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Maraviroc Dosage

Applies to the following strengths: 150 mg; 300 mg; 25 mg; 75 mg; 20 mg/mL

The information at Drugs.com is not a substitute for medical advice. Always consult your doctor or pharmacist.

Usual Adult Dose for:

Usual Pediatric Dose for:

Additional dosage information:

Usual Adult Dose for HIV Infection

With potent CYP450 3A inhibitors (with or without a potent CYP450 3A inducer) including protease inhibitors (except tipranavir/ritonavir), delavirdine, elvitegravir/ritonavir, ketoconazole, itraconazole, clarithromycin, other potent CYP450 3A inhibitors (e.g., nefazodone, telithromycin), boceprevir: 150 mg orally twice a day

With noninteracting concomitant medications, including tipranavir/ritonavir, nevirapine, raltegravir, all NRTIs, enfuvirtide: 300 mg orally twice a day

With potent CYP450 3A inducers (without a potent CYP450 3A inhibitor) including efavirenz, rifampin, etravirine, carbamazepine, phenobarbital, phenytoin: 600 mg orally twice a day

Comments:
-Noninteracting concomitant medications include all agents that are not potent CYP450 3A inhibitors or inducers.

Use: In combination with other antiretroviral agents, for the treatment of only C-C chemokine receptor type 5 (CCR5)-tropic HIV-1 infection

Usual Pediatric Dose for HIV Infection

2 Years or Older:
With potent CYP450 3A inhibitors (with or without a potent CYP450 3A inducer) including protease inhibitors (except tipranavir/ritonavir), delavirdine, elvitegravir/ritonavir, ketoconazole, itraconazole, clarithromycin, other potent CYP450 3A inhibitors (e.g., nefazodone, telithromycin), boceprevir:
-Weight 10 to less than 20 kg: 50 mg orally twice a day
-Weight 20 to less than 30 kg:
---Oral solution: 80 mg orally twice a day
---Tablets: 75 mg orally twice a day
-Weight 30 to less than 40 kg: 100 mg orally twice a day
-Weight at least 40 kg: 150 mg orally twice a day

With noninteracting concomitant medications, including tipranavir/ritonavir, nevirapine, raltegravir, all NRTIs, enfuvirtide:
-Weight less than 30 kg: Not recommended.
-Weight at least 30 kg: 300 mg orally twice a day

With potent CYP450 3A inducers (without a potent CYP450 3A inhibitor) including efavirenz, rifampin, etravirine, carbamazepine, phenobarbital, phenytoin: Not recommended.

Comments:
-Recommended dose should be based on body weight and should not exceed the recommended adult dose.
-Noninteracting concomitant medications include all agents that are not potent CYP450 3A inhibitors or inducers.

Use: In combination with other antiretroviral agents, for the treatment of only CCR5-tropic HIV-1 infection

Renal Dose Adjustments

Adult Patients:
Mild to moderate renal dysfunction (CrCl 30 to 80 mL/min): No adjustment recommended.

Severe renal dysfunction (CrCl less than 30 mL/min):
With potent CYP450 3A inhibitors (with or without a potent CYP450 3A inducer) including protease inhibitors (except tipranavir/ritonavir), delavirdine, elvitegravir/ritonavir, ketoconazole, itraconazole, clarithromycin, other potent CYP450 3A inhibitors (e.g., nefazodone, telithromycin), boceprevir: Contraindicated

With noninteracting concomitant medications, including tipranavir/ritonavir, nevirapine, raltegravir, all NRTIs, enfuvirtide: No adjustment recommended; however, if any symptoms of postural hypotension develop, dose should be reduced to 150 mg orally twice a day.

With potent CYP450 3A inducers (without a potent CYP450 3A inhibitor) including efavirenz, rifampin, etravirine, carbamazepine, phenobarbital, phenytoin: Contraindicated

Pediatric Patients:
Mild or moderate renal dysfunction (CrCl 30 to 80 mL/min): Data not available
Severe renal dysfunction (CrCl less than 30 mL/min): Contraindicated in patients receiving potent CYP450 3A inhibitors

Liver Dose Adjustments

Adult Patients:
-Mild to moderate liver dysfunction: No adjustment recommended.
-Severe liver dysfunction: Data not available

Pediatric Patients: Data not available

Comments:
-Adults with moderate liver dysfunction using maraviroc 150 mg with a potent CYP450 3A inhibitor should be monitored closely for drug-related side effects.

Precautions

US BOXED WARNING:
-HEPATOTOXICITY: Hepatotoxicity reported. Severe rash or indication of systemic allergic reaction (e.g., fever, eosinophilia, elevated IgE) may precede hepatotoxicity. Patients with signs/symptoms of hepatitis or allergic reaction after use of this drug should be evaluated at once.

Safety and efficacy have not been established in patients younger than 2 years; this drug is not recommended for use in these patients.

Consult WARNINGS section for additional precautions.

Dialysis

ESRD on Regular Hemodialysis:
Adult patients:
With potent CYP450 3A inhibitors (with or without a potent CYP450 3A inducer) including protease inhibitors (except tipranavir/ritonavir), delavirdine, elvitegravir/ritonavir, ketoconazole, itraconazole, clarithromycin, other potent CYP450 3A inhibitors (e.g., nefazodone, telithromycin), boceprevir: Contraindicated

With noninteracting concomitant medications, including tipranavir/ritonavir, nevirapine, raltegravir, all NRTIs, enfuvirtide: No adjustment recommended; however, if any symptoms of postural hypotension develop, dose should be reduced to 150 mg orally twice a day.

With potent CYP450 3A inducers (without a potent CYP450 3A inhibitor) including efavirenz, rifampin, etravirine, carbamazepine, phenobarbital, phenytoin: Contraindicated

Pediatric patients: Contraindicated in patients receiving potent CYP450 3A inhibitors

Other Comments

Administration advice:
-Before starting this drug, test all patients for CCR5 tropism using a highly sensitive tropism assay.
-Before starting this drug, monitor patients for ALT, AST, and bilirubin.
-Must administer with other antiretroviral agents.
-May administer without regard to food
-Do not chew the tablets; swallow whole.
-If child is unable to reliably swallow the tablets, use the oral solution formulation; administer with the included press-in bottle adapter and oral dosing syringe.
-Consult the manufacturer product information regarding missed doses.

General:
-Limitations of use: This drug is not recommended for patients with C-X-C chemokine receptor type 4 (CXCR4)- or dual/mixed-tropic HIV-1.
-This drug is recommended for patients with only CCR5-tropic HIV-1 infection; outgrowth of preexisting low-level CXCR4- or dual/mixed-tropic HIV-1 not identified by tropism testing at screening has been associated with virologic failure on this drug.
-Recommended dose differs based on coadministered agents (due to drug interactions).

Monitoring:
-General: For infections (during therapy)
-Hepatic: ALT, AST, and bilirubin (before starting and periodically during therapy as clinically indicated)

Patient advice:
-Read the US FDA-approved patient labeling (Medication Guide and Instructions for Use).
-Stop this drug and seek medical evaluation at once if signs/symptoms of hepatitis or allergic reaction develop after using this drug.
-Avoid potentially hazardous activities (e.g., driving, operating machinery) if dizziness occurs.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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