What are the most common Apretude side effects?

The most common Apretude side effect is an injection-site reaction — pain, swelling or tenderness where the shot is given — reported by more than 80% of users at some point, usually in the first few injections. Other common effects are headache, fatigue, fever and muscle pain, and these are usually mild and short-lived.

How long do Apretude injection-site reactions last?

Injection-site reactions typically last about 2 to 7 days after each injection and tend to become milder over time — many people notice they ease after the third or fourth injection.

Is Apretude safer than Truvada for the kidneys and bones?

For kidneys and bones, yes. Unlike Truvada (TDF), cabotegravir is not cleared by the kidneys and does not lower bone mineral density, so it is often preferred for people with kidney concerns or low bone density. Apretude has its own considerations, such as injection-site reactions.

What happens if I miss my Apretude injection?

Injections are due every 2 months, with a 7-day grace window on either side. If you will be more than 7 days late, contact your provider — you may need to bridge with daily oral PrEP so your protection does not lapse.

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💉 Cabotegravir (CAB) · injectable PrEP

Apretude (cabotegravir): injectable PrEP side effects & cost

Apretude is an FDA-approved injection given every 2 months — no daily pill. Here’s what to expect: the injection-site reactions almost everyone gets, the rarer systemic effects, the serious warning signs, and how its side-effect profile compares with Truvada and Descovy.

Medically reviewed by the Prepmedication.com Medical Review Team Last reviewed 3 July 2026 · Next review Jan 2027 · Sources: FDA Prescribing Information, CDC PrEP Guidelines, HPTN 083/084 · How we review →

What is Apretude?

Active ingredientCabotegravir (CAB), an integrase inhibitor

FormIntramuscular gluteal (buttock) injection

ScheduleTwo starter shots 1 month apart, then every 2 months

Approved forAdults & adolescents ≥35 kg — all genders, incl. vaginal exposure

Made byViiV Healthcare

Key advantageNo daily pill — helpful when adherence is hard

💡 Because cabotegravir is not processed by the kidneys and does not affect bone, Apretude sidesteps the two effects people worry about most with Truvada. Its trade-off is the injection itself.

Common Apretude side effects

1 · Injection-site reactions most common

By far the most common effect. In trials, over 80% of people had an injection-site reaction at some point — but the vast majority were mild-to-moderate and settled on their own.

80%+at some point

Pain, tenderness, swelling, redness, warmth or a firm lump (nodule) Usually lasts 2–7 days and eases over time — many notice it becomes milder after the 3rd–4th injection. What helps: a cold pack, gentle movement, and acetaminophen; the nurse can rotate which side is used.

2 · Systemic effects (less common, usually mild)

15–20%

HeadacheTypically mild and resolves within a few days.

10–15%

Fatigue / tirednessOften around injection time; temporary.

5–10%

Fever & muscle achesLow-grade and short-lived — similar to a post-vaccine feeling.

<5%

NauseaUncommon and usually mild; notably less than with oral Truvada.

Want to check any symptom against what’s expected? Use the interactive body-map symptom guide →

Serious (but rare) side effects — act on these

Uncommon, but important to recognise. If you have any of these, seek care.

Rare

Severe allergic reaction / hypersensitivityRash with fever, hives, swelling of the face, lips or tongue, or trouble breathing. Seek emergency care now and do not have the next injection until reviewed.

Rare

Liver problems (hepatotoxicity)Yellowing of skin or eyes, dark urine, pale stools, right-upper-belly pain, or unusual tiredness. Contact your provider promptly — liver tests may be needed.

Rare

Mood changes / depressionNew or worsening low mood, or any thoughts of self-harm. Reach out for support urgently — Apretude may not be the cause, but it needs assessment, not silence.

🚑 Important: a long-acting injection stays in your body for months, so any serious reaction must be reported to your provider before your next dose. In a life-threatening emergency, contact emergency services.

Apretude vs Truvada vs Descovy: side-effect comparison

Side effect	Apretude (CAB)	Truvada (TDF)	Descovy (TAF)
Injection-site reactions	Very common (80%+)	Not applicable	Not applicable
Kidney impact	None	Monitor eGFR	Minimal
Bone-density loss	None	~2–4% in year 1	Negligible
Headache	15–20%	10–15%	10–15%
Nausea	<5%	20–30% early	10–20% early
Weight gain	Minimal	Minimal	~1–3 kg average
Daily-pill burden	None (2-monthly shot)	Daily	Daily

See the full side-by-side on our Compare PrEP medications page →

When does Apretude start working?

After the 1st injection: not yet protected — the second starter shot is given about a month later.
During initiation: use condoms or an oral PrEP lead-in as your provider advises until protection is established.
On the every-2-month schedule: you stay protected as long as injections are on time — there’s a ±7-day window.

⏱️ Missed window? If you’ll be more than 7 days late, ask your provider about bridging with daily oral PrEP so there’s no gap. A long-overdue injection means lost protection. See missed-dose guidance →

Apretude side effects — FAQ

Can I switch from Truvada or Descovy to Apretude?

Yes, you can switch at any time. Your provider will guide the transition, usually with a short oral-PrEP overlap while the first injection builds up. Confirm you’re HIV-negative before starting.

What if I miss my Apretude injection appointment?

There’s a 7-day grace period around the 2-month due date. If you miss it by more than 7 days, you may need to restart oral PrEP temporarily to stay covered — contact your provider as soon as possible.

Does Apretude interact with other medications?

It has fewer interactions than oral PrEP, but some matter a lot: rifampin/rifabutin (TB), certain anti-seizure drugs (carbamazepine, phenytoin), and St. John’s Wort can lower cabotegravir to ineffective levels. Check yours in our Drug Interaction Checker →

Is Apretude safe during pregnancy?

Data are still growing but reassuring. Because the risk of acquiring HIV in pregnancy is serious, guidelines support continuing PrEP — including Apretude — when you remain at risk. Discuss the choice with your provider.

Will the injection-site lump go away?

Usually yes. A firm nodule can linger for a few days to a couple of weeks and then fades. Tell your provider if a lump grows, becomes very hard, hot and painful, or comes with fever (possible infection).

Is Apretude right for you?

Apretude is covered by many insurance plans and Medicaid, and manufacturer assistance can lower costs for eligible patients. Compare it against every option, or check your other medicines first.

Compare all PrEP options → Check drug interactions

Keep exploring

★ Feature · cost & access

💲 Apretude cost

Apretude is a brand-only injectable, so its list price per dose is high — but in the US most insurance, Medicare and Medicaid cover PrEP (including the injections) with no cost-sharing, and ViiV's copay and patient-assistance programs can reduce out-of-pocket cost for eligible people. Ask about coverage before you start. See how to get PrEP and compare options.

🔬 Sources & review

U.S. FDA — Prescribing Information for Apretude® (cabotegravir extended-release injectable suspension).
U.S. CDC — PrEP for the Prevention of HIV Infection: Clinical Practice Guideline (2021).
HPTN 083 & HPTN 084 trials of long-acting cabotegravir for PrEP.

✔ Last medically reviewed: 3 July 2026 · Prepmedication.com Medical Review Team · Next review due: January 2027 · How we review →

Medical disclaimer. This guide is general information, not a diagnosis or prescription. Side effects and their frequency vary between individuals and data sources; always confirm your plan and any symptom with a qualified clinician. If you may have been exposed to HIV in the last 72 hours, see PEP now.

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