Maraviroc use while Breastfeeding
Medically reviewed by Drugs.com. Last updated on Nov 17, 2022.
Drugs containing Maraviroc: Selzentry
Maraviroc Levels and Effects while Breastfeeding
Summary of Use during Lactation
Minimal information is available on the use of maraviroc during breastfeeding. An alternate agent may be preferred.
Maternal Levels. A woman with HIV was treated with maraviroc 150 mg twice daily, lamivudine 150 mg twice daily and lopinavir 400 mg plus ritonavir 100 mg twice daily. She exclusively breastfed her infant until 6 months of age, then partially breastfed her infant until 7 months of age. At 5 months postpartum, paired maternal milk and plasma samples were obtained before a dose and at 1, 2, 4, 6, 8, and 12 hours after a dose of maraviroc. A peak milk level of 415 mcg/L occurred 2 hours after the dose. The level was almost as high at 4 hours, and then fell to less than 100 mcg/L at 12 hours after the dose. The average milk concentration was 193 mcg/L, which yields a daily infant dose of 29 mcg/kg of maraviroc. Assuming a maternal weight of 60 kg, this translates to a weight-adjusted infant dosage of 0.6%.
Infant Levels. A woman with HIV was treated with maraviroc 150 mg twice daily, lamivudine 150mg twice daily and lopinavir 400 mg plus ritonavir 100 mg twice daily. At 5.5 months of age, a single plasma sample was obtained (time with respect to dose and nursing not stated) from the infant during exclusive breastfeeding. Maraviroc was undetectable (<2.5 mcg/L) in the infant’s plasma.
Effects in Breastfed Infants
A woman with HIV was treated with maraviroc 150 mg twice daily, lamivudine 150mg twice daily and lopinavir 400 mg plus ritonavir 100 mg twice daily. Her infant received zidovudine 4 mg/kg twice daily for 14 days at birth and was exclusively breastfed until 6 months of age, then partially breastfed until 7 months of age. Clinical and laboratory assessment at 2, 4, and 8 weeks, and 3, 6, 9, and 12 months after birth showed normal development. Full blood cell count, renal, and liver parameters remained within normal range. HIV-DNA PCR results were consistently negative, and at 12 months of age, an HIV antibody test was negative.
Effects on Lactation and Breastmilk
Gynecomastia has been reported among men receiving highly active antiretroviral therapy. Gynecomastia is unilateral initially, but progresses to bilateral in about half of cases. No alterations in serum prolactin were noted and spontaneous resolution usually occurred within one year, even with continuation of the regimen.[2-4] Some case reports and in vitro studies have suggested that protease inhibitors might cause hyperprolactinemia and galactorrhea in some male patients,[5,6] although this has been disputed. The relevance of these findings to nursing mothers is not known. The prolactin level in a mother with established lactation may not affect her ability to breastfeed.
Feiterna-Sperling C, Kruger R, Amara A, et al. Pharmacokinetics of maraviroc in plasma and breastmilk in a treatment-experienced perinatally HIV-1-infected woman. Aids. 2019;33:2443–4. [PMC free article: PMC6882546] [PubMed: 31764111]
García-Benayas T, Blanco F, Martin-Carbonero L, et al. Gynecomastia in HIV-infected patients receiving antiretroviral therapy. AIDS Res Hum Retroviruses. 2003;19:739–41. [PubMed: 14585204]
Pantanowitz L, Evans D, Gross PD, et al. HIV-related gynecomastia. Breast J. 2003;9:131–2. [PubMed: 12603389]
Evans DL, Pantanowitz L, Dezube BJ, et al. Breast enlargement in 13 men who were seropositive for human immunodeficiency virus. Clin Infect Dis. 2002;35:1113–9. [PubMed: 12384846]
Hutchinson J, Murphy M, Harries R, et al. Galactorrhoea and hyperprolactinaemia associated with protease-inhibitors. Lancet. 2000;356:1003–4. [PubMed: 11041407]
Orlando G, Brunetti L, Vacca M. Ritonavir and saquinavir directly stimulate anterior pituitary prolactin secretion, in vitro. Int J Immunopathol Pharmacol. 2002;15:65–8. [PubMed: 12593790]
Montero A, Bottasso OA, Luraghi MR, et al. Galactorrhoea, hyperprolactinaemia, and protease inhibitors. Lancet. 2001;357:473–4. [PubMed: 11273087]
CAS Registry Number
HIV Fusion Inhibitors
Disclaimer: Information presented in this database is not meant as a substitute for professional judgment. You should consult your healthcare provider for breastfeeding advice related to your particular situation. The U.S. government does not warrant or assume any liability or responsibility for the accuracy or completeness of the information on this Site.
LactMed is a registered trademark of the U.S. Department of Health and Human Services.
More about maraviroc
- Check interactions
- Pricing & coupons
- Reviews (3)
- Drug images
- Side effects
- Dosage information
- During pregnancy
- Drug class: chemokine receptor antagonist
- En español
Related treatment guides
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.