For years, PrEP meant one thing: a pill every day. Now there are two injections that last much longer. One is given every two months, the other twice a year. For people who find a daily pill hard to keep up, that is a real change. But the shots also bring new rules, especially around testing and what happens after you stop.
A note before we start: OnlineMeds does not supply PrEP injections. They are given by a healthcare provider in a clinic. We do supply generic daily PrEP pills, which is why we want you to have a fair comparison.
The three options
| Daily PrEP pill | Apretude (cabotegravir) | Yeztugo / Yeytuo (lenacapavir) | |
|---|---|---|---|
| How often | Every day | Two injections a month apart, then every 2 months2 | An injection plus tablets on days 1 and 2, then an injection every 6 months3 |
| How it is given | Tablet by mouth | Injection into the buttock muscle, by a healthcare provider2 | Two injections under the skin, by a healthcare provider3 |
| HIV testing | Before starting, then about every 3 months1 | Before starting and before every injection2 | Before starting and before every injection3 |
| Who it is approved for | Truvada: anyone at risk through sex or injecting drugs. Descovy: not for receptive vaginal sex1 | Adults and adolescents of at least 35 kg at risk through sex2 | Adults and adolescents of at least 35 kg at risk through sex3 |
| Generic available | Yes | No | No |
Lenacapavir PrEP is sold as Yeztugo in the US and as Yeytuo in Europe, the UK and Australia. Both injections are approved to reduce the risk of HIV acquired through sex. They are not approved for people whose risk comes only from injecting drugs23.
Where the injections are approved
This changes quickly, so here is the position as of October 2026:
- United States: both Apretude and Yeztugo are FDA-approved for PrEP1.
- European Union: Apretude was authorised in September 2023, and Yeytuo in August 202545.
- United Kingdom: the NHS describes a PrEP injection every two months as an option for some people6. The MHRA licensed Yeytuo in December 20257, but NICE is still assessing whether the NHS in England should fund it, with a committee meeting set for November 20268.
- Australia: the TGA approved Yeytuo in December 2025, for people aged 16 and over9. Ask your PrEP clinic about current availability and subsidy.
Side effects
For both injections, the most common side effects are reactions where the injection was given: pain, tenderness, swelling or a lump23.
- Apretude: besides injection site reactions, the US label lists diarrhoea, headache, fever, tiredness, sleep problems and nausea among the more common side effects. Serious skin and allergic reactions, and liver problems, have been reported rarely2.
- Yeztugo: injection site reactions, headache and nausea were the most common. A small lump under the skin at the injection site was reported by about two in three people in the main trial, and these lumps took a long time to go, often many months3.
Daily PrEP pills can cause nausea, diarrhoea, headache, tiredness or stomach pain, usually in the first weeks1. Our article on Truvada vs Descovy covers the differences between the two pills.
The “tail” after the last injection
This is the most important difference from pills. After the last injection, both medicines stay in the body at slowly falling levels for a long time: the US labels say up to 12 months or longer23.
Why it matters: both labels warn that missed or late injections could lead to HIV infection and to drug resistance. A slowly falling level of medicine may not be enough to block the virus, but can be enough to favour a resistant one. Both US labels also carry a boxed warning about drug resistance in people whose HIV has not been diagnosed23. That is why:
- an HIV test is done before every injection
- keeping to the injection schedule matters, and a missed visit needs a plan (for Apretude, the label allows daily cabotegravir tablets to cover a planned gap2)
- if you stop injections but may still be exposed, you should start another form of PrEP, such as daily pills
Starting an injection, and planning around visits
- A negative HIV test first. Neither injection can be started if your HIV status is unknown or positive23.
- Apretude: you and your provider may choose a short course of cabotegravir tablets first to check you tolerate the medicine. Then come two injections a month apart, and one every two months after that2.
- Yeztugo: the first visit includes the injection and two tablets, with two more tablets the next day. If you miss the day 2 tablets, take them as soon as you can, but never take the day 1 and day 2 doses on the same day. After that, injections are due every 26 weeks, within a window of 2 weeks either side3.
- If you know you will miss a visit (travel, for example), tell your clinic early. Both labels describe how tablets can bridge a gap until the next injection23.
