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 7, 2018; Last Reviewed: December 7, 2018

Excerpt from Table 10a
Generic Name
(Abbreviation)
Trade Name
Formulation Dosing Recommendations 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 BID when used with potent CYP3A inducers: EFV, ETR, and rifampin.
  • Decrease to MVC 150 mg BID when used with CYP3A inhibitors: all PIs except TPV/r, itraconazole.

PK in Pregnancy:
  • A PK study in human pregnancy demonstrated a 20% to 30% overall decrease in AUC, but Ctrough exceeded the recommended minimal concentration of 50 ng/mL.

Dosing in Pregnancy:
  • Standard adult dosing adjusted for concomitant ARV use appears appropriate.
No evidence of teratogenicity in rats or rabbits; insufficient data to assess for teratogenicity in humans.

MCV placental passage category is moderate.b

a Individual ARV drug dosages may need to be adjusted in patients with renal or hepatic insufficiency (for details, see the Adult and Adolescent Guidelines Appendix B, Table 8).
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; CYP3A = cytochrome P450 3A4; EFV = efavirenz; ETR = etravirine; MVC = maraviroc; PI = protease inhibitor; PK = pharmacokinetic; TPV/r = tipranavir/ritonavir

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