Selzentry (Maraviroc) - Oral

Warning:

The Food and Drug Administration (FDA) assigned a black box warning of liver toxicity to Selzentry (maraviroc). Some people might experience symptoms of a severe allergic reaction before having liver toxicity. Symptoms of a severe allergic reaction may include a severe rash, swelling, and breathing difficulties. If you have worsening liver function, symptoms may be dark-colored urine and yellowing of the eyes or skin. If you're experiencing these symptoms, get medical help right away.

What Is Selzentry?

Selzentry (maraviroc) is a medication used to treat human immunodeficiency virus (HIV). HIV is a virus that infects and attacks a person's CD4 T-cells, which are a particular type of white blood cell (WBC) and a part of your immune system.

HIV enters CD4 cells using two binding sites: the CD4 receptor and a co-receptor. HIV can use either the CCR5 co-receptor, the CXCR4 co-receptor, or both, on the surface of the CD4 cells.

Being what is called a CCR5 co-receptor antagonist, Selzentry is effective at treating only the HIV that uses the CCR5 co-receptor. Selzentry won't work if HIV uses only the CXCR4 co-receptor. Selzentry is also ineffective if the HIV strain can use either the CCR5 or CXCR4 co-receptor.

Selzentry needs to be used in combination with other antiretroviral drugs. It is available in prescription tablet or liquid solution dosage forms.

Drug Facts

Generic Name: Maraviroc

Brand Name(s): Selzentry

Drug Availability: Prescription

Therapeutic Classification: CCR5 co-receptor antagonist

Available Generically: Tablet dosage form is available in a generic version

Controlled Substance: No

Administration Route: Oral (by mouth)

Active Ingredient: Maraviroc

Dosage Form(s): Tablet and liquid solution

What Is Selzentry Used For?

Selzentry is used to treat HIV-1. It needs to be used with other antiretroviral medications.

Human immunodeficiency virus (HIV) affects approximately 1.4 million people in the United States, with over 10% unaware of their HIV status.

If you have HIV, you typically experience only flu-like symptoms during the first few weeks of infection. Over time, however, HIV—without treatment—can cause acquired immunodeficiency syndrome (AIDS). AIDS is the late stage of HIV infection when your immune system is so weak that you may have trouble fighting off infections.

How to Take Selzentry

Selzentry needs to be taken with other antiretroviral medications. This medication is generally taken by mouth twice daily, with or without food.

Storage

When you receive Selzentry from the pharmacy, store it at room temperature between 68 degrees to 77 degrees Fahrenheit. It has a short-term safety range of 59 degrees to 86 degrees Fahrenheit. After you open the Selzentry liquid solution bottle, the medication is suitable for only 60 days.

To be safe, you can use a locked cabinet or closet to keep your medication out of the reach of children and pets.

If you plan to travel with Selzentry, get familiar with your final destination's regulations. Checking with the U.S. embassy or consulate might be a helpful resource. In general, however, copy your Selzentry prescription. If possible, keep your medication in its original container from your pharmacy with your name on the label. Ask your pharmacist or healthcare provider if you have any questions about traveling with your medicine.

You can also ask your pharmacist or healthcare provider about the best ways to dispose of your medications. The FDA's website is a potentially helpful resource for where and how to discard all unused and expired drugs. You can also find disposal boxes in your area.

How Long Does Selzentry Take to Work?

You may notice an improvement in your CD4 cell count within three to six months. You may also see low and undetectable HIV levels.

What Are the Side Effects of Selzentry?

