Celsentri (Maraviroc 25 mg)
Film-coated tablet — CCR5 co-receptor antagonist for HIV-1 treatment
Quick Facts About Celsentri
Key Takeaways About Celsentri
- Tropism test required: A viral tropism assay must confirm CCR5-tropic HIV-1 before starting Celsentri — it is not effective against CXCR4-tropic or dual/mixed-tropic virus
- Always used in combination: Celsentri must be taken together with other antiretroviral medicines as part of combination therapy (cART); it is never used alone
- Dose depends on co-medications: The dose of maraviroc varies significantly depending on which other medicines you take — particularly CYP3A4 inhibitors and inducers
- Liver safety monitoring: Hepatotoxicity has been reported; seek immediate medical attention if you develop signs of liver problems such as jaundice, dark urine, or persistent nausea
- Does not prevent transmission: Celsentri does not cure HIV and does not prevent sexual or blood-borne transmission of the virus to others
What Is Celsentri and What Is It Used For?
Celsentri (maraviroc) is a CCR5 co-receptor antagonist — a type of antiretroviral medicine that blocks HIV-1 from entering human immune cells. It is used in combination with other antiretroviral agents for the treatment of CCR5-tropic HIV-1 infection in patients aged 2 years and older.
Celsentri contains the active substance maraviroc, which belongs to a class of medicines known as CCR5 co-receptor antagonists (also called entry inhibitors). Unlike many other antiretroviral drugs that act on the virus after it has entered the cell, maraviroc works at the earliest stage of HIV infection — preventing the virus from entering human CD4+ T-cells in the first place. This unique mechanism of action makes Celsentri a valuable component of combination antiretroviral therapy (cART), particularly for patients who have developed resistance to other classes of antiretroviral drugs.
HIV-1 uses two main co-receptors to enter human immune cells: CCR5 and CXCR4. The chemokine receptor CCR5 is expressed on the surface of several types of immune cells, including CD4+ T-lymphocytes, macrophages, and dendritic cells. During the early stages of HIV infection, the virus predominantly uses the CCR5 co-receptor (known as R5-tropic virus). Maraviroc selectively and reversibly binds to the CCR5 receptor, causing a conformational change that prevents the viral envelope glycoprotein gp120 from interacting with it. This blocks the essential step required for the virus to fuse with and enter the host cell.
Because Celsentri specifically targets the CCR5 co-receptor, it is only effective against CCR5-tropic (R5) HIV-1. It has no activity against CXCR4-tropic (X4) or dual/mixed-tropic (R5/X4) virus. For this reason, a viral tropism test must be performed before starting treatment with Celsentri to confirm that the patient's HIV-1 population exclusively uses the CCR5 co-receptor for cell entry. If the tropism test reveals CXCR4-using virus, an alternative antiretroviral regimen must be selected.
Celsentri was first approved by the European Medicines Agency (EMA) in 2007 and by the U.S. Food and Drug Administration (FDA) under the brand name Selzentry. It was initially indicated for treatment-experienced patients with CCR5-tropic HIV-1, and the indication was subsequently expanded to include treatment-naïve patients. Today, Celsentri is indicated for the treatment of CCR5-tropic HIV-1 infection in adults, adolescents, and children aged 2 years and older weighing at least 10 kg, in combination with other antiretroviral medicinal products.
Celsentri is not a cure for HIV infection or AIDS. It suppresses viral replication when used as part of combination antiretroviral therapy, helping to reduce the viral load and increase CD4 cell counts. Patients must continue to take all prescribed antiretroviral medications, attend regular follow-up appointments, and practise safer sex to prevent transmission of HIV to others.
What Should You Know Before Taking Celsentri?
Before starting Celsentri, a tropism test must confirm CCR5-tropic HIV-1. Inform your doctor about all medical conditions — especially liver disease, cardiovascular problems, or low blood pressure — and provide a complete list of all medications you are taking, as dose adjustments are critical.
