Lenacapavir is a long-acting medicine used to treat and prevent HIV-1. It works by blocking the HIV capsid, which is the outer shell of the virus that helps it grow and spread in the body. By targeting this shell, lenacapavir stops the virus from completing several important steps in its life cycle.
This medicine is given as an injection under the skin every six months. In the United States, it is sold under the name Sunlenca for treatment and Yeztugo for prevention. It is especially useful for people who have HIV that doesn’t respond well to other treatments or for those who have trouble taking daily pills.
Studies have shown that lenacapavir is very effective both in treating HIV and in preventing it. Because it only needs to be taken twice a year, it’s a helpful option for people who want a long-acting, low-maintenance approach to managing or preventing HIV.
Common indications
Lenacapavir is approved by the FDA for two main uses:
- Treating HIV-1 in adults who have tried several other medicines that didn’t work well. It is used along with other HIV medicines (brand name: Sunlenca)
- Preventing HIV infection (PrEP) in adults and teenagers who are at risk of getting HIV (brand name: Yeztugo)
It is most often used when other treatment plans haven’t worked or when people prefer a long-acting injection instead of taking pills every day.
How to take and dosing
Dosing for lenacapavir depends on whether the patient is treating or preventing HIV.
For treatment (Sunlenca)
Lenacapavir treatment starts with pills followed by injections:
- Oral phase: 600 mg on Day 1 and again on Day 2
- Injection: 927 mg subcutaneously (under the skin) on Day 15, then every 6 months
It must be taken with other HIV medications.
For prevention (Yeztugo)
Lenacapavir for HIV prevention involves:
- One 927 mg injection subcutaneously (under the skin) every 6 months
- No pills needed before the shot
Lenacapavir is given at a clinic by a healthcare provider. This helps people stick to their treatment and reduces the need to remember pills every day. It may be especially useful for:
- People who have trouble taking medicine daily
- People who travel often
- People who want a more private or discreet way to take HIV medication
A healthcare provider can help decide if lenacapavir is a good choice.
Side effects
The most frequently reported side effects include pain, redness, or swelling where the shot was given, as well as nausea, headaches and diarrhea. These side effects are usually mild and go away on their own.
Less common but more serious side effects include liver problems (shown by changes in blood tests, kidney function changes, and allergic reactions (which are rare).
Contraindications
Lenacapavir should not be used by people who are allergic to the drug or its ingredients, or take medications that strongly reduce its levels in the body (like some antibiotics or seizure drugs. Your doctor should check all your medications before starting lenacapavir.
Some medicines can lower the amount of lenacapavir in your body and make it less effective. These include drugs that affect liver enzymes such as CYP3A, P-gp, and UGT1A1. Examples include rifampin and carbamazepine.
Always let your doctor know about all the medicines and supplements you’re using