This is not a complete list of side effects, and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

The following are common side effects of Selzentry in people who previously received HIV treatment:

The following are common side effects of Selzentry in people who are new to HIV treatment:

Common side effects of Selzentry in children may include:

Severe Side Effects

Get medical help right away if you experience the following serious side effects:

  • Heart-related effects: In people who previously received HIV treatment, Selzentry is linked to heart-related effects, such as a heart attack.
  • Immune reconstitution syndrome: When you take Selzentry, your immune system may become stronger. As your immune system gains strength, it might start fighting infections that have been hiding in your body. So, keep an eye out for symptoms of an infection. The immune system may also become overreactive and attack parts of your body by mistake. General symptoms of these autoimmune diseases may include rash, low energy, joint pain, and concentration difficulties.
  • Cancer risk: While more research is needed, Selzentry might increase your cancer risk due to its effects on the immune system.
  • Liver toxicity: Selzentry may raise your risk of liver injury. Symptoms of worsening liver function may include dark-colored urine and yellowing of the eyes or skin.
  • Postural (positional) low blood pressure: People with low kidney function may experience extremely low blood pressure. This may occur when you're changing positions from sitting down to standing. Symptoms may include feeling lightheaded and faint.
  • Severe allergic reaction: If you have a severe allergic reaction to Selzentry, you may experience symptoms of swelling, rash, and breathing difficulties.
  • Severe skin rash: Some people taking Selzentry have developed severe rashes, such as Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). SJS and TEN are different names for the same skin condition—with SJS being a slightly less severe but still an emergency situation. TEN, on the other hand, is more severe and life-threatening. If you have SJS or TEN, symptoms may include blistering, peeling, and painful skin.

Call 911 if your symptoms feel life threatening.

Long-Term Side Effects

Selzentry's long-term side effects are similar to its severe side effects, which may include the following:

  • Cancer risk
  • Heart-related effects
  • Immune reconstitution syndrome (inflammatory disorders that occur after starting HIV treatment)
  • Liver toxicity
  • Severe skin rash

Report Side Effects

Salezentry may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your provider may send a report to the FDA's MedWatch Adverse Event Reporting Program online or by phone (800-332-1088).

Dosage: How Much Selzentry Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For oral dosage forms (solution or tablets):
    • For treatment of HIV infection:
      • Adults—150, 300, or 600 milligrams (mg) two times a day, taken together with other medicines. Your doctor may adjust the dose as needed.
      • Children 2 years of age and older—Dose is based on body weight and must be determined by your doctor. The dose is usually 50 to 150 mg (2.5 to 7.5 mL) two times a day, taken together with other medicines. Your doctor may adjust the dose as needed.
        • Weighing 40 kilograms (kg) or more—150 or 300 milligrams (mg) (7.5 to 15 mL) two times a day, taken together with other medicines. Your doctor may adjust the dose as needed.
        • Weighing 30 to less than 40 kg—100 or 300 mg (5 to 15 mL) two times a day, taken together with other medicines. Your doctor may adjust the dose as needed.
        • Weighing 20 to less than 30 kg—75 or 200 mg (4 to 10 mL) two times a day, taken together with other medicines. Your doctor may adjust the dose as needed.
        • Weighing 14 to less than 20 kg—50 or 200 mg (2.5 to 10 mL) two times a day, taken together with other medicines. Your doctor may adjust the dose as needed.
        • Weighing 10 to less than 14 kg—50 or 150 mg (2.5 to 7.5 mL) two times a day, taken together with other medicines. Your doctor may adjust the dose as needed.
        • Weighing 6 to less than 10 kg—100 mg (5 mL) two times a day, taken together with other medicines. Your doctor may adjust the dose as needed.
        • Weighing 4 to less than 6 kg—40 mg (2 mL) two times a day, taken together with other medicines. Your doctor may adjust the dose as needed.
        • Weighing 2 to less than 4 kg—30 mg (1.5 mL) two times a day, taken together with other medicines. Your doctor may adjust the dose as needed.
      • Children younger than 2 years of age—Use and dose must be determined by your doctor.
      • Children weighing less than 2 kilograms (kg)—Use is not recommended.

Modifications

The following modifications should be kept in mind when using Selzentry:

Severe allergic reaction: Avoid using Selzentry if you have a known allergy to it or its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.

Pregnancy: In animal studies, Selzentry wasn't linked to adverse effects on the fetus. We don't know enough about the safety and effectiveness of Selzentry in pregnant people and their unborn fetuses.

