{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T05:20:01Z","timestamp":1787808001417,"version":"build-2784847793"},"reference-count":16,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T00:00:00Z","timestamp":1781740800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J STD AIDS"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Lenacapavir is now approved for highly treatment experienced persons living with HIV (PLWH) and for HIV pre-exposure prophylaxis (PrEP). Limited lenacapavir clinical data exist with real-world drug-drug interactions. We report two possible drug-drug interactions with ambulatory lenacapavir subcutaneous injections in two PLWH prescribed long-acting injection therapy. Case 1 describes a PLWH prescribed clopidogrel after an acute cerebrovascular event receiving an antiretroviral (ARV) regimen including subcutaneous lenacapavir and ibalizumab biweekly infusions. The clopidogrel was discontinued with no harm noted. Case 2 is a highly treatment experienced PLWH prescribed an ARV regimen including subcutaneous lenacapavir and intramuscular cabotegravir\/rilpivirine injections on concomitant inhaled and nasal fluticasone. Symptoms consistent with adrenal insufficiency were reported with immediate fluticasone discontinuation and transition to beclomethasone. The patient\u2019s baseline cortisol concentration was low with improvement after fluticasone discontinuation. The electronic medical record alerts were customized to note these possible lenacapavir drug-drug interactions, similar to protease inhibitors\/pharmacokinetic boosters (ritonavir and cobicistat) to prevent future events. This case series highlights possible lenacapavir drug-drug interactions and is a precautionary tale to other institutions to consider customizing electronic medical alerts for this novel long-acting injection.<\/jats:p>","DOI":"10.1177\/09564624261461789","type":"journal-article","created":{"date-parts":[[2026,6,18]],"date-time":"2026-06-18T09:35:55Z","timestamp":1781775355000},"page":"1115-1120","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["A precautionary tale of lenacapavir drug-drug interactions: A case series of two persons living with HIV receiving long-acting injections"],"prefix":"10.1177","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6124-7205","authenticated-orcid":false,"given":"Patricia","family":"Pecora Fulco","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Department of Internal Medicine\/Division of Infectious Diseases, Virginia Commonwealth University Health, Richmond, VA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Winthrop","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gonzalo M.","family":"Bearman","sequence":"additional","affiliation":[{"name":"Virginia Commonwealth University Health"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,18]]},"reference":[{"key":"e_1_3_4_2_2","volume-title":"Sunlenca (lenacapavir)","year":"2022","unstructured":"Sunlenca (lenacapavir). Gilead Sciences, Inc. December, 2022, vol. 22."},{"key":"e_1_3_4_3_2","volume-title":"Yeztugo (lenacapavir)","year":"2025","unstructured":"Yeztugo (lenacapavir). Gilead Sciences, Inc. June, 2025, vol. 18."},{"key":"e_1_3_4_4_2","first-page":"106002802513798","article-title":"Lenacapavir: a twice-yearly injectable for HIV preexposure prophylaxis","volume":"23","author":"Koren DE","year":"2025","unstructured":"Koren DE, Chahine EB, Sherman EM. Lenacapavir: a twice-yearly injectable for HIV preexposure prophylaxis. Ann Pharmacother 2025; 23: 10600280251379877. https:\/\/doi.org\/10.1177\/10600280251379877","journal-title":"Ann Pharmacother"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/10600280231171375"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2115542"},{"key":"e_1_3_4_7_2","first-page":"ciaf425","article-title":"Long-acting cabotegravir\/rilpivirine, lenacapavir, and ibalizumab use among persons with HIV-1 viremia at a Ryan White-funded clinic in the urban U.S. south","volume":"1","author":"Colasanti JA","year":"2025","unstructured":"Colasanti JA, Aldredge A, Niles-Carnes LV, et al. Long-acting cabotegravir\/rilpivirine, lenacapavir, and ibalizumab use among persons with HIV-1 viremia at a Ryan White-funded clinic in the urban U.S. south. Clin Infect Dis 2025; 1: ciaf425. https:\/\/doi.org\/10.1093\/cid\/ciaf425","journal-title":"Clin Infect Dis"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofae125"},{"key":"e_1_3_4_9_2","unstructured":"University of Liverpool HIV drug interactions. https:\/\/hiv-druginteractions.org\/checker (Accessed October 27 2025)."},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1H423"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40262-018-0637-6"},{"key":"e_1_3_4_12_2","volume-title":"Guidelines for the use of antiretroviral agents in adults and adolescents with HIV","author":"Panel on Antiretroviral Guidelines for Adults and Adolescents","unstructured":"Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the use of antiretroviral agents in adults and adolescents with HIV. 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