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maraviroc (Rx)Brand and Other Names:Selzentry

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

tablet

  • 150mg
  • 300mg
more...

HIV-1 Infection

Indicated for combination antiretroviral treatment of CCR5-tropic HIV-1 in patients who have viral replication and HIV-1 strains resistant to multiple antiretroviral agents

With NRTIs, tipranavir/ritonavir, nevirapine, raltegravir, and other drugs that are not potent CYP3A inhibitors or CYP3A4 inducers: 300 mg PO q12hr

Coadministration with strong CYP3A4 inhibitors (with or without potent CYP3A4 inducers): 150 mg PO q12hr

Coadministration with CYP3A inducers including efavirenz (without a strong CYP3A inhibitor): 600 mg PO q12hr

Renal Impairment

CrCl <30 mL/min or hemodialysis

  • Experiencing postural hypotension: 150 mg PO q12hr
  • Concomitantly administraiton with NRTIs and other medications but without concomitant CYP3A inducers or inhibitors: 300 mg PO q12hr; if postural hypotension occurs, reduce dose to 150 mg q12hr
  • With potent CYP3A inducers or inhibitors: Not recommended

CrCl≥30 mL/min

  • Concomitant administration with potent CYP 3A4 inhibitors with or without a CYP3A4 inducer: 150 mg PO q12hr
  • With potent CYP3A4 inducer without CYP3A4 inhibitor: 600 mg PO q12hr
  • With NRTIs and other medications but without concomitant CYP3A inducers or inhibitors: 300 mg PO q12hr

Hepatic Impairment

Mild to moderate impairment: Maraviroc concentrations increased but dose adjustment not recommended; monitor

Moderate impairment and strong CYP 3A4 inhibitor: Use caution; monitor closely for adverse reactions

Severe impairment: Not studied

Dosage Forms & Strengths

tablet

  • 150mg
  • 300mg
more...

HIV-1 Infection

<16 years: Safety and efficacy not established

>16 years: As in adults; indicated for combination antiretroviral treatment of CCR5-tropic HIV-1 in patients who have viral replication and HIV-1 strains resistant to multiple antiretroviral agents

With NRTIs, tipranavir/ritonavir, nevirapine, raltegravir, and other drugs that are not potent CYP3A4 inhibitors or CYP3A4 inducers: 300 mg PO q12hr

Coadministration with strong CYP3A4 inhibitors (with or without potent CYP3A4 inducers): 150 mg PO q12hr

Coadministration with CYP3A4 inducers including efavirenz (without a strong CYP3A4 inhibitor): 600 mg PO q12hr

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Interactions

Interaction Checker

maraviroc and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            >10%

            Upper respiratory infections (20%)

            Arthritis and musculoskeletal S/S (15%)

            Cough (13%)

            Pyrexia (12%)

            Rash (11%)

            Fever (13%)

            2-10%

            Dizziness (9%)

            Appetite disorder (8%)

            Herpes infection (8%)

            Bronchitis (7%)

            Sinusitis (7%)

            Constipation (6%)

            Apocrine and eccrine gland disorder (5%)

            Paresthesia/dysesthesia (5%)

            Renal/urinary disorder (3-5%)

            Depression (4%)

            Disturbed consciousness (4%)

            Periph neuropathies (4%)

            Pruritus (4%)

            Sensory abnormalities (4%)

            Folliculitis (3%)

            Hypertension (3%)

            Lipodystrophy (3%)

            Muscle pain (3%)

            Influenza (2%)

            Pneumonia (2%)

            Condyloma acuminata

            Dermatitis/eczema

            Dyspepsia

            GI pain

            Stomatitis/ulceration

            <2% (critical ADRs)

            CBN

            Cardiac disorder

            CVA

            Hepatic cirrhosis

            Hepatic failure

            Neoplasms

            C. difficile colitis

            Viral meningitis

            Pneumonia

            Septic shock

            Myositis

            Osteonecrosis

            Rhabdomyolysis

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            Warnings

            Black Box Warnings

            Hepatotoxicity reported; may be preceded by systemic allergic reaction (eg, pruritic rash, eosinophilia, elevated IgE)

            Immediately evaluate if signs or symptoms of hepatitis or allergic reaction occur

            Contraindications

            Hypersensitivity

            Severe renal impairment or end-stage renal disease (CrCl <30 mL/min) in patients taking potent CYP3A4 inhibitors or inducers

            Cautions

            Risks of hepatotoxicity

            Risk of immune reconstitution syndrome if used in combination with other antiretroviral drugs

            Autoimmune disorders (eg, Graves’ disease, polymyositis, Guillain-Barré syndrome) reported in the setting of immune reconstitution, however, the time to onset is more variable, and can occur many months after initiation of treatment

            Do not use in treatment-naïve patients; more likely to experienced virologic failure and developed lamivudine resistance compared to efavirenz

            Tropism testing with a highly sensitive tropism assay is required for the appropriate use

            Evaluate if signs/symptoms of hepatitis, increase LFTs, or rash develop

            Preexisting liver dysfunction or viral hepatitis B or C coinfection

            Patient history of increased risk for cardiovascular events

            History of postural hypotension or concomitant use of blood pressure lowering medication

            Caution in renal and hepatic impairment

            Monitor for developing infections

            Antiretroviral Pregnancy Registry has been established.to monitor maternal-fetal outcomes of pregnant women; register patients by calling 1-800-258-4263

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: breastfeeding not recommended in HIV+ mothers

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Selective antagonist of the interaction between human CCR5 and HIV-1 gp120; blocking this interaction prevents CCR5-tropic HIV-1 entry into cells

            Absorption

            Bioavailability: 23-33%

            Peak plasma time: 0.5-4 hr

            Peak plasma concentration: 333 ng/mL (330 mg BID)

            Distribution

            Protein bound: 76%

            Vd: 194 L

            Metabolism

            Metabolized by cytochrome P450 system, with CYP3A as major enzyme of metabolism

            Elimination

            Half-life: 14-18 hr

            Excretion: 76% (feces); 20% (urine)

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

            Adding plans allows you to:

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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