Maraviroc 150 Mg Tablet

Q1: What is Maraviroc (Axentri) 150mg used for?

Maraviroc is an entry inhibitor used for treatment-experienced HIV patients infected with CCR5-tropic HIV-1 strains only. It is also sometimes used in treatment-naive patients when CCR5 tropism is confirmed and other drug classes are unsuitable.

Q2: How does Maraviroc work differently from other HIV drugs?

Maraviroc is a CCR5 antagonist — it blocks the CCR5 co-receptor on human CD4 cells (not on the virus itself). HIV uses CCR5 as the main entry point; blocking it prevents CCR5-tropic HIV from entering and infecting CD4 cells.

Q3: What is a tropism test and why is it mandatory before Maraviroc?

A CCR5 tropism test (Trofile assay or genotypic tropism testing) must be performed before starting Maraviroc. Patients with CXCR4-tropic or dual/mixed tropic virus will not respond to Maraviroc — only CCR5-tropic strains are susceptible.

Q4: What is the dosing for Maraviroc 150mg?

Dosing depends on concurrent medications: 150mg twice daily with strong CYP3A4 inhibitors (ritonavir/cobicistat-boosted PIs); 300mg twice daily as standard; 600mg twice daily when taken with CYP3A4 inducers (efavirenz, rifampicin). Always confirm dose with your HIV specialist.

Q5: What are the most common side effects?

Common side effects include headache, dizziness, cough, upper respiratory infections, rash, and abdominal pain. Postural hypotension (dizziness when standing) occurs in some patients, particularly elderly.

Q6: What is the hepatotoxicity risk with Maraviroc?

Hepatotoxicity has been reported, sometimes preceded by systemic allergic symptoms (rash, eosinophilia, elevated IgE). Liver function tests should be monitored at baseline and periodically, particularly in patients with pre-existing hepatic disease.

Q7: What cardiovascular concerns apply to Maraviroc?

CCR5 blockade has theoretical cardiovascular implications. An imbalance in cardiovascular events was noted in some clinical trials. Use with caution in patients with significant cardiovascular disease, and monitor blood pressure.

Q8: What drug interactions significantly affect Maraviroc dosing?

CYP3A4 inhibitors (ritonavir, cobicistat) require dose reduction to 150mg. CYP3A4 inducers (efavirenz, rifampicin) require dose increase to 600mg. These dose adjustments are critical for maintaining therapeutic levels.

Q9: Is Maraviroc safe during pregnancy?

Limited data in pregnancy. Maraviroc is generally avoided in pregnancy unless no other suitable alternatives exist. Discuss with your HIV/OB specialist.

Q10: What monitoring is required during Maraviroc treatment?

CD4 count and viral load at baseline, then every 3–6 months. Liver function tests at baseline and periodically. Blood pressure monitoring. Repeat tropism testing if viral load increases (tropism can shift).

Q11: How should Axentri Maraviroc be stored?

Store at room temperature away from light and moisture. Keep in original packaging out of reach of children.

Q12: Do I need a prescription for Maraviroc?

Yes. Maraviroc requires specialist HIV prescribing, mandatory tropism testing, and careful dose selection based on concurrent antiretrovirals.