Vocabria (Cabotegravir)
Pronunciation: kab-oh-TEG-ruh-veer.
- Generic name
- cabotegravir
- Drug class
- HIV-1 integrase strand transfer inhibitor (INSTI)
- Form
- Film-coated tablet, 30 mg
- Route
- Oral (tablet); a separate long-acting intramuscular injectable form of cabotegravir also exists under the same Vocabria brand in some markets and, combined with rilpivirine, as Cabenuva
- Legal status
- Prescription-only in all markets where authorised (US, UK, EU, Canada, Australia confirmed; New Zealand unable to verify).
Availability and supply rules vary by country
Trade names by country: United States
Australia: · Full directory
What cabotegravir is and how it works
Vocabria is the brand name for oral cabotegravir tablets, an HIV-1 integrase inhibitor. It is not used on its own as a long-term regimen -- it is a short-term (about 1 month) oral lead-in tablet used before starting one of two different long-acting injectable regimens: Cabenuva (for ongoing HIV-1 treatment) or Apretude (for HIV-1 prevention/PrEP). (1) (2)
It is important to know exactly which pathway you are on, because the two are genuinely different: if your HIV-1 infection is already under control and you are moving toward Cabenuva injections, Vocabria is taken together with rilpivirine; if you do not have HIV and are starting PrEP to reduce your risk before Apretude injections, Vocabria is taken alone, and you must be confirmed HIV-negative first (using it for PrEP with an undiagnosed HIV-1 infection carries a real, serious risk of the virus becoming resistant to this whole class of medicine -- this is specifically why Apretude, the injectable PrEP product, carries its own FDA boxed warning). Across all cabotegravir products, real safety features to know about include possible liver problems, serious allergic/skin reactions, and mood changes including depression, so regular monitoring and prompt reporting of new symptoms matters. If you ever move to the long-acting injectable form (Cabenuva or Apretude), be aware that the drug can remain in your body at low levels for 12 months or longer after your last injection -- a real, genuine consideration for HIV-risk reduction planning during that time, which your care team will discuss with you.
Mechanism of action: how cabotegravir works
Cabotegravir is an HIV-1 integrase strand transfer inhibitor (INSTI) that blocks the strand-transfer step of retroviral DNA integration into host-cell DNA, preventing HIV-1 replication. It is structurally related to dolutegravir. The oral tablet is used only as a short-term lead-in to assess individual tolerability before starting the corresponding long-acting injectable formulation. (1)
What cabotegravir is used for
Oral lead-in for HIV-1 treatment (with rilpivirine)
Used together with rilpivirine (Edurant) tablets, for about 1 month, before starting Cabenuva long-acting injections, in adults and adolescents (12+, at least 35 kg) whose HIV-1 infection is already virologically suppressed on other antiretroviral treatment. Can also be used to bridge a missed Cabenuva injection visit. (1) (5)
Oral lead-in for HIV-1 PrEP (alone)
Used alone, for about 1 month, before starting Apretude long-acting injections, in HIV-negative adults and adolescents (12+, at least 35 kg) at risk of sexually acquired HIV-1 infection. Can also be used to bridge a missed Apretude injection visit. Requires confirmed HIV-negative status before starting. (1)
Before taking cabotegravir
Do not take / not appropriate for
- Do not take if you have a known hypersensitivity (allergic) reaction to cabotegravir. (all countries) (1)
- Do not take together with carbamazepine, oxcarbazepine, phenobarbital, phenytoin, rifampin, or rifapentine -- these reduce cabotegravir levels significantly. (all countries) (1)
- If using it for PrEP: do not start (or continue) unless you have a confirmed, current negative HIV-1 test -- using it for PrEP with an undiagnosed HIV-1 infection carries a real risk of the virus developing resistance to this whole medicine class. (all countries) (2)
Tell your clinician about
- Which pathway you are on -- HIV-1 treatment (with rilpivirine, heading to Cabenuva) or HIV-1 PrEP (alone, heading to Apretude) -- since the medicines you combine it with and the pre-conditions differ.
