Apretude

How Does Apretude Work?

Apretude's active ingredient, cabotegravir, is an Integrase Strand Transfer Inhibitor (INSTI). HIV relies on an enzyme called integrase to replicate: after entering a CD4 T-cell and converting its RNA to DNA, HIV uses integrase to insert that viral DNA into the host cell's genome. Once integrated, the cell produces new HIV copies. Cabotegravir binds to the active site of HIV integrase, specifically chelating the two magnesium ions integrase requires to function — blocking this critical integration step and halting viral replication.

What makes Apretude unique is its extended-release formulation. Cabotegravir is engineered as a nanosuspension that forms a slow-release depot in the gluteal muscle tissue after injection. The drug dissolves gradually from this depot into the bloodstream over weeks to months, maintaining protective blood concentrations continuously. This is why a single injection every 2 months provides sustained HIV protection without daily pills.

An important pharmacokinetic property: cabotegravir can remain detectable in the bloodstream for up to 12 months or longer after the last injection — the so-called pharmacokinetic 'tail.' During this period, drug levels are present but may fall below fully protective concentrations, which is why HIV testing before each injection and a proper transition plan when stopping are clinically essential.

How Hard Is It to Find Apretude in Stock?

As of 2026, Apretude is not in an FDA-listed drug shortage — ViiV Healthcare continues to manufacture and distribute it without supply disruptions. However, finding access to Apretude can still be challenging for many patients, and the reasons are structural rather than supply-based.

Apretude is not available at retail pharmacies. It's a specialty injectable that must be administered in a clinical setting — distributed through specialty pharmacies to enrolled clinical practices. Not all healthcare providers have set up the necessary infrastructure (specialty pharmacy relationships, billing workflows, HIV testing protocols) to offer it. Access is generally better in urban areas with established HIV prevention programs and worse in rural regions.

To find a provider near you who can administer Apretude, visit medfinder. medfinder reaches out to providers in your area to identify who can fill your prescription — without you having to make endless phone calls.

Who Can Prescribe Apretude?

Apretude is not a controlled substance and does not require special DEA scheduling registration to prescribe. Any licensed prescriber with a standard DEA registration number can prescribe it. The key requirement is that the prescribing provider or their practice must also be set up to administer the injection — which requires specialty pharmacy access, HIV testing capability, and trained staff for gluteal IM injections.

Infectious disease specialists and HIV specialists

Primary care physicians (PCPs) and internists

OB/GYNs (particularly for cisgender women seeking PrEP)

Nurse practitioners (NPs) and physician assistants (PAs)

Sexual health clinic providers and Ryan White-funded health center providers

Telehealth options are available for the prescription component — some telehealth HIV prevention platforms can prescribe Apretude after a virtual consultation and remote HIV lab testing. However, the injection must always be administered in person at a clinical facility. Patients in areas with limited local access may get their prescription via telehealth and receive injections at a nearby clinic or federally qualified health center.

Is Apretude a Controlled Substance?

No. Apretude (cabotegravir) is not a controlled substance. It is not scheduled by the DEA, and there are no special prescription or refill restrictions based on controlled substance scheduling. Any licensed prescriber can prescribe Apretude — including primary care physicians, infectious disease specialists, OB/GYNs, nurse practitioners, and physician assistants.

Unlike controlled substances such as stimulants or opioids, Apretude does not require a special DEA registration number to prescribe, does not have quantity limits based on scheduling, and does not trigger PDMP (prescription drug monitoring program) reporting. The prescription logistics for Apretude are driven by its specialty injectable nature — not by controlled substance rules.

Common Side Effects of Apretude

The most common side effect of Apretude is injection site reactions, affecting approximately 82% of patients in clinical trials. These include pain, redness, hardening (induration), and swelling at the injection site in the buttock. These typically resolve within 1-2 weeks and tend to improve with successive injections.

Injection site reactions (pain, redness, induration, swelling) — ~82%

Headache

Pyrexia (fever)

Fatigue, sleep disorders, dizziness, somnolence

Nausea, diarrhea, vomiting, flatulence, abdominal pain

Myalgia (muscle aches), back pain, rash, decreased appetite

Serious side effects (seek medical attention):

Severe hypersensitivity reactions including Stevens-Johnson syndrome (SJS) / toxic epidermal necrolysis (TEN) — seek emergency care for severe rash, blisters, or difficulty breathing

Hepatotoxicity (liver toxicity) — contact provider for jaundice, dark urine, or persistent nausea

Depressive disorders including suicidal ideation — contact provider promptly for new or worsening depression

Final Thoughts on Apretude

Apretude represents a genuine paradigm shift in HIV prevention. By replacing a daily pill with a once-every-two-months injection, it addresses one of the primary reasons PrEP fails in practice — adherence. The clinical trial data is compelling: 69-90% greater efficacy than daily oral Truvada, over 5,000 patient-years of trial experience, and more than 3 years of real-world use since approval.

For most insured patients, cost is not a barrier — ACA mandates $0 cost-sharing for Apretude as a preventive service, Medicare covers it at $0, and ViiV Healthcare offers both a savings program for commercially insured patients and free medication for uninsured patients with limited income. The main challenge as of 2026 is finding a provider with the infrastructure to administer it.

If you or a patient is interested in Apretude, the first step is finding a provider. medfinder helps patients locate providers and pharmacies that can fill their prescriptions. Enter your medication and location and medfinder will contact providers on your behalf to find who can help.