maraviroc
Maraviroc (Selzentry) is a medication that's used in combination with other antiretroviral (ARV) therapy to treat CCR5-tropic human immunodeficiency virus (HIV) infections. It comes as oral tablets (both generic and brand name) and solution (brand name only) for adults and children weighing over 4 pounds. Typically this medication is taken by mouth twice daily. Missing doses can make it easier for the HIV virus to change form and become resistant towards maraviroc (Selzentry). Some side effects include rash, cough, and fever. Rarely this medication can cause memory loss as well.
What is Maraviroc (Selzentry)?
What is Maraviroc (Selzentry) used for?
Treatment of CCR5-tropic HIV infection (taken with other antiretroviral medications)
How Maraviroc (Selzentry) works
Maraviroc (Selzentry) is a CCR5 antagonist, which means it blocks a protein called CCR5. CCR5 is usually found on the surface of certain immune system cells and is used by the HIV virus to infect healthy cells. By blocking CCR5, maraviroc (Selzentry) stops the virus from getting into these cells, which helps slow down HIV infection and spread in the body.
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What are the side effects of Maraviroc (Selzentry)?
Common Side Effects
- Upper respiratory tract infection (23%)
- Cough (14%)
- Fever (13%)
- Dizziness (9%)
- Trouble sleeping (8%)
- Herpes infection (8%)
- Changes in appetite (8%)
- Constipation (6%)
Other Side Effects
- Pink eye
- Inflamed hair follicles
- Ear infection
- Pins and needles feeling
- Nerve pain
- Muscle pain
- Changes in mood
- Congestion
Serious Side Effects
- Liver problems: nausea, vomiting, not feeling hungry, pain in the right side of the stomach, yellowing of the skin or whites of the eyes, dark-colored urine, light-colored stool
- Severe allergic reactions: facial swelling, hives, rash, itchy skin, blistering or peeling of skin, body aches, trouble breathing, mouth sores
Source:Â DailyMed
The following side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Body aches or pain
burning or stinging of the skin
chills
cough producing mucus
dizziness when getting up suddenly from a lying or sitting position
ear congestion
headache
loss of voice
pain or tenderness around the eyes and cheekbones
painful blisters on the trunk of the body
painful cold sores or blisters on the lips, nose, eyes, or genitals
stuffy or runny nose
tightness of the chest
trouble breathing
unusual tiredness or weakness
Less common
Arm, back, or jaw pain
black, tarry stools
blood in the urine
blurred or double vision
burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feelings
burning, dry, or itching eyes
burning, itching, and pain in the hairy areas, pus at the root of the hair
change in consciousness
chest pain, discomfort, or heaviness
choking
clay-colored stools
cold, clammy skin
confusion
dark-colored urine
dilated neck veins
discharge or excessive tearing
dizziness
drowsiness
fast, weak pulse
frequent urge to urinate
general feeling of discomfort or illness
heavy jaw feeling
inability to speak
increased frequency of urination
irregular breathing
itching or rash
joint pain
light-colored stools
lightheadedness
loosening of a tooth
loss of appetite
loss of bladder control
loss of taste
lumps in the tongue
muscle aches, cramps, pains, spasms, or stiffness
nausea or vomiting
nervousness
noisy breathing
pain or burning during urination
pain or discomfort in the arms, jaw, back, or neck
pain, swelling, or numbness in the mouth or jaw
pale skin
pounding in the ears
redness or swelling in the ear
redness, pain, swelling of the eye, eyelid, or inner lining of the eyelid
seizures
sensitivity of the eye to light
severe or sudden headache
shakiness in the legs, arms, hands, or feet
shivering
skin lumps
slow, fast, or irregular heartbeat
slurred speech
spread of cancer to the liver
stiff neck or back
stomach cramps, lumps, pain, or tenderness
sudden loss of consciousness
sweating
swelling of the face, fingers, feet, or lower legs
swollen glands
tearing
temporary blindness
trembling or shaking of the hands or feet
trouble sleeping
unable to speak
unpleasant breath odor
unsteadiness or awkwardness
unusual bleeding or bruising
vomiting of blood
warts on the genital area
watery and severe diarrhea, which may also be bloody
weakness in the arms, hands, legs, or feet
weakness on one side of the body, sudden and severe
weight gain or loss
yellow eyes or skin
Incidence not known
Blistering, peeling, or loosening of the skin
red irritated eyes
red skin lesions, often with a purple center
sores, ulcers, or white spots in the mouth or on the lips
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Difficulty having a bowel movement (stool)
difficulty with moving
increased or decreased appetite
swelling or redness in the joints
Less common
Acid or sour stomach
belching
blistering, crusting, irritation, or reddening of the skin
discouragement
feeling sad or empty
flushing or redness of the skin
indigestion
irritability
loss of interest or pleasure
redistribution or accumulation of body fat
skin rash, encrusted, scaly, and oozing
sores, ulcers, or white spots on the lips or tongue or inside the mouth
stomach discomfort or upset
tiredness
trouble in concentrating
unusually warm skin
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Pros and cons of Maraviroc (Selzentry)
Pros
Can be taken with or without food
Can be used in young children who weigh at least 4 pounds
Available in a liquid form for people who have difficulty swallowing pills
Tablets are available in many different strengths for dose adjustments
Cons
Doesn't work for every type of HIV, requires a tropism test before starting treatment
Interacts with many medications, like efavirenz (Sustiva) and ritonavir (Norvir)
Not a good option for people with severe kidney problems
Must be taken twice a day with other HIV ARVs
Pharmacist tips for Maraviroc (Selzentry)
Take maraviroc (Selzentry) every day, along with other HIV ARVs, to help the medication work the best it can. If you accidentally miss a dose, take it as soon as you remember. But don’t double up, as this can raise your risk of side effects.
