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Lenacapavir (Sunlenca), the first agent in a new antiretroviral class known as capsid inhibitors, was approved by the FDA on December 22, 2022 for patients with multidrug-resistant HIV infection or intolerance to or safety concerns with other drug classes. Lenacapavir binds two subunits of the viral capsid, disrupting the viral life cycle at several points and ultimately preventing production of replication-competent virus.
Lenacapavir is administered initially as an oral regimen (600 mg days 1 and 2; 300 mg day 8), followed on day 15 by subcutaneous injection (927 mg as two 1.5-mL injections); alternatively, oral and subcutaneous therapy can be initiated simultaneously (600 mg orally days 1 and 2; 927 mg subcutaneously day 1). Subsequently,…