Lenacapavir

Lenacapavir, in combination with other antiretroviral(s), is indicated for the treatment of human immunodeficiency virus type 1 (HIV-1) infection in heavily treatment-experienced adults with multidrug resistant HIV-1 infection failing their current antiretroviral regimen due to resistance, intolerance, or safety considerations. After initiation, lenacapavir is administered by subcutaneous injection every 6 months.

ARV U.S. Brand Name

Sunlenca

ARV Abbreviation(s)

LEN

U.S. FDA Label

Label

ARV Class

Capsid inhibitors

First U.S. Approval

December 22, 2022

U.S. Manufacturer

Sunlenca website for US healthcare professionals (Gilead Sciences)

Formulations

Strength	Formulation	Description	Boosted
300 mg	Film-Coated Tablets	beige oval tablet	No
463.5 mg in 1.5 mL single dose vial	Subcutaneous Injection	Yellow liquid	No

Generic Available?

Other Reference Links

National HIV Curriculum

U.S. Guidelines Links

Lenacapavir information for patients

Adult dosing

2 x 300 mg tablets on days 1 and 2 during initiation phase only. If choosing initiation option 2, add 1 300 mg tablet on day 8. Film-Coated Tablets

2 x 1.5 mL injections. For initiation option 1, taken on day 1 and then every 6 months. For regimen option 2, taken on day 15 and then every 6 months. Subcutaneous Injection

See package insert for regimen initiation options and details.

