Administering Apretude (Cabotegravir) Injection
For Apretude (cabotegravir) injections, use a 23-gauge, 1.5-inch needle for intramuscular administration into the gluteal muscle. 1
Injection Preparation and Administration
Needle Selection and Equipment
- Use a 23-gauge, 1.5-inch needle for optimal delivery into the gluteal muscle
- Prepare a 3 mL syringe to accommodate the full 600 mg (3 mL) dose
- Ensure proper aseptic technique with alcohol swabs for skin preparation
Injection Site
- Administer as a deep intramuscular injection into the gluteal muscle only
- Choose the ventrogluteal site (upper outer quadrant of the buttock)
- Avoid areas with gluteal implants or fillers 1
- Rotate injection sites between left and right gluteal muscles for subsequent doses
Administration Technique
- Prepare the injection site by cleansing with an alcohol swab
- Allow the site to dry completely before injection
- Insert the needle at a 90-degree angle to ensure proper intramuscular placement
- Aspirate to check for blood return (if blood appears, withdraw and use a new needle at a different site)
- Inject the medication slowly to minimize discomfort
- Apply gentle pressure with gauze after removing the needle
Dosing Schedule
- Initial dose: 600 mg (3 mL) administered as gluteal intramuscular injection
- Second dose: 4 weeks after the first injection
- Maintenance doses: Every 8 weeks thereafter 1
Important Considerations
- Confirm HIV-negative status before each injection using both rapid point-of-care and laboratory-based tests 1
- Monitor for injection site reactions, which are common (reported in 81.4% of patients) 2
- Manage injection site reactions with topical/systemic analgesics and hot/cold packs 1
- The medication may persist in the body for up to 12 months after the last injection 1
Patient Monitoring
- Perform HIV testing at each injection visit 1
- Conduct STI screening every 4 months (every second injection) 1
- Monitor liver function tests every 6 months 1
Common Pitfalls to Avoid
- Using too small a needle gauge or length, which may result in improper medication delivery
- Injecting into subcutaneous tissue rather than muscle, which can affect drug absorption
- Failing to rotate injection sites between left and right gluteal muscles
- Not confirming HIV-negative status before administration
- Inadequate monitoring for injection site reactions, which are very common
Despite injection site reactions being common, studies show that most patients (75%) report satisfaction with cabotegravir long-acting injections and 79% are willing to continue with this form of HIV prevention 3.