctor before using Cabenuva.

If you do use Cabenuva while pregnant, consider enrolling in the drug’s pregnancy registry. This registry collects details about pregnancy issues reported with Cabenuva. To learn more, call 800-258-4263 or talk with your doctor.

Breastfeeding: If you’re breastfeeding or planning to breastfeed, talk with your doctor about your options. The chance of transferring HIV through breast milk is very small, even if your viral load isn’t detectable. Still, Cabenuva is known to appear in breast milk for 12 months or longer following the final Cabenuva injection. But it isn’t known whether Cabenuva causes side effects in a child who’s breastfed.

Allergic reaction: If you’ve ever had an allergic reaction to Cabenuva or any of its ingredients, your doctor likely won’t prescribe Cabenuva. This is because using the drug could cause another allergic reaction. You can ask your doctor about other treatments that may be better for you.

How can I prevent interactions?

Taking certain steps can help you avoid interactions with Cabenuva. Before starting treatment, talk with your doctor and pharmacist. Things to discuss with them include:

• whether you drink alcohol or use cannabis
• the list of medications you take, as well as any vitamins, supplements, and herbs
• what to do if you start taking a new drug during your Cabenuva treatment

It’s also important to understand Cabenuva’s label and other paperwork that may come with the drug. Colored stickers that describe interactions may be on the label. The paperwork, sometimes called the patient package insert or medication guide, may have other details about interactions.

If you did not get paperwork with Cabenuva, ask your pharmacist to print a copy for you. If you have difficulty reading or understanding this information, your doctor or pharmacist can help.

Using Cabenuva exactly as prescribed also can help prevent interactions.

What’s next?

Navigating your HIV treatment is a team effort, and your care team is there to help prevent medication interactions. It’s important to keep them in the loop before starting anything new, so they can ensure Cabenuva continues to work at its best for you.

• Share your routine: Give your doctor and pharmacist a quick, up-to-date list of all your daily prescriptions, over-the-counter drugs, and supplements.
• Check before you add: Run any new herbal supplements by your pharmacist just to make sure they won’t interfere with your treatment.
• Trust your body: Let your doctor know if you notice anything unusual, like a fluttering heartbeat or new symptoms that just don’t feel right. These could be side effects of Cabenuva.