Pediatric dosing

Assistance Programs

Gilead Advancing Access program

Displaying 1 - 100 of 106

	Interaction Color Code	Clinical Bottom Line	Clinical Effects	Drug 1 effect	Drug 2 dose	Drug 2 effect	Management
Lenacapavir Pitavastatin 1	Green: Administer standard doses	Administer standard doses	No clinically significant effect expected	Not reported	2 mg x 1 (with food), administered 3 days after LEN	AUC decreased 4%
Lenacapavir Midazolam 1	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential for increased sedation	Not reported	2.5 mg orally x 1 with food, administered 1 day after LEN	AUC increased 308%; Cmax increased 116%. AUC for 1-hydroxy metabolite decreased 16%.	If co-administering, monitor for excess sedation and adjust dose accordingly
Lenacapavir Zolpidem	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of excessive sedation				If coadministering, initiate lowest starting dose. Monitor for excessive sedation.
Lenacapavir Warfarin	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of bleeding				Use with caution. Monitor INR and for warfarin adverse effects (e.g. bleeding)
Lenacapavir Voriconazole	Green: Administer standard doses	Administer standard doses	No clinically significant effect expected	AUC increased 41%; Cmax increased 9%	400 mg BID x 2 days then 200 mg BID	Not reported
Lenacapavir Verapamil	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of verapamil adverse effects				If coadministering, monitor for cardiac medication adverse effects (e.g. hypotension)
Lenacapavir Vardenafil	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Increased risk of vardenafil adverse effects (e.g. flushing, headache, hypotension)				If co-administering vardenafil for erectile dysfunction, dose should not exceed 5 mg per 24 hour. Monitor for adverse effects.
Lenacapavir Ubrogepant	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of ubrogepant adverse effects				If coadministering, avoid taking a second dose of ubrogepant within 24 hours
Lenacapavir Triazolam	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Increased risk of triazolam adverse effects				If coadministering, monitor for triazolam adverse effects (e.g. sedation, respiratory depression).
Lenacapavir Triamcinolone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of corticosteroid adverse effects (e.g. Cushing's syndrome and adrenal supression).				If used for local injections, monitor for corticosteroid-related adverse effects (e.g. Cushing's syndrome, adrenal insufficiency).
Lenacapavir Trazodone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of trazodone adverse effects (e.g. sedation, CNS effects)				If coadministering start with lowest dose and titrate to clinical effect. Monitor for trazodone-related adverse events.
Lenacapavir Tramadol	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Increased risk of tramadol adverse effects				If coadministering, consider decreasing tramadol dose when coadministering. Titrate to clinical effect and monitor for sedation.
Lenacapavir Thioridazine	Yellow: Adjust dosing	Minimal data to guide interaction: risks likely to outweigh benefits	Potential loss of antiviral efficacy				Consider using alternative antipsychotic
Lenacapavir Tenofovir alafenamide	Green: Administer standard doses	Administer standard doses	No clinically significant effect expected	Not reported	25 mg x 1	TAF AUC increased 32%; Cmax increased 24%. TFV AUC increased 47%; Cmax increased 23%
Lenacapavir Tadalafil	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Increased risk of tadalafil adverse effects (e.g. flushing, headache, hypotension)				Pulmonary arterial hypertension: coadministration of lenacapavir with tadalafil is not recommended. Erectile dysfunction: When used on an "as needed" basis, tadalafil dose should not exceed 10 mg every 72 hours. If used once daily (chronic administration), tadalafil dose should not exceed 2.5 mg daily.
Lenacapavir Tacrolimus	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of immunosuppressant adverse effects				Initiate adjusted dose of immunosuppressant to account for increased concentration and follow up with therapeutic drug monitoring to refine dosing. Monitor for adverse effects of immunosuppressant. Consult with specialist as necessary.
Lenacapavir Suvorexant	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of excessive sedation				If coadministering, initiate dose at 5 mg daily. May increase to 10 mg daily if not effective. Monitor for excessive sedation.
Lenacapavir St. John's Wort	Red: Avoid combination	Do not coadminister: reduced levels of lenacapavir	Potential loss of antiviral efficacy				Contraindicated. Use alternative agents.
Lenacapavir Sirolimus	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of immunosuppressant adverse effects				Initiate adjusted dose of immunosuppressant to account for increased concentration and follow up with therapeutic drug monitoring to refine dosing. Monitor for adverse effects of immunosuppressant. Consult with specialist as necessary.