Contraindications
Do not take Celsentri if you are allergic (hypersensitive) to maraviroc or any of the other ingredients of this medicine. Hypersensitivity reactions, including severe skin rash and evidence of systemic allergic reaction (such as fever, eosinophilia, or elevated IgE), have been reported in association with hepatotoxicity. If you develop signs of a serious allergic reaction, stop taking Celsentri and contact your doctor immediately.
Celsentri should not be used in patients with CXCR4-tropic or dual/mixed-tropic HIV-1, as determined by a validated tropism assay. Initiating treatment in patients without confirmed CCR5-tropic virus may result in treatment failure and the potential development of drug resistance. If a change in viral tropism is suspected during treatment (for example, following virological failure), a repeat tropism test should be performed.
Patients with severe hepatic impairment should not take Celsentri unless the potential benefits clearly outweigh the risks, as there are insufficient data on the use of maraviroc in this population. Maraviroc is extensively metabolised by the liver, and altered hepatic function may lead to unpredictable drug levels and an increased risk of adverse effects.
Warnings and Precautions
Talk to your doctor or pharmacist before taking Celsentri if you have any of the following conditions or circumstances:
- Liver disease: Hepatotoxicity preceded by a systemic allergic reaction (rash, eosinophilia, elevated IgE) has been reported with maraviroc. Patients with pre-existing liver disease, including chronic hepatitis B or C co-infection, may be at increased risk. Liver function tests should be monitored regularly
- Cardiovascular disease: Maraviroc may cause postural hypotension (a drop in blood pressure upon standing). Use with caution in patients with cardiovascular disease, those on antihypertensive medications, or those with a history of postural hypotension. Patients taking concomitant medication known to lower blood pressure should be advised of the possibility of additive effects
- Kidney impairment: Maraviroc is primarily cleared by the kidneys. Patients with severe renal impairment (creatinine clearance <30 mL/min) who are also taking potent CYP3A4 inhibitors should not take Celsentri due to the risk of drug accumulation. Dose adjustment guidance is limited for patients with severe renal impairment
- Immune reconstitution inflammatory syndrome (IRIS): When starting combination antiretroviral therapy, patients with severe immune deficiency may develop an inflammatory response to dormant or residual opportunistic infections. This may require additional medical treatment
- Osteonecrosis: Cases of osteonecrosis (bone death) have been reported in patients with advanced HIV disease or long-term combination antiretroviral therapy. Patients should be advised to seek medical attention if they experience joint pain, stiffness, or difficulty with movement
- Infections: The CCR5 receptor plays a role in the immune response to certain infections. Theoretically, blocking CCR5 might affect the body's ability to combat certain infections, although clinical studies have not demonstrated an increased risk of serious infections with maraviroc
Regular monitoring is essential during treatment with Celsentri. Your doctor will arrange periodic blood tests to check your viral load, CD4 cell count, liver function, and kidney function. Attend all scheduled appointments and report any new or unusual symptoms promptly. If virological failure occurs, a repeat tropism test should be performed, as a shift from CCR5-tropic to CXCR4-tropic or dual/mixed-tropic virus may occur during the course of HIV disease.
Pregnancy and Breastfeeding
If you are pregnant, think you may be pregnant, or are planning to become pregnant, consult your HIV specialist before taking Celsentri. Animal reproductive toxicology studies with maraviroc have not shown evidence of teratogenicity or effects on fertility at clinically relevant exposures. However, data on the use of maraviroc in pregnant women are limited. Based on the available evidence, Celsentri should only be used during pregnancy if the potential benefit to the mother justifies the potential risk to the fetus.
Maraviroc has been detected in rat milk in animal studies, but it is not known whether it is excreted in human breast milk. Women living with HIV are generally advised not to breastfeed in order to avoid postnatal transmission of the virus to the infant. If you are breastfeeding or planning to breastfeed, discuss all available options with your healthcare provider.
The Antiretroviral Pregnancy Registry monitors pregnancy outcomes in women exposed to antiretroviral medicines during pregnancy. Patients and healthcare providers are encouraged to report any pregnancies occurring during treatment with Celsentri to contribute to the growing body of safety data.
