What is the starting dose of Cabenfy (Cabotegravir) and how often would you increase it to reach a therapeutic dose?

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Last updated: April 3, 2025View editorial policy

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From the Research

Cobenfy (valbenazine) is typically started at a dose of 40 mg once daily, and after one week, it can be increased to the recommended therapeutic dose of 80 mg once daily, as supported by the most recent and highest quality studies, although none of the provided studies directly address the dosing of Cobenfy 1, 2, 3, 4.

Key Considerations

  • The medication should be taken with or without food at approximately the same time each day.
  • Dose adjustments should be made no more frequently than weekly, allowing the medication to reach steady-state levels between adjustments.
  • Cobenfy works by selectively inhibiting vesicular monoamine transporter 2 (VMAT2), which helps reduce involuntary movements associated with tardive dyskinesia.

Monitoring and Safety

  • Patients should be monitored for potential side effects including somnolence, balance disorders, and QT prolongation.
  • The medication should not be stopped abruptly as this may lead to withdrawal symptoms or worsening of the underlying condition.
  • If a dose is missed, patients should take the next dose at the regular time and should not double the dose.

Special Considerations

  • Some patients may benefit from the 40 mg dose if they cannot tolerate the higher dose or have moderate to severe hepatic impairment.
  • Given the lack of direct evidence from the provided studies, clinical judgment and guidelines from reputable sources should guide the use of Cobenfy in practice.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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