Lenacapavir Simvastatin	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Increased risk of simvastatin adverse effects				Initiate simvastatin with the lowest starting dose and titrate to clinical effect. Monitor for adverse effects of lovastatin (e.g. myopathy, elevated transaminases).
Lenacapavir Sildenafil	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Increased risk of sildenafil adverse effects (e.g. flushing, headache, hypotension).				Use of PDE-5 inhibitors for pulmonary arterial hypertension (PAH): Concomitant administration of SUNLENCA with tadalafil for the treatment of PAH is not recommended. Use of PDE-5 inhibitors for erectile dysfunction (ED): Refer to the prescribing information of sildenafil for dose recommendations. Use of PDE-5 inhibitors for pulmonary arterial hypertension (PAH): Do not coadminaster sildenafil with Lenacapavir. Use of PDE-5 inhibitors for erectile dysfunction (ED): Adjust dosing to avoid increased levels sildenafil
Lenacapavir Rosuvastatin	Green: Administer standard doses	Administer standard doses	Potential for increased rosuvastatin adverse effects (e.g. myalgias, increased transaminases)	Not reported	5 mg orally x 1	AUC increased 31%; Cmax increased 57%
Lenacapavir Rivaroxaban	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of bleeding				Use with caution. Monitor for rivaroxaban adverse effects (e.g. bleeding). Avoid coadministration in persons with renal impairment (CrCL 15 - 80 ml/min) due to increased risk of bleeding.
Lenacapavir Rimegepant	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of rimegepant adverse effects				If coadministering, avoid taking a second dose of rimegepant within 48 hours
Lenacapavir Rifapentine	Red: Avoid combination	Do not coadminister: reduced levels of lenacapavir	Potential loss of antiviral efficacy				Use alternative agents
Lenacapavir Rifabutin	Red: Avoid combination	Do not coadminister: reduced levels of lenacapavir	Potential loss of antiviral efficacy				Use alternative agents
Lenacapavir Ranolazine	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of ranolazine adverse effects				If coadministering, do not exceed ranolazine dose of 500 mg twice daily.
Lenacapavir Quinidine	Red: Avoid combination	Do not coadminister: potentially increased levels of quinidine	Potential increased risk of quinidine adverse effects				Use alternative agents.
Lenacapavir Quetiapine	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of quetiapine adverse effects (e.g. sedation, QT prolongation)				Consider using alternative antipsychotics. If coadministering, consider quetiapine dose reduction and monitor for adverse effects.
Lenacapavir Propafenone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of propafenone adverse effects				Consider using alternative antiarrhythmic or ARV. If coadministering, monitor for propafenone adverse effects.
Lenacapavir Primidone	Red: Avoid combination	Do not coadminister: reduced levels of lenacapavir	Potential loss of antiviral efficacy				Use alternative agents.
Lenacapavir Prednisone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of corticosteroid adverse effects (e.g. Cushing's syndrome and adrenal supression).				If co-administering, initiate with the lowest starting dose and titrate to clinical effect. Monitor for corticosteroid-related adverse effects (e.g. Cushing's syndrome, adrenal insufficiency).
Lenacapavir Prednisolone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of corticosteroid adverse effects (e.g. Cushing's syndrome and adrenal supression).				If co-administering, initiate with the lowest starting dose and titrate to clinical effect. Monitor for corticosteroid-related adverse effects (e.g. Cushing's syndrome, adrenal insufficiency).
Lenacapavir Praziquantel	Yellow: Adjust dosing	Minimal data to guide interaction: risks likely to outweigh benefits	Potential increased risk of praziquantel adverse effects				Consider alternative antiretroviral. If coadministration is necessary, monitor for praziquantel adverse effects.
Lenacapavir Pitavastatin	Green: Administer standard doses	Administer standard doses	No clinically significant effect expected	Not reported	2 mg x 1 (with food, simultaneous administration with oral LEN)	AUC increased 11%
Lenacapavir Pimozide	Red: Avoid combination	Do not coadminister: potentially increased levels of pimozide	Potential increased risk of pimozide adverse effects				Contraindicated. Use alternative agents
Lenacapavir Phenytoin	Red: Avoid combination	Do not coadminister: reduced levels of lenacapavir	Potential loss of antiviral efficacy				Contraindicated. Use alternative agents.
Lenacapavir Phenobarbital	Red: Avoid combination	Do not coadminister: reduced levels of lenacapavir	Potential loss of antiviral efficacy				Use alternative agents
Lenacapavir Oxycodone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Increased risk of oxycodone adverse effects				If coadministering, monitor therapeutic effects and adverse reactions (e.g. sedation, respiratory depression)