Consider enrolling in the Antiretroviral Pregnancy Registry (APR) by calling 1-800-258-4263. Discuss with your healthcare provider if you plan to become pregnant or are pregnant. Your healthcare provider may help you weigh the benefits and risks of taking Selzentry during pregnancy.

Breastfeeding: In animal studies, Selzentry was present in rat breast milk. We don't know enough about the safety and effects of Selzentry in human breast milk and nursing babies. Breastfeeding, however, isn't recommended, to limit the chances of HIV passing onto an HIV-negative baby. Avoiding breastfeeding may also prevent treatment-resistant HIV in HIV-positive babies.

Talk with your healthcare provider if you plan to breastfeed. Your healthcare provider will help you weigh the benefits and harms of taking Selzentry while nursing. They can also discuss the different ways available to feed your baby.

Adults over 65: Clinical studies haven't included a large enough number of people in this age group to see whether they respond differently from younger adults. In adults that take several medications and have kidney or liver impairment, use Selzentry with caution.

Children: The Food and Drug Administration (FDA) approved Selzentry for children between zero to 18 years old. The child taking Selzentry must weigh at least 2 kilograms (4.4 pounds). However, Selzentry isn't recommended for a preterm newborn.

Kidney problems: Selzentry is linked to a higher likelihood of postural (positional) low blood pressure in people with severe kidney impairment or end-stage renal disease (ESRD). If you experience this side effect, your healthcare provider will adjust your Selzntry dosage. Selzentry isn't recommended if you have one of these severe kidney conditions and/or if you take medications—like St. John's wort for depression—that strongly affect CYP3A liver proteins.

Liver problems: The liver is responsible for breaking down Selzentry and clearing the medication out of the body. If you have liver impairment, Selzentry may build up in your body. This raises your risk for side effects. Therefore, your healthcare provider may adjust your Selzentry dosage and closely monitor for side effects.

Missed Dose

If you accidentally forgot your Selzentry dose, take it as soon as you remember. However, if it's less than six hours before your next scheduled dose, skip the missed dose and take the following dose at your next scheduled dosing time. Don't try to double up to make up for the missed dose.

Find ways to help yourself remember to keep your appointments and take your medication. If you miss too many doses, Selzentry might be less effective at treating HIV. In fact, there's a higher chance of developing treatment-resistant HIV.

Overdose: What Happens If I Take Too Much Selzentry?

A suspected overdose of Selzentry will likely result in dangerously low postural blood pressure (after sitting or lying down). Symptoms may include:

  • Dizziness
  • Fainting
  • Lightheadedness

If you think you're experiencing an overdose or life-threatening symptoms, seek immediate medical attention.

What Happens If I Overdose on Selzentry?

If you think you or someone else may have overdosed on Selzentry, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Selzentry, call 911 immediately.

Precautions

Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your doctor check your progress at regular visits to make sure this medicine is working properly. Blood tests may be needed to check for unwanted effects.

Your immune system may get stronger when you start taking HIV medicines. Tell your doctor right away if you notice any changes in your health. Sometimes the immune system will start to fight infections that were hidden in your body, such as pneumonia, herpes, or tuberculosis. Autoimmune disorders such as Graves' disease, polymyositis, and Guillain-Barré syndrome may also occur.

This medicine may cause some people to become dizzy. If this happens, do not drive, use machines, or do anything else that could be dangerous if you are dizzy. You may also feel lightheaded when getting up suddenly from a lying or sitting position, so stand up slowly.

Liver problems with allergic reactions may occur while you are using this medicine. Check with your doctor right away if you have a skin rash with fever, dark-colored urine, pain in the upper right stomach area, vomiting, or yellow eyes or skin.

