Maraviroc
| Interaction Color Code | Clinical Bottom Line | Clinical Effects | Drug 1 effect | Drug 2 dose | Drug 2 effect | Management | |
|---|---|---|---|---|---|---|---|
| Ritonavir MVC 1042 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Increased maraviroc effects |
100 mg BID | Maraviroc AUC increased 161%; Cmin increased 355%; Cmax increased 28% |
Reduce dose of maraviroc to 150 mg BID with strong CYP3A4 inhibitors |
|
| Darunavir MVC 884 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential for increased maraviroc adverse effects |
Not reported |
150 mg BID | Cmax increase 77%, AUC increase 210%, Cmin increase 427% |
Use maraviroc 150 mg BID when combined with darunavir / ritonavir |
| Darunavir MVC 883 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential for increased maraviroc adverse effects |
Not reported |
150 mg BID | Cmax increase 129%, AUC increase 305%, Cmin increase 700% |
Use maraviroc 150 mg BID when combined with darunavir / ritonavir |
| Atazanavir MVC 764 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential increase in maraviroc adverse effects |
Not reported |
300 mg BID | Maraviroc AUC increased 388%, Cmax increased 167%, Cmin increased 567% |
Decrease maraviroc dose to 150 mg BID |
| Atazanavir MVC 763 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential increase in maraviroc adverse effects |
Not reported |
300 mg BID | Maraviroc AUC increased 257%, Cmax increased 109%, Cmin increased 319% |
Decrease maraviroc dose to 150 mg BID |
| Nevirapine MVC 594 | Green: Administer standard doses | Administer standard doses | Nevirapine AUC no significant change |
300 mg single dose | Maraviroc Cmax increased 54% |
Use standard dose maraviroc. If coadministering with nevirapine plus a protease inhibitor, reduce dose of maraviroc to 150 mg BID |
|
| Etravirine MVC 519 | Yellow: Adjust dosing | Adjust dosing to avoid reduced levels of maraviroc | No significant change |
300 mg BID | Maraviroc AUC decreased 53%; Cmax decreased 60%; Cmin decreased 39% |
Increase maraviroc to 600 mg BID when combined with etravirine. When etravirine and maraviroc are coadministered with a strong CYP3A4 inhibitor, decrease maraviroc dose to 150 mg BID |
|
| Etravirine MVC 518 | Yellow: Adjust dosing | Adjust dosing to avoid reduced levels of maraviroc | Increased maraviroc effects |
150 mg BID | Maraviroc AUC increased 3.10 fold; Cmax increased 1.76 fold; Cmin increased 5.27 fold |
Increase maraviroc to 600 mg BID when combined with etravirine. When etravirine and maraviroc are coadministered with a strong CYP3A4 inhibitor, decrease maraviroc dose to 150 mg BID |
|
| Etravirine MVC 517 | Yellow: Adjust dosing | Adjust dosing to avoid reduced levels of maraviroc | Increased maraviroc effects |
No significant change on etravirine, darunavir or ritonavir pharmacokinetics |
300 mg BID | Maraviroc AUC increased 210%; Cmax increased 77%; Cmin increased 430% |
Increase maraviroc to 600 mg BID when combined with etravirine. When etravirine and maraviroc are coadministered with a strong CYP3A4 inhibitor, decrease maraviroc dose to 150 mg BID |
| Etravirine MVC 516 | Yellow: Adjust dosing | Adjust dosing to avoid reduced levels of maraviroc | Decreased maraviroc effects |
300 mg BID | Maraviroc AUC decreased 53%; Cmax decreased 60%; Cmin decreased 39% |
Increase maraviroc to 600 mg BID when combined with etravirine. When etravirine and maraviroc are coadministered with a strong CYP3A4 inhibitor, decrease maraviroc dose to 150 mg BID |
|
| Efavirenz MVC 364 | Yellow: Adjust dosing | Adjust dosing to avoid reduced levels of maraviroc | Decreased maraviroc effects |
100 mg BID | Maraviroc AUC decreased 45%; Cmax decreased 51%; Cmin decreased 45% |
Increase maraviroc dose to 600 mg BID |
|
| Efavirenz MVC 363 | Yellow: Adjust dosing | Adjust dosing to avoid reduced levels of maraviroc | Decreased maraviroc effects |
100 mg BID | Maraviroc AUC decreased 45%; Cmax decreased 51%; Cmin decreased 45% |
Increase maraviroc dose to 600 mg BID |
|
| Raltegravir MVC 300 | Green: Administer standard doses | Administer standard doses | Raltegravir AUC decreased 37%; Cmin decreased 28%; Cmax decreased 33% |