Lenacapavir Oxcarbazepine	Red: Avoid combination	Do not coadminister: reduced levels of lenacapavir	Potential loss of antiviral efficacy				Use alternative agents
Lenacapavir Nifedipine	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of nifedipine adverse effects				If coadministering, monitor for cardiac medication adverse effects (e.g. hypotension)
Lenacapavir Nevirapine	Red: Avoid combination	Do not coadminister: reduced levels of lenacapavir	Potential loss of antiviral efficacy				Use alternative agents
Lenacapavir Naloxegol	Yellow: Adjust dosing	Minimal data to guide interaction: risks likely to outweigh benefits	Increased risk of naloxegol adverse effects				Consider using alternative agents. If coadministration is unavoidable, decrease dose of naloxegol and monitor for adverse reactions.
Lenacapavir Mometasone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of corticosteroid adverse effects (e.g. Cushing's syndrome and adrenal supression).				If coadministering, initiate lowest starting dose and titrate to clinical effect. Monitor for adverse effects such as adrenal insufficiency and Cushing's syndrome.
Lenacapavir Midazolam	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential for increased sedation	Not reported	2.5 mg orally x 1, administered simultaneously with LEN	AUC increased 259%; Cmax increased 94%. AUC for 1-hydroxy metabolite decreased 24%.	If co-administering, monitor for excess sedation and adjust dose accordingly
Lenacapavir Methylprednisolone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of corticosteroid adverse effects (e.g. Cushing's syndrome and adrenal supression).				If used for local injections, monitor for corticosteroid-related adverse effects (e.g. Cushing's syndrome, adrenal insufficiency).
Lenacapavir Methylergonovine	Red: Avoid combination	Do not coadminister: potentially increased levels of methylergonovine	Increased risk of methylergonovine adverse effects				Use alternative agents
Lenacapavir Methadone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Unknown effect on methadone				If initiating methadone in a person already on lenacapavir, start with lowest feasible dose and titrate to clinical effect. If initiating lenacapavir in a person stable on methadone, dose adjustment of methadone may be required. Monitor for clinical efficacy and adverse effects (e.g. sedation, respiratory depression).
Lenacapavir Mefloquine	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of mefloquine adverse effects				If coadministering, monitor for mefloquine adverse effects (e.g. QT prolongation)
Lenacapavir Mavacamten	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of mavacamten adverse effects				If initiating lenacapavir in patients stable on mavacamten, reduce mavacamten dose by one level (e.g. 15 mg to 10 mg, 10 mg to 5 mg, 5 mg to 2.5 mg). If initiating mavacamten in patients stable on lenacapavir, use typical starting dose (5 mg daily).
Lenacapavir Lurasidone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of lurasidone adverse effects				If initiating lurasidone in a person stable on lenacapavir, recommended starting dose is 20 mg daily, not to exceed 80 mg daily. If initiating lenacapavir in a person stable on lurasidone, reduce lurasidone dose by 50%
Lenacapavir Lumateperone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of lumateperone adverse effects				If coadministering, reduce lumateperone dose to 21 mg
Lenacapavir Lovastatin	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Increased risk of lovastatin adverse effects				Initiate lovastatin with the lowest starting dose and titrate to clinical effect. Monitor for adverse effects of lovastatin (e.g. myopathy, elevated transaminases).
Lenacapavir Lomitapide	Red: Avoid combination	Do not coadminister: potentially increased levels of lomitapide	Potential increased risk of lomitapide adverse effects				Contraindicated. Use alternative agents
Lenacapavir Lidocaine	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of lidocaine adverse effects				Consider using alternative antiarrythmic or ARV. If coadministering, monitor for lidocaine adverse effects.
Lenacapavir Lamborexant	Red: Avoid combination	Do not coadminister: potentially increased levels of lamborexant	Potential increased risk of excessive sedation				Use alternative agents.
Lenacapavir Ivabradine	Red: Avoid combination	Do not coadminister: potentially increased levels of ivabradine	Potential increased risk of ivabradine adverse effects				Use alternative agents.
Lenacapavir Hydrocortisone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of corticosteroid adverse effects (e.g. Cushing's syndrome and adrenal supression).				If co-administering, initiate with the lowest starting dose and titrate to clinical effect. Monitor for hydrocortisone-related adverse effects.
