What is Maraviroc: Uses, Dosage, Side Effects and More

Maraviroc is a prescription medication specifically designed to treat HIV infection in adults. It belongs to a unique class of HIV drugs called CCR5 antagonists, which work differently from other HIV medications by blocking a specific doorway that HIV uses to enter your immune cells.

This medication isn't a cure for HIV, but it can be a powerful tool in your treatment toolkit. When used as part of combination therapy with other HIV drugs, maraviroc helps keep the virus under control and supports your immune system's ability to stay strong.

What is Maraviroc?

Maraviroc is an antiretroviral medication that specifically targets how HIV enters your CD4 cells. Think of it as a specialized lock that prevents HIV from using one of its main entry points into your immune cells.

Unlike many other HIV medications that work after the virus has already infected your cells, maraviroc works at the very beginning of the infection process. It blocks the CCR5 receptor, which is like a doorway that certain types of HIV use to get inside your healthy immune cells.

This medication is always used in combination with other HIV drugs, never alone. Your doctor will typically prescribe it as part of what's called combination antiretroviral therapy, or cART, which uses multiple medications to attack HIV from different angles.

What is Maraviroc Used For?

Maraviroc is primarily used to treat HIV-1 infection in adults who have a specific type of HIV called CCR5-tropic virus. Before prescribing this medication, your doctor will need to test your HIV to make sure it's the right type that maraviroc can effectively target.

This medication is especially valuable for people who have developed resistance to other HIV medications. If your current HIV treatment isn't working as well as it should, or if you've tried multiple regimens without success, maraviroc might offer a new pathway to viral suppression.

Your doctor might also consider maraviroc if you're starting HIV treatment for the first time, particularly if testing shows you have CCR5-tropic HIV. However, it's more commonly used in treatment-experienced patients who need additional options.

How Does Maraviroc Work?

Maraviroc works as a moderately strong HIV medication by blocking a specific pathway that HIV uses to infect your cells. It's considered a targeted therapy because it focuses on one particular mechanism of HIV infection.

When HIV tries to enter your CD4 cells, it needs to attach to certain receptors on the cell surface. Maraviroc specifically blocks the CCR5 receptor, which prevents CCR5-tropic HIV from successfully entering and infecting your healthy immune cells.

This blocking action happens outside your cells, which makes maraviroc unique among HIV medications. Most other HIV drugs work inside cells after infection has already occurred, but maraviroc stops the infection process before it can even begin.

The medication's effectiveness depends on your HIV being CCR5-tropic. Some people have CXCR4-tropic HIV or dual-tropic HIV, which use different entry points that maraviroc cannot block.

How Should I Take Maraviroc?

Maraviroc is typically taken as a tablet twice daily, with or without food. You can take it with water, milk, or juice - whatever feels most comfortable for your stomach.

Taking maraviroc with food might help reduce any stomach upset, though it's not required. Some people find that taking it with a light snack or meal makes it easier to remember and gentler on their digestive system.

The timing of your doses matters more than what you eat with them. Try to take your doses about 12 hours apart and at the same times each day. This helps maintain steady levels of the medication in your system.

If you take other HIV medications, you'll need to coordinate the timing with maraviroc. Some drug combinations need to be taken together, while others work better when spaced apart. Your pharmacist can help you create a schedule that works with your other medications.

How Long Should I Take Maraviroc For?

Maraviroc is typically a long-term medication that you'll take for as long as it continues to be effective in controlling your HIV. Most people who respond well to maraviroc-containing regimens take it indefinitely as part of their ongoing HIV treatment.

Your doctor will monitor your viral load regularly to make sure maraviroc is working effectively. If your viral load stays undetectable and your CD4 count remains stable or improves, you'll likely continue taking it.

The duration of treatment also depends on how well you tolerate the medication and whether your HIV remains CCR5-tropic. Some people's HIV can change over time, potentially becoming resistant to maraviroc or switching to use different entry pathways.

Never stop taking maraviroc without discussing it with your doctor first. Stopping HIV medications suddenly can lead to viral rebound and potentially the development of drug resistance.

What Are the Side Effects of Maraviroc?

Like all medications, maraviroc can cause side effects, though many people tolerate it well. Most side effects are mild to moderate and often improve as your body adjusts to the medication.

