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Updated Adult and Adolescent ARV Guidelines

The Adult and Adolescent ARV Guidelines were updated on February 12, 2013. 

Please send your comments with the subject line "Comments on Adult and Adolescent ARV Guidelines" to ContactUs@aidsinfo.nih.gov by February 26, 2013.

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Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents

Drug Interactions

Drug Interactions between CCR5 Antagonist and Other Drugs

(Last updated:3/27/2012; last reviewed:2/12/2013)

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Table 15e. Drug Interactions between CCR5 Antagonist and Other Drugs
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(This table provides information relating to pharmacokinetic (PK) interactions between maraviroc (MVC) and non antiretroviral (ARV) drugs. For interactions between ARV agents and for dosing recommendations, please refer to Table 16b.

Concomitant Drug
Class/Name 

CCR5 Antagonist 

Effect on CCR5 Antagonist or Concomitant Drug Concentrations

Dosing Recommendations and Clinical Comments 
Anticonvulsants
Carbamazepine
Phenobarbital
Phenytoin		 MVC  ↓ MVC possible If used without a strong CYP3A inhibitor, use MVC 600 mg BID or an alternative antiepileptic agent.
Antifungals
Itraconazole MVC  ↑ MVC possible Dose: MVC 150 mg BID
Ketoconazole MVC MVC AUC ↑ 400% Dose: MVC 150 mg BID
Voriconazole MVC  ↑ MVC possible Consider dose reduction to MVC 150 mg BID
Antimycobacterials
Clarithromycin MVC  ↑ MVC possible Dose: MVC 150 mg BID
Rifabutin MVC  ↓ MVC possible If used without a strong CYP3A inducer or inhibitor, use MVC 300 mg BID.
If used with a strong CYP3A inhibitor, use MVC 150 mg BID.
Rifampin MVC  MVC AUC ↓ 64% Co-administration is not recommended.
If co-administration is necessary, use MVC 600 mg BID.
If co-administered with a strong CYP3A inhibitor, use MVC 300 mg BID.
Rifapentine MVC  ↓ MVC expected Do not co-administer.
Herbal Products
St. John’s wort MVC ↓ MVC possible Co-administration is not recommended.
Hormonal Contraceptives
Hormonal contraceptives MVC No significant effect on ethinyl estradiol or levonorgestrel Safe to use in combination
Key to Abbreviations: ARV = antiretroviral, AUC = area under the curve, BID = twice daily, CYP = cytochrome P, MVC = maraviroc, PK = pharmacokinetic