Home Drug Guide Maraviroc

Drug Guide

Generic Name

Maraviroc

Brand Names Selzentry

Classification

Therapeutic: Antiretroviral for HIV infection

Pharmacological: CCR5 Antagonist

FDA Approved Indications

  • HIV-1 infection in treatment-experienced patients with CCR5-trophic virus

Mechanism of Action

Maraviroc selectively binds to the CCR5 receptor on CD4 T-cells, preventing the CCR5-tropic HIV from entering and infecting the cells.

Dosage and Administration

Adult: 300 mg orally twice daily, adjust according to drug interactions and renal function

Pediatric: Not established for children under 16 years

Geriatric: Use with caution; adjust for renal impairment

Renal Impairment: Reduce dose in patients with moderate to severe renal impairment (creatinine clearance < 80 mL/min)

Hepatic Impairment: No specific recommendations; use caution in severe hepatic impairment

Pharmacokinetics

Absorption: Well absorbed, bioavailability approximately 23-33%

Distribution: Extensive; protein binding approximately 76-87%

Metabolism: Metabolized primarily via CYP3A4 enzyme

Excretion: Primarily through feces (~76%), some unchanged in urine

Half Life: Approximately 14-18 hours

Contraindications

  • Use with CYP3A4 inducers (e.g., rifampin, phenobarbital) which can decrease efficacy

Precautions

  • Monitor for hepatotoxicity, especially in patients with underlying liver disease
  • Assess baseline hepatic function

Adverse Reactions - Common

  • Musculoskeletal symptoms (e.g., myalgia, arthralgia) (Common)
  • Upper respiratory tract infections (Common)
  • Fever (Common)

Adverse Reactions - Serious

  • Hepatotoxicity, including cases of hepatic failure (Rare)
  • Cardiovascular events (Rare)

Drug-Drug Interactions

  • CYP3A4 inhibitors (e.g., ketoconazole, ritonavir) increase maraviroc levels; dose adjustment required.
  • CYP3A4 inducers decrease maraviroc levels; avoid or adjust dose.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess for baseline liver function, renal function, and HIV status (tropic testing) before initiation.

Diagnoses:

  • Risk for infection related to immunosuppression
  • Risk for hepatotoxicity

Implementation: Administer as prescribed, monitor for adverse effects, and perform periodic laboratory assessments.

Evaluation: Evaluate viral load, CD4 counts, and hepatic function periodically to assess efficacy and safety.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Report any signs of liver problems (e.g., jaundice, dark urine).
  • Inform healthcare provider before starting new medications or herbal supplements.

Special Considerations

Black Box Warnings:

  • Hepatotoxicity can occur; monitor liver function.
  • Potential for drug interactions leading to treatment failure or toxicity.

Genetic Factors: Pharmacogenomic testing for CCR5-tropic virus is recommended before initiation.

Lab Test Interference: May affect certain laboratory tests, such as liver function tests.

Overdose Management

Signs/Symptoms: Nausea, vomiting, dizziness, malaise.

Treatment: Supportive care, activated charcoal if ingestion is recent, and monitoring of vital signs. No specific antidote.

Storage and Handling

Storage: Store at room temperature (20°C to 25°C), protected from moisture and light.

Stability: Stable for at least 2 years when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.