Recommendations for the Use of Antiretroviral Drugs in Pregnant Women with HIV Infection and Interventions to Reduce Perinatal HIV Transmission in the United States

The information in the brief version is excerpted directly from the full-text guidelines. The brief version is a compilation of the tables and boxed recommendations.

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Entry and Attachment Inhibitors

Maraviroc (Selzentry, MVC)

Last Updated: December 24, 2019; Last Reviewed: December 24, 2019

Excerpt from Table 8

Excerpt from Table 8
Generic Name
(Abbreviation)
Trade Name
Formulation Dosing Recommendationsa Use in Pregnancy
Maraviroc
(MVC)
Selzentry
MVC (Selzentry) 
Tablets:
  • 150 mg
  • 300 mg
Standard Adult Dose:
  • MVC 300 mg twice daily with or without food
  • MVC should only be used for patients with CCR5-tropic virus (and no X4-tropic virus).
Dose Adjustments:
  • Increase to MVC 600 mg twice daily when used with the potent CYP3A inducers EFV, ETR, and rifampin.
  • Decrease to MVC 150 mg twice daily when used with CYP3A inhibitors, which includes all PIs except TPV/r and itraconazole.

Pregnancy
PKs in Pregnancy:
  • A PK study in human pregnancy demonstrated a 20% to 30% overall decrease in MVC AUC, but Ctrough exceeded the recommended minimal concentration of 50 ng/mL.
Dosing in Pregnancy:
  • Adjusting the standard adult MVC dose for concomitant use with ARV drugs seems appropriate.
Moderate placental transfer to fetus.b

No evidence of teratogenicity in rats or rabbits; insufficient data to assess for teratogenicity in humans.
a Individual ARV drug doses may need to be adjusted in patients with renal or hepatic insufficiency (for details, see the Adult and Adolescent Antiretroviral Guidelines, Appendix B, Table 10).

b Placental transfer categories are determined by mean or median cord blood/maternal delivery plasma drug ratio:
          High: >0.6
          Moderate: 0.3–0.6
          Low: <0.3

Key to Acronyms:
ARV = antiretroviral; AUC = area under the curve; BID = twice daily; CYP = cytochrome; EFV = efavirenz; ETR = etravirine; MVC = maraviroc; PI = protease inhibitor; PK = pharmacokinetic; TPV/r = tipranavir/ritonavir

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