Here are the more common side effects you might experience, and it's helpful to know what to expect so you can discuss any concerns with your healthcare team:

• Nausea and stomach upset
• Diarrhea or loose stools
• Headache
• Fatigue or feeling tired
• Dizziness, especially when standing up
• Trouble sleeping
• Muscle aches or joint pain
• Changes in appetite

These common side effects usually become less bothersome within the first few weeks of treatment. If they persist or interfere with your daily life, your doctor can suggest strategies to help manage them.

More serious side effects are less common but require immediate medical attention. These include signs of liver problems like yellowing of your skin or eyes, severe stomach pain, or unusual fatigue that doesn't improve with rest.

Some people may experience allergic reactions, which could include rash, itching, swelling, or difficulty breathing. If you notice any of these symptoms, contact your healthcare provider right away.

There are also some rare but serious side effects that your doctor will monitor for through regular blood tests and check-ups. These might include changes in your liver function, heart problems, or unusual infections.

Who Should Not Take Maraviroc?

Maraviroc isn't suitable for everyone, and your doctor will carefully evaluate whether it's the right choice for your specific situation. The most important factor is having CCR5-tropic HIV, as the medication won't work against other types of HIV.

People with severe liver problems should use maraviroc with caution or avoid it entirely. Since the medication is processed through your liver, existing liver disease can make it harder for your body to handle the medication safely.

If you have certain heart conditions, particularly those affecting your heart rhythm, your doctor will need to weigh the benefits and risks carefully. Maraviroc can sometimes affect heart function, especially in people with pre-existing cardiac problems.

Here are situations where maraviroc might not be appropriate, and your doctor will discuss these factors with you during your consultation:

• CXCR4-tropic or dual-tropic HIV infection
• Severe liver disease or liver failure
• Certain heart rhythm disorders
• Severe kidney disease
• Pregnancy (limited safety data available)
• Breastfeeding
• Age under 18 (not approved for pediatric use)

Your doctor will also consider your other medications, as some drugs can interact with maraviroc in ways that make it less effective or increase side effects.

If you have a history of depression or other mental health conditions, your doctor will monitor you closely, as some people experience mood changes when starting new HIV medications.

Maraviroc Brand Names

Maraviroc is available under the brand name Selzentry in the United States and Celsentri in many other countries. Both contain the same active ingredient and work identically.

The medication comes in 150mg and 300mg tablets, and your doctor will determine the right strength based on your other medications and individual needs. The dosing can vary depending on what other HIV drugs you're taking.

Generic versions of maraviroc may become available in some regions, but the brand name versions are still the most commonly prescribed. Your pharmacist can help you understand what's available in your area.

Maraviroc Alternatives

If maraviroc isn't suitable for you, there are several other HIV medication options available. The best alternative depends on your specific type of HIV, your treatment history, and how well you've responded to other medications.

Other entry inhibitor medications include enfuvirtide, though it's given by injection and is rarely used today. More commonly, your doctor might consider integrase strand transfer inhibitors like dolutegravir or raltegravir.

Protease inhibitors such as darunavir or atazanavir represent another class of HIV medications that work through a different mechanism. These might be good alternatives if you have CXCR4-tropic HIV that won't respond to maraviroc.

Non-nucleoside reverse transcriptase inhibitors (NNRTIs) like efavirenz or rilpivirine offer yet another approach to HIV treatment. Your doctor will consider factors like your viral resistance pattern and potential side effects when choosing alternatives.

Is Maraviroc Better Than Other HIV Medications?

Maraviroc isn't necessarily better or worse than other HIV medications - it's simply different and particularly valuable for specific situations. The "best" HIV medication is always the one that works most effectively for your individual circumstances.

Compared to some newer HIV medications, maraviroc requires twice-daily dosing, which some people find less convenient than once-daily options. However, its unique mechanism of action makes it irreplaceable for certain treatment scenarios.

For people with CCR5-tropic HIV who have developed resistance to multiple other medications, maraviroc can be a lifeline. It attacks HIV from an angle that other drugs don't, which means it can often work even when other medications have stopped being effective.

The medication tends to be well-tolerated by most people, with side effects that are generally manageable. Some people actually prefer maraviroc because it doesn't cause some of the common side effects associated with other HIV drug classes.