Key takeaways
- Common side effects: Most people receiving Cabenuva (cabotegravir) experience injection site reactions, such as pain, swelling, or discoloration. These reactions typically resolve within a few days. Other common but mild side effects include fever, fatigue, headache, and nausea.
- Serious side effects require medical attention: Although rare, Cabenuva can cause serious issues, including liver problems, severe allergic reactions, and postinjection reactions (like trouble breathing or dizziness) that usually occur within minutes of treatment.
- Mental health effects: Some people report mood changes, depression, or suicidal thoughts while receiving Cabenuva injections. It is important to talk with your doctor immediately if you notice any new or worsening mental health symptoms.
Cabenuva (cabotegravir/rilpivirine) is a prescription drug used to treat HIV in certain adults and children.
Cabenuva comes as a liquid suspension (a type of liquid mixture) that’s injected into your gluteal (butt) muscle by a healthcare professional. Cabenuva contains two active ingredients — cabotegravir and rilpivirine — which are given as two separate injections.
Keep reading to learn about the common, mild, and serious side effects Cabenuva can cause.
Some people may experience mild to serious side effects during Cabenuva treatment. Here are a few examples of the drug’s commonly reported side effects:
- injection site reactions*
- fever
- fatigue
- headache
- muscle or joint pain
* To learn more about this side effect, see the “Side effects explained” section.
Mild side effects have been reported with Cabenuva. These include:
- nausea
- headache
- dizziness
- insomnia
- 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 Cabenuva treatment unless your doctor recommends it.
Cabenuva may cause mild side effects other than those listed in the article previously. See the drug’s prescribing information for details.
* To learn more about this side effect, see the “Side effects explained” section.
Serious side effects have been reported with Cabenuva. These include:
- depression or other mood changes
- liver problems
- postinjection reaction*
- severe allergic reaction*
If you develop serious side effects during Cabenuva treatment, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.
* To learn more about this side effect, see the “Side effects explained” section.
Experiencing side effects? After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you develop a side effect while taking this drug and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.
Yes, Cabenuva may cause long-term side effects. “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 include 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 from 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 or discoloration
- itchiness
- pain or tenderness
- hardened lump
What might help
If you have an injection site reaction during Cabenuva treatment, these tips may help relieve your symptoms:
- Apply ice to the site before and after the injection (for no longer than 15 minutes at a time),
- Ask for a prescription numbing cream to apply to the site before receiving the injection.
- Take acetaminophen (Tylenol) to help relieve pain from the injection.
- Avoid 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.
Postinjection reaction
Some people may have a postinjection 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.
After receiving your injection, you’ll be observed for about 10 minutes to check for a reaction. If one occurs, it can be managed immediately.
Postinjection reactions may cause symptoms such as:
- difficulty 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
Your doctor will have medications on hand to treat low blood pressure, breathing difficulties, and pain in the event you experience a postinjection reaction during Cabenuva treatment. If you have concerns about the risk of a postinjection 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 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 to 8 weeks after starting Cabenuva treatment. Symptoms to look for include:
- widespread body rash
- swollen lymph nodes
- high fever
- facial swelling
There have also been rare reports of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
SJS is a rare and extremely serious condition that causes your skin to come loose and detach.
TEN is also a rare and serious skin condition that causes severe peeling and blistering which progresses quickly. It causes large raw areas that may ooze or weep and can also affect the mucous membranes — including the mouth, throat, eyes, and genital region.
DRESS, SJS, and TEN are all life threatening emergencies that require immediate medical care.
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 diphenhydramine (Benadryl)
- 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 treatment.
If you have symptoms of a severe allergic reaction, such as swelling, difficulty breathing, serious skin rash, or fever, 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 a new drug or combination of treatments.
Your side effect notes can include things such as:
- what dose of the drug you were receiving 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
Sharing notes 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.
Cabenuva can sometimes cause harmful effects in people with certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether this drug 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 hepatitis C
- taking other prescription or over-the-counter medications, herbs, vitamins, or supplements especially:
- kidney problems
- history of mental health conditions, especially depression or suicidal thoughts
- previous allergic reaction to Cabenuva
- regular alcohol consumption
- pregnancy or 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 or chat at 988lifeline.org. Caring counselors are available to listen and provide free and confidential support 24/7.
- Text HOME to the Crisis Text Line at 741741 to connect with a volunteer crisis counselor for free and confidential support 24/7.
- 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’re not in the same household, stay on the phone with them until help arrives.
Cabenuva and Biktarvy (bictegravir sodium/emtricitabine/tenofovir alafenamide) are both used to treat HIV. Biktarvy comes as an oral tablet taken once daily, while Cabenuva is given as an intramuscular injection every 1 to 2 months.
The following table 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 problems 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 • postinjection reaction • severe allergic reaction |
To learn more about how these drugs compare, talk with your doctor.
More resources on Cabenuva
For a comprehensive look at Cabenuva, check out these articles:
- Cabenuva Overview: Side Effects, Uses, Dosage, and More
- Cabenuva: Pregnancy and Breastfeeding Information
- Cabenuva Interactions: Alcohol, Medications, and Others
- Dosage Details for Cabenuva
- Cabenuva Cost 2026: Savings Tips and More
More resources on Biktarvy
For a a detailed overview of Biktarvy, take a look at these articles:
Like most drugs, Cabenuva can cause side effects that range from mild to serious — but most are temporary and go away after a few days to weeks. If you have questions about side effects Cabenuva can cause, talk with your doctor.
Examples of questions to help get you started include:
- Does Cabenuva cause weight gain?
- How long do side effects of Cabenuva usually last?
- Do Cabenuva injections cause permanent muscle damage and long lasting pain?
- Can I develop drug resistance to Cabenuva?
Disclaimer: While Healthline strives for factual, comprehensive, and current information, this article is not a substitute for a licensed healthcare professional’s expertise. Always consult a doctor before taking or discontinuing any medication. Drug information is subject to change and may not cover all uses, directions, precautions, warnings, interactions, reactions, or adverse effects. The lack of a warning does not guarantee a drug’s safety, effectiveness, or appropriateness for all patients or specific uses. Learn more about our approach to content integrity.