HIVInfo.us - maraviroc information

maraviroc (Selzentry)
General Information	Maraviroc (Selzentry) is almost always used as one component of a multidrug combination to suppress the human immunodeficiency (HIV) viral load.
Specifics	Maraviroc is one of the newest and most effective antiviral medications used to treat HIV. Maraviroc is different from all other FDA-approved HIV medications in that it binds to a human cell receptor and not to HIV. Maraviroc works by inhibiting the binding of HIV to uninfected T-cells (also known as CD4-lymphocytes.) Maraviroc is classified as a co-receptor inhibitor. Specifically maraviroc inhibits strains of HIV that use the CCR5 co-receptor to bind to T-cells (also known as CD4-lymphocytes.)
Dosing including preparation and administration	The dosing of maraviroc depends on the dosing of other medications that the patient may be taking. Maraviroc is taken as 150 mg twice a day with protease inhibitors (except for tipranavir), delavirdine (Rescriptor), ketoconazole (Nizoral or generic), itraconazole (Sporanox), clarithromycin (Biaxin), nefazodone (Serzone), telithromycin (Ketek). Maraviroc is taken as 300 mg twice a day with tipranavir (Aptivus) plus ritonavir (Norvir), nevirapine (Viramune), all of the nukes (NRTIs), and enfuvirtide (Fuzeon). Maraviroc is taken as 600 mg twice a day with efavirenz (Sustiva), rifampin, carbemazepine (Tegretol), phenobarbital, phenytoin (Dilantin).
Adherence (this refers to your willingness, ability, and actual performance in taking your medications) For further information and tips on adherence, go to the Adherence section of this site.	The "all or none" rule applies to all antiviral medications such as maraviroc: you should commit yourself to taking every dose, every day OR take none at all. Missing doses leads to a worsening of HIV infections (resistance to medications) and makes finding a good antiviral medication harder to do. As with any antiviral drug or antibiotic, try not to ever miss a dose. If you miss a dose and notice that you have done so within a few hours of its scheduled time, you may take the dose as usual and take the next dose at its regular time. You should never change the dose of maraviroc without speaking to your healthcare provider first. If you miss more than one dose, look at the reasons why you missed them and come up with a plan to avoid it in the future. For example, if you fell asleep too early, take the medicine earlier in the evening, with your later meal, set an alarm, or have someone appointed to wake you up for your medicine. It is strongly recommended that you consider using weekly pill boxes and arrange all of your doses a week in advance. Buy a small pill box so that you can carry a dose or two of your medicines with you in case you are away from home. Obviously in the case of maraviroc, a lot of planning has to be done as it may be difficult to carry extra maraviroc, syringes, and other supplies with you.
Possible Side Effects The package insert for most drugs including maraviroc is often overwhelming and scary with perhaps an overemphasis on side effects. We have summarized the important and more common problems here.	Many people take maraviroc without many side effects. The most common side effect of maraviroc is related to the fact that maraviroc dilates blood vessels. This might result in lower blood pressure or feeling faint when one changes position rapidly. Rarely some persons may be allergic to maraviroc and they can develop skin rashes and fever. In trials of another related drug, there was a rare tendency to get lymph node cancers (lymphoma). This has not been seen with maraviroc, but we only have information about this drug that goes back a year or two. Usually you will have blood tests done in the first month to look for the beneficial effects of maraviroc and any side effects. Many minor side effects will either stay constant or get better with time. It is mainly the side effects that are severe or get worse that may cause significant health risks for you.
Interactions This refers to the way that maraviroc affects other medications	The interactions of maraviroc with other drugs is taken into account with the dosing recommendations listed above. However, make sure your healthcare providers knows all the medications you are taking including any herbal and over the counter medications.
Report to you healthcare provider or go to an Emergency Room if you have severe side effects, increasing side effects, shortness of breath, uncontrollable diarrhea, back pain, groin pain, fever, weakness, jaundice (eyes and skin turn yellow,) muscle pain, nausea and vomiting so that you cannot hold down your food and liquids.
You can download this handout in PDF format by clicking HERE.