- Any history of liver problems, or hepatitis B or C infection.
- Any history of depression, anxiety, or other mental health conditions, since mood changes including depression have been reported.
- Any past allergic reaction to cabotegravir or a severe skin reaction to any medicine.
- All other medicines you take, especially rifamycin antibiotics or anticonvulsants, which can reduce cabotegravir's effectiveness.
- If you are pregnant, planning pregnancy, or breastfeeding.
How to take cabotegravir
- Take one tablet once daily, with a meal, for about 1 month (at least 28 days) as directed by your clinician.
- If you are on the HIV-1 treatment pathway, take it together with your rilpivirine (Edurant) tablet at the same time each day.
- If you are on the PrEP pathway, take it alone, exactly as prescribed.
- This oral lead-in phase is used specifically to check you tolerate cabotegravir well before starting the corresponding long-acting injection (Cabenuva or Apretude).
- Do not stop or change how you take this medicine without talking to your clinician first -- this is especially important for the HIV-1 treatment pathway, where interrupting therapy can allow the virus to become active again and raises the risk of drug resistance.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3) (4) (5) (6) (7)
Missed dose
Take a missed dose as soon as you remember on the same day, then continue your normal schedule -- do not take an extra dose. Because this lead-in phase is time-limited and precedes an injection, contact your clinic promptly about any missed doses so your injection start date can be adjusted appropriately.
Overdose
There is no specific antidote for cabotegravir overdose. If an overdose is suspected, contact a doctor or poison control centre promptly; treatment is supportive and symptom-directed. (1)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms.
Headache.
What to notice: Headache.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Nausea.
What to notice: Nausea.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Diarrhoea.
What to notice: Diarrhoea.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Sleep disturbance or insomnia.
What to notice: Sleep disturbance or insomnia.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Fatigue.
What to notice: Fatigue.
What to do: Discuss persistent or troublesome symptoms with the treating clinician or pharmacist. (1)
Serious warnings
Liver problems (hepatotoxicity) — high caution
Symptoms: Yellowing of the skin or eyes (jaundice), dark urine, severe tiredness, loss of appetite, nausea, or pain in the upper right abdomen.
Action: Report these symptoms to your clinician promptly. Liver function is monitored during treatment, and cabotegravir should be evaluated for discontinuation if hepatotoxicity is suspected. (1)
Serious allergic/skin reactions — emergency
Symptoms: Severe rash, blistering or peeling skin, fever, swelling of the face/lips/tongue, or difficulty breathing -- these can be signs of a severe reaction such as Stevens-Johnson syndrome or toxic epidermal necrolysis.
Action: Seek emergency medical help immediately, and let the treating team decide on further doses. These are rare but serious, reported reactions with cabotegravir. (1) (2)
Depressive disorders — high caution
Symptoms: Low mood, depression, mood swings, or thoughts of self-harm or suicide.
Action: Tell a clinician promptly, or seek urgent mental health support, if these occur. Depressive disorders including suicidal ideation and suicide attempts have been reported with cabotegravir. (1)
HIV-1 drug resistance risk (PrEP pathway with undiagnosed infection) — high caution
Symptoms: Not applicable as a spontaneous symptom -- this is a pre-treatment testing requirement.
Action: You must have a confirmed negative HIV-1 test before starting or continuing on the PrEP pathway. Using cabotegravir for PrEP while unknowingly HIV-positive has led to drug-resistant virus in real cases -- this is why Apretude (the injectable PrEP product) carries its own FDA boxed warning on this exact risk. (2)
Long-acting injectable drug-level 'tail' (relevant if you transition to Cabenuva or Apretude injections) — high caution
Symptoms: Not applicable as a spontaneous symptom -- this is a pharmacokinetic/planning consideration.
