Yeztugo (Lenacapavir) Loading Dose: What to Expect at Your First Appointment

You might have heard about Yeztugo (lenacapavir), the new form of injectable PrEP that prevents HIV when taken every 6 months. This differs from oral PrEP pills, which need to be taken every day for maximum protection.

But here's something you might not know: while Yeztugo is an injectable medication, your first appointment involves taking some pills, too.

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What is the Yeztugo (lenacapavir) loading dose?

The loading dose (also called the initiation dose) is a kickstarter for your PrEP protection. It's made up of:

• Day 1 (at your appointment): Two injections plus two pills taken by mouth
• Day 2 (the following day, at home): Two more pills taken by mouth

Think of it like jump-starting a car — the loading dose gets your protection up and running quickly, then the long-acting injection takes over for the long haul.

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Why do you need the loading dose?

Yeztugo is a "long-acting" medication, which means it's designed to release slowly throughout your body over a long period. This is why it can protect you for six whole months with just one dose.

But this slow-release feature also means that an injection alone can't provide immediate protection. Without the loading dose, it would take over 21 days for injectable Yeztugo to reach protective levels in your system.

That's where those four pills come in. The loading dose provides a higher concentration of medication right away, so you're protected against HIV after finishing your second day of pills.

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What your first Yeztugo appointment will look like

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1. Taking an HIV test

Just like with any form of PrEP, your healthcare provider will test you for HIV infection before starting Yeztugo. This step is important to ensure safety with PrEP — if you test positive for HIV, you won't be able to take Yeztugo because using it on its own could lead to HIV drug resistance. Instead, your provider will start a complete HIV treatment plan.

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2. Getting your injections

Once your HIV test comes back negative, you'll receive two injections (1.5 mL each). These go under your skin, not into a muscle, so they're typically less painful than other types of shots.

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3. Taking your Day 1 pills

During your injection appointment, you'll take two 300mg Yeztugo tablets. You can take these with or without food, whatever feels more comfortable for you.

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4. Planning ahead

Before you finish your visit, your provider will also help you set up a plan for your next injection. Since Yeztugo is given only twice a year, it’s important to keep those dates on your calendar. If your injection ever needs to be delayed, your healthcare team can support you with scheduling and may recommend temporary steps to keep your PrEP protection on track.

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5. Post-appointment: Taking your Day 2 pills

The next day, you'll take two more 300mg tablets at home. Worried about forgetting? Oral pills are only needed at the start so try setting a reminder, adding it to your calendar, or linking it with something you already do every day — like brushing your teeth — to help you remember this dose.

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Are there any side effects from the loading dose?

Yeztugo pills — used in the loading dose — do not have any unique side effects compared to injected Yeztugo. Read our guide to PrEP side effects to learn more.

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How does this compare to oral PrEP?

If you're coming from oral PrEP (like Truvada or Descovy), you might be wondering how the timing compares. Oral PrEP doesn't have a loading dose, and it takes time to build up protective levels in your body:

• About 7 days for protection during receptive anal sex
• About 21 days for protection during receptive vaginal sex or injection drug use

With Yeztugo's loading dose, you get immediate protection. In fact, research has found that people will reach the therapeutic levels of PrEP just hours after taking the Day 2 loading dose pills.

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Will you need another loading dose?

Good news: as long as you stick with your Yeztugo schedule, you won't need another loading dose. Your follow-up appointments every six months will just involve the two injections — no more pills.

The only time you would need to repeat the loading dose is if you miss an injection by more than 28 weeks (about 6.5 months) and haven't been taking any oral PrEP medication in the meantime.

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How can I get Yeztugo (lenacapavir)?

Yeztugo is FDA-approved in the U.S., but access is still limited as healthcare systems make it more widely available.

At Freddie, we're working hard to bring Yeztugo to our patients as quickly as possible. You can book a free appointment to discuss your PrEP options with a Freddie clinician.

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