300 mg Q12H | Maraviroc Cmin decreased 21%; Cmax decreased 20% |
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| Maraviroc Oxcarbazepine 62 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential decrease in antiretroviral efficacy |
Use alternative agents |
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| Maraviroc Eslicarbazepine 61 | Orange: Minimal data to guide interaction | Minimal data to guide interaction: risks likely to outweigh benefits | Potential decrease in antiretroviral efficacy |
Use alternative agents |
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| Maraviroc St. John's Wort (Hypericum perforatum) 60 | Red: Avoid combination | Do not coadminister: Potential for reduced levels of maraviroc | Potential decrease in antiretroviral efficacy |
Use alternative agents |
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| Maraviroc Dasabuvir + Ombitasvir / Paritaprevir / Ritonavir 59 | Red: Avoid combination | Do not coadminister: Potential for increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Use alternative agents |
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| Maraviroc RPT 58 | Green: Administer standard doses | Do not coadminister: Potential for reduced levels of maraviroc | Potential decrease in antiretroviral efficacy |
Use alternative agents |
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| Maraviroc RAL 57 | Green: Administer standard doses | Administer standard doses | Maraviroc AUC decreased 14%; Cmax decreased 21% |
400 mg BID | Raltegravir AUC decreased 37%; Cmin decreased 27% |
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| Maraviroc NVP 56 | Green: Administer standard doses | Administer standard doses | Maraviroc AUC no change; Cmax increased 54% |
200 mg BID | Not reported |
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| Maraviroc RFB 55 | Green: Administer standard doses | Administer standard doses | Maraviroc AUC no change; Cmin decreased 30% |
300 mg daily | Not reported |
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| Maraviroc Voriconazole 54 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Reduce maraviroc dose to 150 mg BID |
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| Maraviroc Voriconazole 53 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Reduce maraviroc dose to 150 mg BID |
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| Maraviroc Posaconazole 52 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Reduce maraviroc dose to 150 mg BID |
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| Maraviroc Itraconazole 51 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Reduce maraviroc dose to 150 mg BID |
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| Maraviroc Clarithromycin 50 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Reduce maraviroc dose to 150 mg BID |
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| Maraviroc DRV 49 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Maraviroc Cmin increased 16%; Cmax no significant change (when compared to maraviroc 300 mg BID without darunavir / ritonavir in separate control arm) |
800 / 100 mg BID | Not reported |
Reduce dose of maraviroc to 150 mg BID |
|
| Maraviroc DRV/c 48 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Reduce dose of maraviroc to 150 mg BID |
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| Maraviroc RTV 47 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Maraviroc AUC increased 161%; Cmax increased 28% |
100 mg BID | Not reported |
Reduce dose of maraviroc to 150 mg BID |
| Maraviroc DRV/r 46 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Maraviroc AUC increased 305%; Cmax increased 129% |
600 mg / 100 mg BID | Not reported |
Reduce dose of maraviroc to 150 mg BID |
| Maraviroc ATV/r 45 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Maraviroc AUC increased 388%; Cmax increased 167% |
300 mg / 100 mg daily | Not reported |
Reduce dose of maraviroc to 150 mg BID |
| Maraviroc ATV 44 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Maraviroc AUC increased 257%; Cmax increased 109% |
400 mg daily | Not reported |