Serious allergic and skin reactions (eg, Stevens-Johnson syndrome, toxic epidermal necrolysis, or drug rash with eosinophilia and systemic symptoms (DRESS)) may occur while using this medicine. These could be life-threatening and require immediate medical attention. Check with your doctor right away if you have blistering, peeling, or loosening of the skin, red skin lesions, severe acne or skin rash, joint or muscle aches, sores or ulcers on the skin, or fever or chills while you are using this medicine.

Using this medicine may increase your risk of getting infections or cancer. Talk to your doctor if you have concerns about this risk.

This medicine will not keep you from giving HIV to your partner during sex. Make sure you understand and practice safe sex, even if your partner also has HIV, by using a latex condom or other barrier method. This medicine will also not keep you from giving HIV to other people if they are exposed to your blood. Do not re-use or share needles with anyone.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal (eg, St. John's wort) or vitamin supplements.

What Are Reasons I Shouldn’t Take Selzentry?

Before taking Selzentry, talk with your healthcare provider if any of the following applies to you.

  • Severe allergic reaction: Avoid this medication if you have a severe allergic reaction to Selzentry or any of its components.
  • Pregnancy: There's limited information about the effects and safety of Selzentry on the unborn fetus. Consider enrolling in the Antiretroviral Pregnancy Registry (APR) by calling 1-800-258-4263. You can also talk with your healthcare provider to help weigh the benefits and risks of taking Selzentry during pregnancy.
  • Breastfeeding: There is little information about the effects and safety of Selzentry on nursing babies. In general, however, breastfeeding should be avoided to prevent passing HIV on to an HIV-negative infant or developing treatment-resistant HIV in an HIV-positive baby.
  • Children: The Food and Drug Administration (FDA) approved Selzentry use in children between zero to 18 years old—as long as the child weighs at least 2 kilograms (4.4 pounds). Selzentry, however, isn't recommended in preterm newborns.
  • Adults over 65: There's not enough data to assess the differences between Selzentry's safety and effectiveness between older and younger adults.
  • Kidney or liver problems: Selzentry isn't recommended for people with severe kidney impairment or end-stage renal disease (ESRD)—or who are also taking medications (e.g., St. John's wort for depression) that strongly affect CYP3A liver proteins.

What Other Medications Interact With Selzentry?

Selzentry has numerous possible interactions with medications that affect CYP3A and P-glycoprotein (P-gp).

CYP3A is part of the cytochrome P450 (CYP450) family of proteins responsible for breaking down medications. P-gp, on the other hand, is a protein that moves drugs around the body.

If a medication is a CYP3A or P-gp inhibitor, it prevents these proteins from working. As a result, there's a higher chance of Selzentry building up in your body. This can also lead to a higher risk of side effects. So, if you need to take a CYP3A or P-gp inhibitor with Selzentry, your healthcare provider will likely lower your Selzentry dosage.

If a medication is a CYP3A or P-gp inducer, on the other hand, it encourages these proteins to do their jobs quickly. This may lead to lower amounts of Selzentry in the body and decrease its effectiveness. Therefore, your healthcare provider will likely raise your Selzentry dosage.

The following are some examples of medications that will likely interact with Selzentry:

  • Carbamazepine is an anti-seizure medication. It's also a potent CYP3A inducer.
  • Ketoconazole antifungal is a CYP3A and P-gp inhibitor.
  • Phenobarbital is another anti-seizure medication. It's a moderate CYP3A inducer.
  • Phenytoin is also an anti-seizure medication. Like carbamazepine, phenytoin is considered a potent CYP3A inducer.
  • Rifampin is typically used with other medications for tuberculosis (TB). It's also considered a potent CYP3A inducer.
  • St. John's wort is a natural medication commonly used for depression. It's also a potent CYP3A inducer. Taking St. John's wort with Selzentry should be avoided.
  • Verapamil is a medication with many uses, including abnormal heart rhythm and migraines. It's considered to be a moderate CYP3A and P-gp inhibitor.

Talk with your pharmacist or healthcare provider for more detailed information about medication interactions with Selzentry.