Interactions to know about
Apretude must not be used with some epilepsy medicines (carbamazepine, oxcarbazepine, phenobarbital, phenytoin) or the TB medicines rifampicin and rifapentine, because they lower cabotegravir levels2. Lenacapavir raises the levels of some other medicines, and its label notes this can still matter for medicines started up to 9 months after the last injection3. Tell every prescriber you are on, or have recently stopped, a PrEP injection.
Cost and access
The injections are new, branded medicines with no generic versions, and they are given in clinics, which adds visits. In the US, HIV.gov says PrEP and the clinic visits and tests needed for it are covered without co-payments by almost all health insurance plans1. Elsewhere, access depends on whether your health system funds the injections.
Daily PrEP pills remain the most widely available option, and generic versions such as Tenvir-EM (the same ingredients as Truvada) and Tafmune-EM (the same ingredients as Descovy) cost far less than the brands. Our guide to what PrEP costs compares prices, and our PrEP guide explains prescriptions and import rules.
Who might prefer which
- A daily pill may suit you if you are comfortable with a daily routine, want an option you can start and stop easily, want on-demand dosing where suitable, or need the lowest cost. See daily vs on-demand PrEP.
- An injection may suit you if you struggle to remember a daily pill, want privacy (no pills at home), and can commit to clinic visits every two or six months for the next injection and an HIV test.
- Talk it through with a PrEP clinic. They will also check whether your risk comes from sex, injecting drugs or both, because the injections are approved for sexual exposure.
For how long PrEP takes to work once you start, and how to stop safely, see our guide to starting, missing and stopping PrEP.
Frequently asked questions
Is injectable PrEP better than pills?
Not better for everyone, but different. Injections remove the need to remember a daily pill, which helps many people. They need regular clinic visits and an HIV test before every injection, and they leave a long tail of medicine after you stop.
How long does injectable PrEP last?
Apretude is given every 2 months after two starting injections a month apart. Yeztugo (Yeytuo) is given every 6 months, after a first injection with tablets on days 1 and 2. Low levels of both can stay in the body for 12 months or longer after the last dose.
Is injectable PrEP available in Australia?
The TGA approved lenacapavir (Yeytuo) for PrEP in December 2025, for people aged 16 and over. Availability and subsidy can change, so ask a PrEP clinic about current access.
Is the PrEP shot covered by insurance?
In the US, HIV.gov says PrEP and the visits and tests it needs are covered without co-payments by almost all health insurance plans. In other countries it depends on whether the health system funds the injection.
Does OnlineMeds sell the PrEP injection?
No. PrEP injections are given by healthcare providers in clinics. We supply generic daily PrEP pills, which need a prescription.
What is the difference between Yeztugo and Yeytuo?
They are the same medicine, lenacapavir for PrEP. It is sold as Yeztugo in the US and as Yeytuo in Europe, the UK and Australia.
Sources & references
- HIV.gov. Pre-Exposure Prophylaxis (PrEP). Updated 9 October 2026.
- US National Library of Medicine, DailyMed. Apretude (cabotegravir) prescribing information.
- US National Library of Medicine, DailyMed. Yeztugo (lenacapavir) prescribing information.
- European Medicines Agency. Apretude: EPAR.
- European Medicines Agency. Yeytuo: EPAR.
- NHS. HIV and AIDS: prevention. Last reviewed 9 July 2025.
- Medicines and Healthcare products Regulatory Agency. MHRA approves lenacapavir for the prevention of sexually transmitted HIV-1 infection. 19 December 2025.
- National Institute for Health and Care Excellence. Lenacapavir for preventing HIV-1 in adults and young people [ID6495]: in development.
- Therapeutic Goods Administration. TGA approves registration of lenacapavir for PrEP for HIV (Yeytuo). 9 January 2026.
Related reading
- How to get PrEP
- Cabenuva: the long-acting HIV injection
- PrEP vs PEP
- Truvada vs Descovy
- Generic Truvada and generic Descovy
- All HIV and PrEP medicines
This content is for informational purposes only and is not medical advice. Approvals and availability change; check with a PrEP clinic in your country. Used as prescribed by a licensed medical professional.
Simran Jha is a licensed clinical pharmacist with 17 years of experience. She holds a B.Pharm and M.Pharm from Dr. YSR University of Health Sciences. At OnlineMeds, she reviews medicine and health content to help ensure it is accurate, evidence-based, and easy to understand.