Action: If you later move to the injectable form and then stop it, cabotegravir can remain in your body at low levels for 12 months or longer. During this tail period, drug levels may be too low to fully protect against HIV or fully suppress it, yet still high enough to encourage the virus to become drug-resistant if exposure or rebound occurs. Your clinician will discuss a follow-on plan (such as switching to another effective oral medicine) to cover this window. (2) (3)
Interactions
- Carbamazepine, oxcarbazepine, phenobarbital, phenytoin, rifampin, rifapentine: contraindicated -- these significantly reduce cabotegravir blood levels. (1)
- Rifabutin: contraindicated when used for the HIV-1 treatment pathway (with rilpivirine); may be used with dose modification on the PrEP pathway -- discuss with your clinician, since the two pathways are handled differently. (1)
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
Discuss with your clinician; cabotegravir may be used in pregnancy under specialist guidance depending on the clinical situation, and pregnancy status/plans should always be discussed before starting either pathway. (1) (2) (3) (4) (5) (6) (7)
Breastfeeding
Discuss with your clinician, since specific guidance depends on your HIV status and country breastfeeding recommendations for people with or at risk of HIV. (1) (2) (3) (4) (5) (6) (7)
Children
Authorised in adolescents 12 years and older weighing at least 35 kg in the markets reviewed (US, UK, EU); not established below this age/weight threshold. (1) (2) (3) (4) (5) (6) (7)
Elderly
No specific age-based dose adjustment described in the sources reviewed for this dossier. (1) (2) (3) (4) (5) (6) (7)
Hepatic_impairment
Use with caution given the real hepatotoxicity risk; liver function monitoring recommended, particularly on the treatment pathway. (1) (2) (3) (4) (5) (6) (7)
Renal_impairment
No specific renal dose adjustment described in the sources reviewed for this dossier. (1) (2) (3) (4) (5) (6) (7)
Source_ids
Monitoring
Before starting
- Confirm HIV-1 status matches the intended pathway (virologically suppressed for treatment; confirmed negative for PrEP).
- Baseline liver function tests.
- Review of medicines for the contraindicated anticonvulsant/rifamycin interactions.
- Mental health history review given the depressive-disorder risk.
During treatment
- Periodic HIV-1 testing (especially on the PrEP pathway, to catch any breakthrough infection early).
- Liver function monitoring.
- Screening for new mood changes or depressive symptoms.
- Confirmation of tolerability before transitioning to the corresponding long-acting injection.
Storage
Store at controlled room temperature as directed on the product label, out of reach of children.
Professional information
Clinician-facing context only, sourced from the current US FDA/DailyMed prescribing information for Vocabria and Apretude, UK EMC SmPC, EU EMA's centralised EPAR, Health Canada's DIN/product database, and Australia's TGA ARTG/AusPAR reviewed for this dossier; verify against the current full label before prescribing.
United States, United Kingdom, European Union, Canada, Australia
Indication: HIV-1 treatment oral lead-in (with rilpivirine) / HIV-1 PrEP oral lead-in (alone)
Dose summary: 30 mg once daily with a meal for approximately 1 month (at least 28 days), then transition to the corresponding long-acting injectable (Cabenuva for treatment, Apretude for PrEP).
Renal context: No specific renal dose adjustment described in the sources reviewed. (1)
Hepatic guidance
Use with caution in hepatic impairment given the real, reported hepatotoxicity risk; monitor liver chemistries.
Overdose note
No specific antidote identified in the sources reviewed; manage supportively. (1)
Frequently asked questions
What is the difference between Vocabria, Cabenuva, and Apretude?
All three contain cabotegravir, but they are genuinely different products with different roles. Vocabria (this page) is the oral tablet, used only as a short-term (about 1 month) lead-in -- either with rilpivirine, before starting Cabenuva injections for ongoing HIV-1 treatment, or alone, before starting Apretude injections for HIV-1 PrEP (prevention). Cabenuva is the long-acting injectable combination of cabotegravir and rilpivirine used for ongoing HIV-1 treatment. Apretude is the long-acting injectable of cabotegravir alone, used only for HIV-1 PrEP -- and it carries its own FDA boxed warning about drug-resistance risk if used in someone with an undiagnosed HIV-1 infection, a warning that Vocabria's own oral-tablet label does not carry. (1) (2)
Is Vocabria available in the US, UK, EU, Canada, Australia, and New Zealand?
