Maraviroc Tablets For HIV: Uses, Dosage, Interactions

Maraviroc, marketed as

Celsentri

(Europe) or

Selzentry

(US), is a CCR5 antagonist used in combination with other antiretroviral drugs to treat CCR5-tropic HIV-1 infection in adults and children. It blocks HIV entry into CD4 cells by binding to the CCR5 co-receptor, preventing viral fusion and infection without curing HIV or preventing transmission.

About maraviroc tablets

Maraviroc belongs to the class of

entry inhibitors

or

CCR5 antagonists

, distinct from other antiretrovirals that act after HIV enters cells. It selectively binds to human CCR5 receptors on immune cells, disrupting the interaction between HIV-1 gp120 and CCR5 needed for CCR5-tropic virus entry.

Treatment requires confirmation of CCR5-tropic HIV via tropism testing, as maraviroc is ineffective against CXCR4-tropic or dual/mixed-tropic strains. It is always used in

combination antiretroviral therapy (ART)

to suppress viral replication, increase CD4 counts, and reduce opportunistic infection risk.

Clinical trials like MOTIVATE-1 and MOTIVATE-2 demonstrated superior viral suppression: 45-56% achieved <50 copies/mL with maraviroc plus optimized background therapy (OBT) vs. 16-22% with placebo + OBT at 48 weeks. In treatment-naïve patients, it matched efavirenz efficacy when tropism was confirmed.

Before taking maraviroc tablets

Allergy

Avoid if allergic to maraviroc or any ingredients. Rare hypersensitivity reactions include rash, fever, and organ dysfunction; discontinue immediately if suspected.

Pregnancy and breastfeeding

Limited data; use only if benefits outweigh risks. No evidence of harm, but register in antiretroviral pregnancy registry. HIV transmission via breast milk possible; breastfeeding not recommended in high-resource settings.

Babies and children

Approved for ages 2+ weighing ≥10kg with CCR5-tropic HIV. Dosing based on weight and concomitant meds. Safety in <2 years unestablished.

Taking other medicines and herbal products

Maraviroc is metabolized by CYP3A; adjust dose with CYP3A inhibitors (e.g., ketoconazole: 150mg BID) or inducers (e.g., efavirenz: 600mg BID). Check interactions with protease inhibitors, NNRTIs.

Drug Class	Examples	Dose Adjustment
Strong CYP3A Inhibitors	Lopinavir/ritonavir, darunavir/ritonavir	150 mg BID
CYP3A Inducers	Efavirenz, etravirine	600 mg BID
Nevirapine	–	300 mg BID with low-dose ritonavir
No Adjustment	Tenofovir, zidovudine	300 mg BID

Conditions to look out for

• Heart/liver disease: Monitor liver enzymes; rare hepatotoxicity.
• Low blood pressure: May cause postural hypotension.
• High cholesterol: Monitor lipids.
• Immune reconstitution syndrome: Possible with starting ART.

How and when to take maraviroc tablets

Dosage

Adults: 300mg BID without CYP3A interactions; adjust per table above. Take with or without food.

Children (2-18 years, ≥10kg): Weight-based, e.g., 10-20kg: 50-75mg BID; max 300mg BID.

If you forget a dose

Take as soon as remembered unless near next dose; do not double. Adherence prevents resistance.

Swallowing difficulties

Tablets may be crushed and mixed with water/fruit juice for oral syringe administration; stable for 30 min.

If you take too much maraviroc

Overdose symptoms: postural hypotension, headache, dizziness. No specific antidote; supportive care, monitor vitals. Contact poison control.

Side-effects

Common (>1/10): cough, fever, rash, muscle pain.

Frequency	Side Effects
Common (1-10%)	Rash, pyrexia, cough, dizziness, diarrhea, nausea, muscle/joint pain, hypertension
Uncommon	Hepatitis, anemia, neutropenia, anxiety, sleep disorders
Rare	Severe rash (DRESS), myocardial ischaemia, liver failure

Lab abnormalities: elevated liver enzymes, low lymphocytes, high eosinophils. CD4 increases greater with maraviroc vs. placebo. Report rash/fever promptly.

Resistance to maraviroc

HIV mutates, developing resistance via CCR5 mutations or tropism shift to CXCR4. Combining with ≥2 active drugs delays resistance. Tropism shifts cause faster failure (30 days earlier).

Tropism testing

Mandatory pre-treatment; re-test if virologic failure. Genotypic assays recommended.

Stopping or switching treatment

Do not stop without doctor advice; viral rebound risks resistance. Switch if tropism change or intolerance.

Expiry dates

Check packaging; discard expired. Store below 30°C.

Further information

• Does not prevent HIV transmission; use condoms/PrEP.
• Regular monitoring: viral load, CD4, tropism, labs.
• Adherence critical for efficacy.

Frequently Asked Questions

What is maraviroc used for?

Treats CCR5-tropic HIV-1 in combination ART; suppresses virus, boosts immunity.

Does maraviroc cure HIV?

No, manages but does not cure or prevent transmission.

Who should not take maraviroc?

Those with CXCR4/dual-tropic HIV or hypersensitivity.

Common side effects?

Rash, cough, fever, muscle pain; monitor liver function.

How to take with other HIV drugs?

Dose adjusts based on interactions; always test tropism first.