Sunlenca vs. Yeztugo for HIV Treatment and HIV Prevention: Important Differences and Potential Risks.

Sunlenca

(lenacapavir)

Yeztugo

(lenacapavir)

Summary for Sunlenca

Prescription only

Sunlenca (lenacapavir) is the first FDA-approved, twice-yearly injectable medication used for hard-to-treat human immunodeficiency virus (HIV) infections. It's injected under the skin on the belly by a healthcare provider every 6 months (after the starting dose is finished). Sunlenca (lenacapavir) is available as either an injection or a tablet, but the tablet form is only taken at the start of treatment. The most common side effects people experienced with Sunlenca (lenacapavir) involved reactions at the injection site, including swelling, pain, and redness.

Indications for Sunlenca

Human immunodeficiency virus type 1 (HIV-1) infection in people who've received HIV medications in the past, and:

Past HIV medications are no longer working, or
Can't tolerate side effects of past HIV medications, or
Safety concerns about past HIV medication

Pros and Cons for Sunlenca

Pros

Injected once every 6 months (after starting dose), so it's convenient for people with a busy schedule
Has few side effects
Might work well for people who didn’t see benefits with other medications for HIV
A possible option for people with kidney or liver problems

Cons

Likely to cause post-injection reactions
Unknown if safe or works well in children
Interacts with a lot of medications such as lovastatin, dexamethasone, and rivaroxaban (Xarelto)
Needs to be taken with other HIV medications

Common Side Effects for Sunlenca

Injection site reactions:

Swelling (36%)
Pain (31%)
Redness (31%)
Small lump (25%)
Hardening of skin (15%)
Itching (6%)

Warnings for Sunlenca

Overactive immune system
Injection site reactions
Worsening of HIV infection with missed doses
Interaction with other medications

Summary for Yeztugo

Prescription only

Yeztugo (lenacapavir) works as an HIV-1 capsid inhibitor. It's used for pre-exposure prophylaxis (PrEP) to lower your risk of getting human immunodeficiency virus (HIV) from sex. It's for HIV-negative adults and adolescents who weigh at least 77 lbs at risk of getting HIV. Yeztugo (lenacapavir) starts with two injections under the skin plus tablets taken by mouth on day 1, then only tablets on day 2. After that, you get two injections every 6 months. If an injection will be late, you might need to take the tablets once weekly as a temporary bridge. Side effects include injection site reactions and headache.

Indications for Yeztugo

Prevention of HIV infection (PrEP or pre-exposure prophylaxis)

Pros and Cons for Yeztugo

Pros

Long-acting HIV prevention; only need injections every 6 months after the first starting doses
Works across diverse groups at high risk of HIV
Okay for most people with kidney problems

Cons

Must test negative for HIV before starting and at every injection visit
Common to have injection site lumps and pain, which can last a while
Can interact with some medications like seizure medications, antifungals, and herbal products

Common Side Effects for Yeztugo

Injection site reactions (e.g., lump, pain; up to 83%)
Headache (up to 7%)
Nausea (up to 5%)

Warnings for Yeztugo

Take extra steps to prevent HIV and other sexually transmitted infections (STIs)
Risk of HIV resistance
Risk of losing protection with missed or delayed injections
Long-acting effects of the injection and drug interactions
Serious injection site reactions with improper administration