You can take maraviroc (Selzentry) with or without food. It might be best to take your two doses 12 hours apart.
Get your routine blood tests done on time before and during treatment with maraviroc (Selzentry). This helps your healthcare team check that the medication is working for you and not causing side effects.
Speak with your HIV specialist before stopping maraviroc (Selzentry) or any of your HIV medications. Stopping your HIV medications too soon can cause the virus to spread and become harder to treat.
If your child is taking maraviroc (Selzentry) and you notice major weight changes, let their HIV specialist know. The dose of the medication might need to be adjusted based on your child’s weight.
Maraviroc (Selzentry) can interact with many other medications. This might mean some medications need to be stopped, or the dose of maraviroc (Selzentry) might need to be adjusted. Let your healthcare team know about all the medications you're taking, including over-the-counter products and supplements.
Maraviroc (Selzentry) can cause serious liver problems. Let your HIV specialist know if you experience symptoms such as itchy rash, yellowing of your skin or the whites of your eyes, vomiting, dark urine, or stomach pain.
More tips for taking maraviroc (Selzentry) oral solution
Maraviroc (Selzentry) oral solution should be kept in its original container and at room temperature. Once the bottle has been opened, throw away any remaining liquid 60 days after.
Maraviroc (Selzentry) oral solution will come with a press-in bottle adaptor and 2 oral syringes. Follow the directions included with the medication to make sure you or your child is getting the correct dose.
Frequently asked questions about Maraviroc (Selzentry)
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What are the risks and warnings for Maraviroc (Selzentry)?
Maraviroc (Selzentry) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Liver problems
Risk factors: Hepatitis B or C | History of liver problems
Maraviroc (Selzentry) can cause life-threatening liver problems. These are more common in the first month of treatment. Your HIV specialist will order blood tests for you before and during treatment so they can make sure this medication is safe for your liver. It's also known that allergic reactions, like severe rash and fever, often happen before any liver problems appear. Let your care team know immediately if you experience rash, hives, shortness of breath, feeling sleepy, nausea, loss of appetite, light-colored stool, upper right stomach pain, yellowing of the skin or eyes, or dark urine.
Severe skin reactions and allergic reactions
Risk factor: Taking medications that can cause allergic reactions
Maraviroc (Selzentry) can sometimes cause rash and other severe skin reactions. In rare cases, these skin reactions can lead to hospitalization and other complications. The risk is higher if you're also taking medications that also have a higher risk of causing allergic reactions. Get medical care right away if you have a rash, blistering or peeling skin, painful sores on your face, swelling, or trouble breathing.
Heart problems and low blood pressure
Risk factors: History of heart problems | History of kidney problems
In one study, some people who took maraviroc (Selzentry) had a heart attack during treatment. Although it's not clear how much this medication affects the heart, it's important to let your healthcare team know if you have a history of heart problems before starting maraviroc (Selzentry). Get medical attention right away if you have symptoms of a heart attack, such as chest pain, sweating, nausea, or dizziness.
In addition, maraviroc (Selzentry) can also cause low blood pressure when your body changes positions. This can make you feel dizzy and lightheaded when you stand up, and it can be worse for people with kidney problems. Talk to your HIV specialist if this happens to you, they might need to adjust your dose.
Overactive immune system
Taking HIV ARV therapy, such as maraviroc (Selzentry), can cause changes to your immune system called immune reconstitution syndrome. This condition happens when your immune system becomes overly active after you start combination therapy. So your immune system begins to fight off different infections that it was too weak to fight off before you started treatment. In rare cases, your immune response might improve too much with treatment that it starts to attack normal cells in your body (autoimmune). You can develop these conditions as early as during the first few weeks of treatment or many months later. Tell your healthcare team right away if you start having any new symptoms, such as fever, pain, hair loss, bulging eyes, or sweating, after starting maraviroc (Selzentry).