Lenacapavir Fluticasone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of corticosteroid adverse effects (e.g. Cushing's syndrome and adrenal supression).				If coadministering, initiate lowest starting dose and titrate to clinical effect. Monitor for adverse effects such as adrenal insufficiency and Cushing's syndrome.
Lenacapavir Flibanserin	Red: Avoid combination	Do not coadminster: potentially increased levels of flibanserin	Potential increased risk of GI adverse effects, insomnia, dry mouth, tachycardia				Use alternative agents.
Lenacapavir Fentanyl	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Increased risk of fentanyl adverse effects				If coadministering, monitor therapeutic effects and adverse reactions (e.g. sedation, respiratory depression)
Lenacapavir Felodipine	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of felodipine adverse effects				If coadministering, monitor for cardiac medication adverse effects (e.g. hypotension)
Lenacapavir Famotidine	Green: Administer standard doses	Administer standard doses	No clinically significant effect expected	AUC increased 28%	40 mg daily	Not reported
Lenacapavir Everolimus	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of immunosuppressant adverse effects				Initiate adjusted dose of immunosuppressant to account for increased concentration and follow up with therapeutic drug monitoring to refine dosing. Monitor for adverse effects of immunosuppressant. Consult with specialist as necessary.
Lenacapavir Etravirine	Red: Avoid combination	Do not coadminister: potentially reduced levels of lenacapavir	Potential loss of antiviral efficacy				Use alternative agents.
Lenacapavir Ethosuximide	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased ethosuximide effects				If coadministering monitor for ethosuximide-related adverse events.
Lenacapavir Eszopiclone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of excessive sedation				If coadministering, initiate lowest starting dose. Monitor for excessive sedation.
Lenacapavir Eslicarbazepine	Red: Avoid combination	Do not coadminister: reduced levels of lenacapavir	Potential loss of antiviral efficacy				Use alternative agents.
Lenacapavir Ergotamine	Red: Avoid combination	Do not coadminister: potentially increased levels of ergotamine	Increased risk of ergotamine adverse effects				Use alternative agents
Lenacapavir Eplerenone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of eplerenone adverse effects				If coadministering in the setting of post-MI heart failure, eplerenone dose not to exceed 25 mg daily. If coadministered for hypertension, initiate eplerenone at 25mg daily. Dose not to exceed 25 mg twice daily.
Lenacapavir Efavirenz	Red: Avoid combination	Do not coadminister: decreased levels of lenacapavir	Potential for loss of lenacapavir efficacy	AUC decreased 55%; Cmax decreased 36%	600 mg daily (fasted)	Not reported	Use alternative agents
Lenacapavir Edoxaban	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of bleeding				Use with caution. Monitor for edoxaban adverse effects (e.g. bleeding)
Lenacapavir Dronedarone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of dronedarone adverse effects				Consider using alternative cardiac medication or ARV. If coadministering, monitor for dronedarone adverse effects.
Lenacapavir Disopyramide	Red: Avoid combination	Do not coadminister: potentially increased levels of disopyramide	Potential increased risk of disopyramide adverse effects				Use alternative agents.
Lenacapavir Diltiazem	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of diltiazem adverse effects				If coadministering, monitor for cardiac medication adverse effects (e.g. hypotension)
Lenacapavir Dihydroergotamine	Red: Avoid combination	Do not coadminister: potentially increased levels of dihydroergotamine	Increased risk of dihydroergotamine adverse effects				Use alternative agents
Lenacapavir Digoxin	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of digoxin adverse effects				Use with caution and monitor digoxin therapeutic concentration
Lenacapavir Diazepam	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of sedation, respiratory depression				Consider alternative benzodiazepines. If coadministering, use lowest effective dose and monitor for diazepam adverse effects.
Lenacapavir Dexamethasone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of corticosteroid adverse effects (e.g. Cushing's syndrome and adrenal supression).				If co-administering, initiate with the lowest starting dose and titrate to clinical effect. Do not use doses of dexamethasone > 16 mg. Monitor for dexamethasone-related adverse effects.
Lenacapavir Darunavir/cobicistat	Green: Administer standard doses	Administer standard doses	No clinically significant effect expected	AUC increased 94%; Cmax increased 130%	800/150 mg once daily (in fed state)	Not reported
Lenacapavir Daridorexant	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of excessive sedation				If coadministering, maximum dose of daridorexant is 25 mg.
