By Michael Gwarisa
As Zimbabwe prepares to roll out Lenacapavir, an injectable pre-exposure prophylaxis drug, anticipation is growing among people waiting for their turn. The initial consignment consists of just 2,000 doses, meaning distribution will focus on groups classified as high risk.
Despite its high efficacy, Dr Owen Mugurungi, Director of AIDS, TB and Malaria in the Ministry of Health and Child Care, has urged the public not to create unnecessary demand or pressure. He emphasised that Lenacapavir is simply an additional option to the existing PrEP products already available in the country.
While excitement is evident, some people remain concerned about possible adverse reactions. Like any medication, Lenacapavir has potential side effects, although many are similar to those associated with other injectable treatments. Commonly reported effects include injection site reactions such as pain, swelling or redness. Some individuals may also experience headache, nausea or fatigue. These effects are usually mild to moderate and resolve on their own.
However, experts warn that certain medical conditions and medications may make Lenacapavir unsuitable.
Dr Emily Gwavava, a specialist PrEP consultant in the Ministry of Health and Child Care, said some comorbidities and medications have a high likelihood of interacting with Lenacapavir and may interfere with its effectiveness.
Patients Taking Anti TB and Anti-Epileptic Medicines
“Lenacapavir is metabolised in the liver. Drugs that affect the CYP3A pathway, such as some anti-TB medicines and anti epileptics, can speed up its metabolism and reduce its effectiveness,” said Dr Gwavava.
She noted that while dose adjustments may be possible in other settings, Zimbabwe currently does not have quantified guidance for adjusting doses. As a result, patients taking anti TB drugs or anti epileptics are advised to avoid Lenacapavir for now.
People Taking Antidepressants and Sex Enhancing Products
Dr Gwavava also raised concerns about interactions with certain antidepressants and sex enhancing drugs. Lenacapavir can affect the same CYP3A pathway, potentially increasing the concentration of sex enhancing medicines such as sildenafil.
“This raises concerns such as priapism in men, which is a prolonged and painful erection that can cause serious complications if not treated,” she said.
Sex enhancing products may also include herbal remedies and beverages marketed for sexual performance. Although some drinks sold locally are promoted as performance boosters, there is limited scientific evidence to support such claims. Individuals using these products are encouraged to consult healthcare providers before starting Lenacapavir.
