Maraviroc Dosage

Medically reviewed by Drugs.com. Last updated on Oct 28, 2024.

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

Usual Adult Dose for HIV Infection

With potent CYP450 3A inhibitors (with or without a potent CYP450 3A inducer): 150 mg orally twice a day

With noninteracting concomitant medications: 300 mg orally twice a day

With potent and moderate CYP450 3A inducers (without a potent CYP450 3A inhibitor): 600 mg orally twice a day

Comments:

Potent CYP450 3A inhibitors (with or without a potent CYP450 3A inducer) including: protease inhibitors (except tipranavir/ritonavir), elvitegravir/ritonavir, ketoconazole, itraconazole, clarithromycin, cobicistat, nefazodone, telithromycin
Noninteracting concomitant medications include all agents that are not potent CYP450 3A inhibitors or inducers such as: dolutegravir, tipranavir/ritonavir, nevirapine, raltegravir, all NRTIs, enfuvirtide.
Potent and moderate CYP450 3A inducers (without a potent CYP450 3A inhibitor) including: efavirenz, rifampin, etravirine, carbamazepine, phenobarbital, phenytoin

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

ORAL SOLUTION:
Weight At Least 2 kg:
With potent CYP450 3A inhibitors (with or without a potent CYP450 3A inducer):

Weight 2 to less than 10 kg: Not recommended (insufficient data available to recommended use).
Weight 10 to less than 20 kg: 50 mg orally twice a day
Weight 20 to less than 30 kg: 80 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:

Weight 2 to less than 4 kg: 30 mg orally twice a day
Weight 4 to less than 6 kg: 40 mg orally twice a day
Weight 6 to less than 10 kg: 100 mg orally twice a day
Weight 10 to less than 14 kg: 150 mg orally twice a day
Weight 14 to less than 30 kg: 200 mg orally twice a day
Weight at least 30 kg: 300 mg orally twice a day

With potent and moderate CYP450 3A inducers (without a potent CYP450 3A inhibitor): Not recommended (insufficient data available to recommended use).

TABLETS:
2 Years or Older Weighing At Least 10 kg:
With potent CYP450 3A inhibitors (with or without a potent CYP450 3A inducer):

Weight 10 to less than 20 kg: 50 mg orally twice a day
Weight 20 to less than 30 kg: 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:

Weight 10 to less than 14 kg: 150 mg orally twice a day
Weight 14 to less than 30 kg: 200 mg orally twice a day
Weight at least 30 kg: 300 mg orally twice a day

With potent and moderate CYP450 3A inducers (without a potent CYP450 3A inhibitor): Not recommended (insufficient data available to recommended use).

Comments:

Recommended dose should be based on body weight and should not exceed the recommended adult dose.
Potent CYP450 3A inhibitors (with or without a potent CYP450 3A inducer) including: protease inhibitors (except tipranavir/ritonavir), elvitegravir/ritonavir, ketoconazole, itraconazole, clarithromycin, cobicistat, nefazodone, telithromycin
Noninteracting concomitant medications include all agents that are not potent CYP450 3A inhibitors or inducers such as: dolutegravir, tipranavir/ritonavir, nevirapine, raltegravir, all NRTIs, enfuvirtide.
Potent and moderate CYP450 3A inducers (without a potent CYP450 3A inhibitor) including: efavirenz, rifampin, etravirine, carbamazepine, phenobarbital, phenytoin

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): Contraindicated
With noninteracting concomitant medications: No adjustment recommended.
With potent and moderate CYP450 3A inducers (without a potent CYP450 3A inhibitor): 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 or inducers

Comments:

Potent CYP450 3A inhibitors (with or without a potent CYP450 3A inducer) including: protease inhibitors (except tipranavir/ritonavir), elvitegravir/ritonavir, ketoconazole, itraconazole, clarithromycin, cobicistat, nefazodone, telithromycin
Noninteracting concomitant medications include all agents that are not potent CYP450 3A inhibitors or inducers such as: dolutegravir, tipranavir/ritonavir, nevirapine, raltegravir, all NRTIs, enfuvirtide.
Potent and moderate CYP450 3A inducers (without a potent CYP450 3A inhibitor) including: efavirenz, rifampin, etravirine, carbamazepine, phenobarbital, phenytoin

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 evidence of systemic allergic reaction (e.g., fever, eosinophilia, elevated immunoglobulin E [IgE]) may precede hepatotoxicity. Patients with signs/symptoms of hepatitis or allergic reaction after use of this drug should be evaluated at once.

CONTRAINDICATIONS:

Severe renal dysfunction or ESRD (CrCl less than 30 mL/min) when concurrently taking potent CYP450 3A inhibitors or inducers

This drug is not recommended for use in preterm neonates or pediatric patients weighing less than 2 kg.

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): Contraindicated
With noninteracting concomitant medications: No adjustment recommended; however, if any symptoms of postural hypotension develop, dose should be reduced to 150 mg orally twice a day.
With potent and moderate CYP450 3A inducers (without a potent CYP450 3A inhibitor): Contraindicated

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

Comments:

Potent CYP450 3A inhibitors (with or without a potent CYP450 3A inducer) including: protease inhibitors (except tipranavir/ritonavir), elvitegravir/ritonavir, ketoconazole, itraconazole, clarithromycin, cobicistat, nefazodone, telithromycin
Noninteracting concomitant medications include all agents that are not potent CYP450 3A inhibitors or inducers such as: dolutegravir, tipranavir/ritonavir, nevirapine, raltegravir, all NRTIs, enfuvirtide.
Potent and moderate CYP450 3A inducers (without a potent CYP450 3A inhibitor) including: efavirenz, rifampin, etravirine, carbamazepine, phenobarbital, phenytoin

Other Comments

Administration advice:

Before starting this drug for treatment of HIV-1 infection, test all patients for CCR5 tropism using a highly sensitive tropism assay.
Before starting this drug and periodically during therapy as clinically indicated, monitor patients for ALT, AST, and bilirubin.
Administer with other antiretroviral agents.
Administer with or without food.
Do not chew the tablets; swallow whole.
Before prescribing the tablets, assess children for ability to swallow tablets; if child is unable to reliably swallow the tablets, use the oral solution formulation.
Administer the oral solution with the included press-in bottle adapter and the appropriate oral dosing syringe: for doses up to 2.5 mL, use the 3-mL syringe; for doses greater than 2.5 mL, use the 10-mL syringe. Take care when measuring neonate doses due to the small volume of oral solution needed.
Discard any unused oral solution 60 days after first opening the bottle.
Consult the manufacturer product information regarding missed doses.

Storage requirements:

Store at 20C to 25C (68F to 77F); excursions permitted between 15C and 30C (59F and 86F).

General:

Limitations of Use: This drug is not recommended for patients with C-X-C chemokine receptor type 4 (CXCR4)-tropic 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-tropic or dual/mixed-tropic HIV-1 not identified by tropism testing at screening has been associated with virologic failure on this drug.
Recommended dosage differs based on coadministered agents (due to drug interactions).

Monitoring:

General: For CCR5 tropism (before therapy); 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 during therapy.
It is important to take this drug with other antiretroviral agents on a regular dosing schedule; avoid missing doses as it can lead to development of resistance.