Lenacapavir Dabigatran	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of bleeding				Use with caution. Monitor for dabigatran adverse effects (e.g. bleeding)
Lenacapavir Cyclosporine	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of immunosuppressant adverse effects				Initiate adjusted dose of immunosuppressant to account for increased concentration and follow up with therapeutic drug monitoring to refine dosing. Monitor for adverse effects of immunosuppressant. Consult with specialist as necessary.
Lenacapavir Colchicine	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of GI adverse effects				If using for gout flare may coadminister a single dose of 1.2 mg. May not repeat dose for at least 3 days. If using for Familiar Mediterranean Fever do not exceed colchicine dose of 1.2 mg daily.
Lenacapavir Cobicistat	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Increased risk of lenacapavir adverse effects	AUC increased 128%; Cmax increased 110%	150 mg once daily (in fed state)	Not reported	Management of interaction depends on component that cobicistat is serving as a PK booster for. See partner antiretroviral for further details.
Lenacapavir Clopidogrel	Yellow: Adjust dosing	Minimal data to guide interaction: risks likely to outweigh benefits	Potential increased risk of bleeding				Consider using alternative ARV or antiplatelet agents. If coadministering, monitor for clopidogrel-related adverse events (e.g. bleeding)
Lenacapavir Clonazepam	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of sedation, respiratory depression				Consider alternative benzodiazepines. If coadministering, use lowest effective dose and monitor for clonazepam adverse effects.
Lenacapavir Cisapride	Red: Avoid combination	Do not coadminister: potentially increased levels of cisapride	Potential increased risk of cisapride adverse effects				Contraindicated. Use alternative agents
Lenacapavir Carbamazepine	Red: Avoid combination	Do not coadminister: reduced levels of lenacapavir	Potential loss of antiviral efficacy				Contraindicated. Use alternative agents.
Lenacapavir Buspirone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of buspirone adverse effects				If coadministering start with lowest dose and titrate to clinical effect. Monitor for buspirone-related adverse events.
Lenacapavir Buprenorphine	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Unknown effect on buprenorphine				If initiating buprenorphine in a person already on lenacapavir, start with lowest feasible dose and titrate to clinical effect. If initiating lenacapavir in a person stable on buprenorphine, dose adjustment of buprenorphine may be required. Monitor for clinical efficacy and adverse effects (e.g. sedation, respiratory depression).
Lenacapavir Budesonide	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of corticosteroid adverse effects (e.g. Cushing's syndrome and adrenal supression).				If coadministering, initiate lowest starting dose and titrate to clinical effect. Monitor for adverse effects such as adrenal insufficiency and Cushing's syndrome.
Lenacapavir Brexpiprazole	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of brexpiprazole adverse effects				If coadministering in patients known to be poor CYP2D6 metabolizers, use 1/4 of brexpiprazole dose. Monitor for adverse events.
Lenacapavir Betamethasone	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of corticosteroid adverse effects (e.g. Cushing's syndrome and adrenal supression).				If used for local injections, monitor for corticosteroid-related adverse effects (e.g. Cushing's syndrome, adrenal insufficiency).
Lenacapavir Bedaquiline	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential for increased bedaquiline levels				Consider alternative agents. If coadministering, monitor LFTs and ECG.
Lenacapavir Avanafil	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of avanafil adverse effects (e.g. hypotension)				If coadministering, avanafil dose should not exceed 50 mg in 24 hours
Lenacapavir Atazanavir/ritonavir	Red: Avoid combination	Do not coadminister: potentially increased levels of lenacapavir	Potential increase in lenacapavir adverse effects				Use alternative agents
Lenacapavir Atazanavir/cobicistat	Red: Avoid combination	Do not coadminister: increased levels of atazanavir	Potential for increased atazanavir adverse effects (e.g. hyperbilirubinemia, gastrointestinal effects).	AUC increased 321%; Cmax increased 560%	300/150 mg daily (fed state)	Not reported	Use alternative agents
Lenacapavir Artemether/Lumefantrine	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of lumefantrine adverse effects				If coadministering, monitor for lumefantrine adverse effects (e.g. QT prolongation)
Lenacapavir Apixaban	Yellow: Adjust dosing	Minimal data to guide interaction: weigh risks and benefits of using this combination	Potential increased risk of bleeding				Use with caution. Monitor for apixaban adverse effects (e.g. bleeding)

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