And be sure to talk with your healthcare provider about any other medicines you take or plan to take, including over-the-counter, nonprescription products, vitamins, herbs, or plant-based medicines.

What Medications Are Similar?

Several medications are available to treat HIV. Selzentry, however, is the only member of the CCR5 co-receptor antagonist medication class.

Compared to some other HIV treatment options, experts don't typically support Selzentry as an initial go-to choice for most people. Recommendations are based on the following disadvantages of Selzentry.

  • Inconvenience: Selzentry is dosed twice daily.
  • Additional testing requirement: Before starting Selzentry, further testing is required to determine whether HIV uses CCR5 or CXCR4 to enter CD4 cells.
  • Less effectiveness: Selzentry-based treatments don't lower HIV levels as well as other first-choice HIV combination treatments.

Frequently Asked Questions

  • Where is Selzentry available?

    Selzentry is available as a prescription from your healthcare provider. Your local retail pharmacy may carry this medication. If it's not on its shelves, the pharmacy staff may need to order it for you.

  • How much does Selzentry cost?

    The Selzentry tablet dosage form is available as the generic maraviroc. The Selzentry liquid solution, however, doesn't have a generic version yet, so the medication might be costly.

    If cost is a concern, talk to your healthcare provider or pharmacist about available patient assistance programs for you.

  • Why do I need to get another lab test before I can take Selzentry?

    Selzentry is effective if HIV uses only the CCR5 co-receptor to enter and infect CD4 cells. If the HIV in your body can use CXCR4 co-receptors, then Selzentry will not work for you.

  • If Selzentry isn't a go-to option, why am I taking it?

    Many people start or switch to Selzentry if they're experiencing severe side effects from their previous HIV combination therapy (regimen).

    Another possible reason is that the previous HIV combo regimen isn't working as well anymore, so Selzentry might be used to help your current regimen work better.

How Can I Stay Healthy While Taking Selzentry?

While living with HIV may have its challenges, there are ways to help improve quality of life. Refer below for some general tips:

  • Take HIV-related medications as recommended by your healthcare provider.
  • Keep up with labs and appointments with your healthcare provider.
  • Learn more about HIV.
  • Share with your loved ones about your HIV status when you are ready. While this is a difficult step, building your social support network is essential.
  • Stop smoking. HIV-positive smokers are more likely to have heart disease and cancer than the general public.
  • Routinely exercising lowers your heart disease risk and bone loss.
  • Practice safe sex to limit the spread of HIV.
  • Stay up to date with your vaccines.
  • Consider joining support groups or working with a mental health professional to help you find coping strategies to change how you think, feel, react, or respond to living with HIV.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended as a replacement for medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

14 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. HIV.gov. HIV/AIDS glossary: coreceptor.

  2. HIV.gov. Guidelines for the use of antiretroviral agents in adults and adolescents living with HIV.

  3. Food and Drug Administration. Selzentry label.

  4. HIV.gov. U.S. statistics.

  5. Centers for Disease Control and Prevention. About HIV.

  6. Food and Drug Adminstration. About HIV and the Center for Drug Evaluation and Research's role.

  7. World Health Organization. HIV/AIDS.

  8. Woollard SM, Kanmogne GD. Maraviroc: a review of its use in HIV infection and beyond. 2015;9:5447-5468. doi: 10.2147/DDDT.S90580

  9. National Organization of Rare Disorders. Stevens-Johnson syndrome and toxic epidermal necrolysis.

  10. MedlinePlus. Stevens-Johnson syndrome/toxic epidermal necrolysis.

  11. MedlinePlus. Maraviroc.

  12. ScienceDirect. Cytochrome P450.

  13. ScienceDirect. P-glycoprotein.

  14. Food and Drug Administration. Drug development and drug interactions: table of substrates, inhibitors and inducers.

By Ross Phan, PharmD, BCACP, BCGP, BCPS
Ross is a writer for Verywell with years of experience practicing pharmacy in various settings. She is also a board-certified clinical pharmacist and the founder of Off Script Consults.