[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [HIV capsid inhibitors](https://durgical.com/en/pharmacology/classes/hiv-capsid-inhibitors/) › Lenacapavir

# Lenacapavir

## HIV capsid inhibitors?

HIV capsid inhibitors

A long-acting HIV capsid inhibitor, given as tablets and then as an injection every six months, for treatment and to prevent HIV infection.

Updated Nov 1, 2026

## Quick facts

**Group**
[HIV capsid inhibitors](https://durgical.com/en/pharmacology/classes/hiv-capsid-inhibitors/)

**Target**
HIV-1 capsid protein (p24)

**Used for**
HIV-1 infection

**Key effects**
Injection-site swelling · Nausea · Headache

**Monitor**
HIV viral load · Injection sites

**ATC**
J05AX31

No doses: the clinician sets them by the current guideline.

On this page

- The basics Mechanism of action
- Indications
- Adverse effects
- Pharmacokinetics
- Memory aid

- Safety Contraindications
- Key interactions
- What is monitored
- Administration and safety
- Pregnancy and breastfeeding
- Nursing care

- Study Test yourself

- Connections Connections

## Mechanism of action

◆**HIV-1 capsid protein (p24)**Lenacapavir

ⓘ The figure shows lenacapavir (then called GS-6207) bound to an HIV-1 capsid hexamer.

**Target in 3D:** HIV-1 capsid protein (p24). PDB structure 6V2F (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/6V2F) · Drag to rotate · pinch to zoom

Lenacapavir binds a pocket between neighbouring subunits of the HIV-1 capsid protein. The capsid protects the viral genome until it reaches the nucleus and must be assembled again in every new virion; lenacapavir disturbs these capsid functions, including assembly of new capsids. Because no other antiretroviral acts on the capsid, it remains active against virus resistant to the other classes.

- The capsid shields the HIV genome
- Lenacapavir binds between capsid subunits
- Capsid function and assembly are disturbed
- New infectious virus is not formed

## Indications

- HIV-1 infection, with other antiretrovirals, including virus resistant to other classes [HIV infection and AIDS →](https://durgical.com/en/conditions/hiv-infection-and-aids/)
- Pre-exposure prophylaxis to reduce the risk of acquiring HIV, together with safer sex [HIV infection and AIDS →](https://durgical.com/en/conditions/hiv-infection-and-aids/)

## Adverse effects

### Common

- Injection-site swelling, pain, redness, itching or lumps (nodules)
- Nausea
- Headache

### Serious (rare, important)

- Immune reconstitution syndrome: new or worsening signs of infection after starting treatment

## Contraindications

- Hypersensitivity to lenacapavir
- Medicines listed as not to be combined, such as St John's wort

## Key interactions

**St John's wort**
Lowers lenacapavir levels; avoided

**Many other medicines**
Doses or monitoring may change; the effect lasts months after the last injection

**Grapefruit**
Discussed with the care team during treatment

## What is monitored

- HIV viral load (treatment) or regular HIV tests (prophylaxis)
- Injection sites
- New signs of infection early in treatment

## Administration and safety

- Subcutaneous injection into the abdomen or thigh by a health professional, every six months
- Oral tablets start therapy or bridge a missed injection
- Late injections risk low levels and resistance: appointments are tracked closely

## Pregnancy and breastfeeding

Human data are limited; benefit and risk are weighed with the HIV team.

## Nursing care

- Confirm a negative HIV test before starting prophylaxis
- Record the date of each injection and schedule the next one
- Check the injection site and explain that lumps can persist
- Teach to tell every prescriber when the last injection was given

## Pharmacokinetics

**Absorption**
Oral tablets start therapy; the subcutaneous injection forms a depot that releases the drug slowly

**Elimination**
Interactions can persist for up to nine months after the last injection

**Half-life**
Very long, so the injection is repeated only every six months

## Memory aid

LEN-a-CAP: a «cap» on the virus shell that lasts half a year.

## Test yourself

Think of the answer, then tap the question to see it.

## What is the target of lenacapavir?

The HIV-1 capsid protein (p24).

## How often is lenacapavir injected?

Every six months, under the skin.

## Which two uses does lenacapavir have?

Treatment of HIV, including resistant virus (with other drugs), and pre-exposure prophylaxis.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/lenacapavir/)

[More Pharmacology questions →](https://durgical.com/en/practice/?f=pharmacology)

## Connections

## Related drugs 3

- [Cabotegravir](https://durgical.com/en/pharmacology/cabotegravir/)
- [Bictegravir](https://durgical.com/en/pharmacology/bictegravir/)
- [Darunavir](https://durgical.com/en/pharmacology/darunavir/)

## Related conditions 1

- [HIV infection and AIDS](https://durgical.com/en/conditions/hiv-infection-and-aids/)

[← Back to the class: HIV capsid inhibitors](https://durgical.com/en/pharmacology/classes/hiv-capsid-inhibitors/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Lenacapavir: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a623006.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Lenacapavir Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a623005.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [Crystal structure of the HIV capsid hexamer bound to the small molecule long-acting inhibitor, GS-6207](https://www.rcsb.org/structure/6V2F) (RCSB Protein Data Bank, 2020).

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Representative model, for educational purposes only.

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