Switching from Apretude to Yeztugo: What You Need to Know
You're on Apretude (cabotegravir, every 2 months) and want to switch to Yeztugo (lenacapavir, every 6 months). Here's how the transition works, what to ask your provider, and how to keep continuous protection.
Why Switch?
Both Apretude and Yeztugo are injectable PrEP — both are covered at $0 with insurance or manufacturer programs — and both are highly effective at preventing HIV. The main reason to switch is convenience:
| Apretude (Current) | Yeztugo (Switch To) | |
|---|---|---|
| Injection frequency | Every 2 months | Every 6 months |
| Annual clinic visits | 6 injections/year | 2 injections/year |
| Injection type | Intramuscular (gluteal — provider-administered) | Subcutaneous (belly — potentially self-injectable in future) |
| Drug class | Integrase inhibitor (cabotegravir) | Capsid inhibitor (lenacapavir) |
| Annual cost (insured) | $0 | $0 |
Can I Switch Without Waiting?
This is the most common question, and the honest answer is: talk to your provider about timing. There are no large-scale studies specifically examining direct Apretude-to-Yeztugo transitions. However, the drugs use different mechanisms (integrase inhibitor vs. capsid inhibitor), so there are no known drug interaction concerns.
The key consideration is ensuring continuous HIV protection during the transition. Your provider will likely recommend one of these approaches:
Switch at your next Apretude appointment
When your next bimonthly Apretude injection is due, receive a Yeztugo injection instead. This ensures no gap in protection. Yeztugo requires an oral loading phase (oral lenacapavir tablets on days 1 and 2, then day 8) before the first injection — your provider will coordinate this timing.
Overlap with oral PrEP during transition
Some providers may recommend a brief course of oral PrEP to bridge the transition, especially if the timing between your last Apretude injection and Yeztugo initiation isn't exact.
The Yeztugo Loading Phase
Unlike Apretude (which starts with two monthly injections), Yeztugo begins with oral loading doses:
Day 1: Take oral lenacapavir tablets
Day 2: Take oral lenacapavir tablets
Day 8: Take oral lenacapavir tablets
Day 8 (same day): Receive first subcutaneous injection
Every 6 months: Receive maintenance injection
Cost and Coverage for the Switch
If your insurance covers Apretude, it should also cover Yeztugo — both are FDA-approved PrEP medications covered under the ACA at $0. However, your insurer may require a new prior authorization for Yeztugo since it's a different drug.
If you're currently receiving free Apretude through ViiVConnect, you'll need to enroll separately in Gilead Advancing Access for Yeztugo coverage. Both programs serve uninsured patients under 500% FPL at $0 — the switch is administrative, not financial.
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Questions to Ask Your Provider
Bring these to your next appointment: