Is Lenacapavir safe for kidneys?

One of the main reasons people switch from the daily PrEP pill to the six-month jab (Lenacapavir) is actually to protect their kidneys, but the question still stands: Is Lenacapavir safe for kidneys?

If you’ve been on the daily pill for a while, you know that the “old” PrEP (containing TDF) can sometimes cause a bit of strain on the kidneys. This is why your nurse always asks for a urine sample or a blood test every few months.

Here is how the new jab compares when it comes to your kidney health.

Is Lenacapavir safe for kidneys?

Generally, yes. The daily PrEP pills are processed through your kidneys quite heavily. For most people, this isn’t an issue, but for some, it can lead to a slight drop in kidney function over many years.

Lenacapavir works differently. Because it is a “capsid inhibitor” and is injected into the skin, it doesn’t put the same kind of immediate pressure on your renal system that a daily oral dose of tenofovir does. For people who have had to stop taking the pill because of kidney concerns, the jab is often a much safer alternative.

Do I still need kidney tests?

Even though the jab is “kinder” to your kidneys, the South African Department of Health guidelines still require regular check-ups. When you go in for your twice-yearly jab, your healthcare provider will likely still check your:

• Creatinine levels: A quick blood test to see how well your kidneys are filtering.
• Urine protein: To make sure everything is functioning normally.

These tests are mostly a precaution to make sure no other health issues (like high blood pressure or diabetes) are affecting your kidneys while you are on PrEP.

Who should be careful?

If you already have known kidney disease or a very low “eGFR” (the score doctors use to measure kidney health), you must tell your doctor before switching. While Lenacapavir is generally safe, your medical team will want to monitor you more closely during the first few months to ensure your body is handling the new medication well.

Side effects to watch out for

While the jab won’t “hurt” your kidneys in the way you might fear, it does have other side effects you should know about:

• Injection site reactions: Most people get a small, hard lump under the skin where the jab was given. This is normal and doesn’t mean anything is wrong with your internal organs.
• Liver health: In very rare cases, any strong medication can affect the liver, so your clinic will keep an eye on your general blood work once a year.

The switch to the six-month jab is usually a “win” for your kidneys. You’re moving from 365 pills a year to just two injections, which significantly reduces the daily workload on your renal system. Just keep up with your six-monthly clinic dates to stay on top of your overall health!