Serious infections
Risk factors: Active, chronic (long-term), or recurrent infection | Taking other medications that can lower the immune system
Maraviroc (Selzentry) can lower your ability to fight infections. Serious infections, such as upper respiratory tract infection and herpes infection, have happened in people taking this medication. If you take certain medications, like corticosteroids, with maraviroc (Selzentry), you'll likely need to be careful since this raises your risk of getting a serious infection. Let your healthcare team know right away if you have signs or symptoms of an infection, such as fever, cough, or sore throat.
Interactions with other medications
Some medications can interfere with how well your body gets rid of maraviroc (Selzentry) from your system. This can affect the amount of maraviroc (Selzentry) in your body, how well it works, and the risk of side effects.
Taking tuberculosis medication (e.g., rifampin (Rifadin)) can lower the amount of maraviroc (Selzentry) in your body. This can make maraviroc (Selzentry) not work as well to treat your HIV. On the other hand, taking clarithromycin can raise the amount of maraviroc (Selzentry) in your body. This can lead to more side effects, such as upper respiratory tract infections.
Because maraviroc (Selzentry) can have serious interactions with other medications, tell your healthcare team about all the medications you take or plan to take. They’ll check that it's safe to use them together.
Maraviroc (Selzentry) dosage forms
Typical dosing for Maraviroc (Selzentry)
Maraviroc (Selzentry) is available as oral tablets and an oral solution (20 mg/mL). Your dose might be different depending on your kidney health and other medications you take.
Adults: The typical dose ranges from 150 mg to 600 mg by mouth twice daily.
Children: Dosage for children is dependent on their body weight.
Weighing at least 88 pounds: The typical dose ranges from 150 mg to 300 mg by mouth twice daily.
Weighing 66 to 87 pounds: The typical dose ranges from 100 mg to 300 mg by mouth twice daily.
Weighing 44 to 65 pounds: The typical dose ranges from 75 mg to 200 mg by mouth twice daily.
Weighing 31 to 43 pounds: The typical dose ranges from 50 mg to 200 mg by mouth twice daily.
Weighing 22 to 30 pounds: The typical dose ranges from 50 mg to 150 mg by mouth twice daily.
Weighing 13 to 21 pounds: The typical dose is 100 mg by mouth twice daily.
Weighing 9 to 12 pounds: The typical dose is 40 mg by mouth twice daily.
Weighing 4 to 8 pounds: The typical dose is 30 mg by mouth twice daily.
Interactions between Maraviroc (Selzentry) and other drugs
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
- Atazanavir
- Boceprevir
- Carbamazepine
- Clarithromycin
- Cobicistat
- Conivaptan
- Darunavir
- Delavirdine
- Efavirenz
- Enzalutamide
- Etravirine
- Fosamprenavir
- Fosphenytoin
- Idelalisib
- Indinavir
- Itraconazole
- Ketoconazole
- Lopinavir
- Nefazodone
- Nelfinavir
- Phenobarbital
- Phenytoin
- Posaconazole
- Primidone
- Rifampin
- Ritonavir
- Saquinavir
- St John's Wort
- Telaprevir
- Telithromycin
- Voriconazole
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Abametapir
- Cabotegravir
- Capmatinib
- Ceritinib
- Duvelisib
- Fosnetupitant
- Ivosidenib
- Larotrectinib
- Lasmiditan
- Lefamulin
- Lorlatinib
- Lumacaftor
- Netupitant
- Pexidartinib
- Venetoclax
How much does Maraviroc (Selzentry) cost?
Maraviroc (Selzentry) contraindications
People with severe kidney problems who are taking certain medications that interact with maraviroc (Selzentry) (e.g., clarithromycin, Triumeq)
What are alternatives to Maraviroc (Selzentry)?
Treatment of CCR5-tropic HIV infection (taken with other antiretroviral medications)
Treatment of HIV infection in people ages 3 months and older
Maraviroc (Selzentry) images
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References
Best studies we foundClinicalInfoHIV.gov. (n.d.). CCR5.
ClinicalInfoHIV.gov. (n.d.). Immune reconstitution inflammatory syndrome (IRIS).
ClinicalInfoHIV.gov. (n.d.). R5-tropic virus.
ClinicalInfoHIV.gov. (2018). Laboratory testing. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents With HIV.
ClinicalTrials.gov. (n.d.). Search results: Maraviroc. National Library of Medicine.
Hardy, W. D., et al. (2010). Two-year safety and virologic efficacy of maraviroc in treatment-experienced patients with CCR5-tropic HIV-1 infection: 96-week combined analysis of MOTIVATE 1 and 2. Journal of Acquired Immune Deficiency Syndromes.
HIVinfo.NIH.gov. (2021). Drug resistance.
Thapa, S., et al. (2023). Immune reconstitution inflammatory syndrome. StatPearls.
U.S. Food and Drug Administration. (2009). Selzntry (maraviroc) 150 mg, and 300 mg tablets.
ViiV Healthcare Company. (2022). Selzentry- maraviroc tablet, film coated; Selzentry- maraviroc solution; Selzentry- maraviroc [package insert]. DailyMed.
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