Reduce dose of maraviroc to 150 mg BID |
| Maraviroc Elvitegravir / Cobicistat / Emtricitabine / Tenofovir alafenamide 43 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Reduce dose of maraviroc to 150 mg BID |
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| Maraviroc ATV/c 42 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Potential maraviroc-associated adverse effects |
Reduce dose of maraviroc to 150 mg BID |
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| Maraviroc Ketoconazole 41 | Yellow: Adjust dosing | Adjust dosing to avoid increased levels of maraviroc | Increased maraviroc effects |
Maraviroc AUC increased 400%; Cmax increased 238%; Cmin increased 275% |
400 mg daily | Not reported |
Reduce dose of maraviroc to 150 mg BID |
| Maraviroc Phenytoin 40 | Yellow: Adjust dosing | Adjust dosing to avoid decreased levels of maraviroc | Potential decrease in antiretroviral efficacy |
Increase maraviroc dose to 600 mg BID. If including MVC, ETR plus a strong CYP3A4 inhibitor in the regimen, reduce maraviroc dose to 150 mg BID |
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| Maraviroc Phenobarbital 39 | Yellow: Adjust dosing | Adjust dosing to avoid decreased levels of maraviroc | Potential decrease in antiretroviral efficacy |
Increase maraviroc dose to 600 mg BID. If including MVC, ETR plus a strong CYP3A4 inhibitor in the regimen, reduce maraviroc dose to 150 mg BID |
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| Maraviroc ETR 38 | Yellow: Adjust dosing | Adjust dosing to avoid decreased levels of maraviroc | Potential decrease in antiretroviral efficacy |
Maraviroc AUC decreased 53%; Cmin decreased 39% |
200 mg BID | Not reported |
Increase maraviroc dose to 600 mg BID. If including MVC, ETR plus a strong CYP3A4 inhibitor in the regimen, reduce maraviroc dose to 150 mg BID |
| Maraviroc CBZ 37 | Yellow: Adjust dosing | Adjust dosing to avoid decreased levels of maraviroc | Potential decrease in antiretroviral efficacy |
Increase maraviroc dose to 600 mg BID. If including MVC, ETR plus a strong CYP3A4 inhibitor in the regimen, reduce maraviroc dose to 150 mg BID |
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| Maraviroc EFV 36 | Yellow: Adjust dosing | Adjust dosing to avoid decreased levels of maraviroc | Maraviroc AUC increased 15%; Cmax increased 16% when compared to maraviroc 100 mg BID given alone. |
600 mg daily | Not reported |
Increase maraviroc dose to 600 mg BID. If including MVC, EFV plus a strong CYP3A4 inhibitor in the regimen, reduce maraviroc dose to 150 mg BID |
|
| Maraviroc EFV 35 | Yellow: Adjust dosing | Adjust dosing to avoid decreased levels of maraviroc | Potential decrease in antiretroviral efficacy |
Maraviroc AUC decreased 45%; Cmax decreased 51% |
600 mg daily | Not reported |
Increase maraviroc dose to 600 mg BID. If including MVC, EFV plus a strong CYP3A4 inhibitor in the regimen, reduce maraviroc dose to 150 mg BID |
| Maraviroc RIF 34 | Yellow: Adjust dosing | Adjust dosing to avoid decreased levels of maraviroc | Maraviroc AUC increased 4%; Cmax decreased 3% when compared to maraviroc 100 mg BID given alone. |
600 mg daily | Not reported |
Increase maraviroc dose to 600 mg BID. If also including a strong CYP3A4 inhibitor in the regimen, consider using an alternative agent due to difficulty predicting maraviroc concentrations. |
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| Maraviroc RIF 33 | Yellow: Adjust dosing | Adjust dosing to avoid decreased levels of maraviroc | Potential decrease in antiretroviral efficacy |
Maraviroc AUC decreased 63%; Cmax decreased 66%; Cmin decreased 78% |
600 mg daily | Not reported |
Increase maraviroc dose to 600 mg BID. If also including a strong CYP3A4 inhibitor in the regimen, consider using an alternative agent due to difficulty predicting maraviroc concentrations. |
| Fostemsavir MVC 13 | Green: Administer standard doses | Administer standard doses | Temsavir Cmax increased 13%, AUC increased 10%, Cmin decreased 10% |
300 mg BID | Maraviroc AUC increased 25%, Cmin increased 37% |
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| Maraviroc |