It is confirmed authorised in the US, UK, EU (via a genuine EU-wide centralised marketing authorisation, not just national authorisation), Canada, and Australia. Despite multiple direct search and Medsafe database attempts, this review could not locate a New Zealand Medsafe entry for Vocabria, Apretude, or cabotegravir -- this is disclosed honestly as unable to verify, not assumed to mean it is unavailable. (1) (4) (5) (6) (7)
What is the 'tail' effect I've heard about with long-acting cabotegravir injections?
This applies to the long-acting injectable forms (Cabenuva and Apretude), not the Vocabria oral tablet itself. After the last injection, cabotegravir can remain detectable in the body at low levels for 12 months or longer. During that window, levels may be too low to reliably prevent or suppress HIV, but still high enough to encourage drug-resistant HIV to develop if you are exposed to the virus or experience a treatment gap during this period. This is a real, recognised consideration your care team plans for, often by switching you to another effective oral medicine to cover the tail period. (2) (3)
Does Vocabria carry a boxed warning?
No -- Vocabria's own oral-tablet FDA prescribing information does not carry a boxed warning. This is a genuine, real distinction from Apretude (the separate injectable PrEP-only product), which does carry an FDA boxed warning about the risk of drug-resistant HIV developing if it is used for PrEP in someone with an undiagnosed HIV-1 infection. (1) (2)
What is the mechanism of action of cabotegravir?
Cabotegravir is an HIV-1 integrase strand transfer inhibitor (INSTI) that blocks the strand-transfer step of retroviral DNA integration into host-cell DNA, preventing HIV-1 replication. It is structurally related to dolutegravir. The oral tablet is used only as a short-term lead-in to assess individual tolerability before starting the corresponding long-acting injectable formulation. (1)
References
- VOCABRIA (cabotegravir) tablets, for oral use -- full prescribing informationDailyMed (U.S. National Library of Medicine) / FDA-approved prescribing information · United States · accessed 2026-07-30 · source 1
- APRETUDE (cabotegravir extended-release injectable suspension) -- full prescribing informationDailyMed (U.S. National Library of Medicine) / FDA-approved prescribing information · United States · accessed 2026-07-30 · source 2
- The Long-Acting Cabotegravir Tail as an Implementation Challenge: Planning for Safe Discontinuationpeer-reviewed HIV/infectious-disease literature (PMC / peer-reviewed journal review) · international / clinical literature · accessed 2026-07-30 · source 3
- Vocabria 30 mg film-coated tablets / Vocabria 600 mg prolonged-release suspension for injection -- Summary of Product Characteristicselectronic medicines compendium (emc), United Kingdom -- Summary of Product Characteristics · United Kingdom · accessed 2026-07-30 · source 4
- Vocabria -- EPAR medicine overviewEuropean Medicines Agency (EMA) -- European Public Assessment Report (EPAR), centralised marketing authorisation · European Union · accessed 2026-07-30 · source 5
- VOCABRIA (cabotegravir) -- DIN 02497204, product monographHealth Canada -- Drug Product Database (DIN) / product monograph · Canada · accessed 2026-07-30 · source 6
- VOCABRIA cabotegravir (as sodium) 30 mg film-coated tablet -- ARTG entry 323721Therapeutic Goods Administration (TGA), Australia -- Australian Register of Therapeutic Goods (ARTG) and Australian Public Assessment Report (AusPAR) · Australia · accessed 2026-07-30 · source 7
Brand names by country
Single-ingredient cabotegravir names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Vocabria30 mg · viiv healthcare company