Hepatotoxicity with allergic features has been reported with maraviroc use. This may be preceded by evidence of a systemic allergic reaction (including pruritic rash, eosinophilia, or elevated IgE). Patients with signs or symptoms of hepatitis or allergic reaction following treatment with Celsentri should be evaluated immediately. Discontinuation of Celsentri should be considered in patients with signs of hepatotoxicity.
How Does Celsentri Interact with Other Drugs?
Maraviroc is metabolised by CYP3A4, making its blood levels highly sensitive to co-administration with CYP3A4 inhibitors and inducers. The dose of Celsentri must be adjusted when taken with protease inhibitors, cobicistat, efavirenz, rifampicin, and certain other medicines.
Drug interactions are a critical consideration with Celsentri because maraviroc is primarily metabolised by the cytochrome P450 enzyme CYP3A4 in the liver. Medicines that inhibit CYP3A4 can significantly increase maraviroc plasma concentrations, while CYP3A4 inducers can substantially reduce them. These pharmacokinetic changes can affect both the efficacy and safety of Celsentri, necessitating dose adjustments that are specific to the co-administered medicine.
The clinical importance of these interactions cannot be overstated. When maraviroc is taken with a potent CYP3A4 inhibitor such as a ritonavir-boosted or cobicistat-boosted protease inhibitor, ketoconazole, itraconazole, or clarithromycin, the dose of Celsentri must be reduced to 150 mg twice daily (compared to the standard 300 mg twice daily). Conversely, when co-administered with a potent CYP3A4 inducer such as efavirenz (without a potent CYP3A4 inhibitor), rifampicin, carbamazepine, phenobarbital, or phenytoin, the dose must be increased to 600 mg twice daily.
Maraviroc is also a substrate of the efflux transporter P-glycoprotein (P-gp). Medicines that inhibit P-gp may also contribute to increased maraviroc exposure. Additionally, maraviroc is a weak inhibitor of CYP2D6 at clinically relevant concentrations, although this is generally not considered clinically significant. It is essential to provide your doctor with a comprehensive list of all medications, including over-the-counter medicines, herbal products, and dietary supplements.
Clinically Significant Drug Interactions
| Co-administered Drug | Effect on Maraviroc | Celsentri Dose | Recommendation |
|---|---|---|---|
| Ritonavir-boosted PIs (e.g., darunavir/r, lopinavir/r, atazanavir/r) | Increased maraviroc levels (CYP3A4 inhibition) | 150 mg twice daily | Mandatory dose reduction; monitor for side effects |
| Cobicistat-boosted regimens | Increased maraviroc levels (CYP3A4 inhibition) | 150 mg twice daily | Mandatory dose reduction; same as ritonavir-boosted PIs |
| Ketoconazole, itraconazole | Increased maraviroc levels (CYP3A4 inhibition) | 150 mg twice daily | Mandatory dose reduction; monitor hepatic function |
| Clarithromycin, telithromycin | Increased maraviroc levels (CYP3A4 inhibition) | 150 mg twice daily | Dose reduction recommended |
| Efavirenz (without a potent CYP3A4 inhibitor) | Decreased maraviroc levels (CYP3A4 induction) | 600 mg twice daily | Mandatory dose increase; monitor virological response |
| Rifampicin (rifampin) | Markedly decreased maraviroc levels (potent CYP3A4 induction) | 600 mg twice daily | Dose increase essential; avoid if possible with CYP3A4 inhibitors |
| Carbamazepine, phenobarbital, phenytoin | Decreased maraviroc levels (CYP3A4 induction) | 600 mg twice daily | Dose increase; monitor anticonvulsant levels if applicable |
| St. John’s Wort (Hypericum perforatum) | Potentially markedly decreased maraviroc levels | Not recommended | Avoid concurrent use; may lead to loss of virological response |
Other Interactions of Note
When Celsentri is co-administered with NNRTIs other than efavirenz (such as nevirapine or etravirine) without a potent CYP3A4 inhibitor, the standard dose of 300 mg twice daily should be used. When etravirine is combined with a boosted protease inhibitor, the potent CYP3A4 inhibitory effect of the PI predominates, and the reduced dose of 150 mg twice daily should be used.
Integrase strand transfer inhibitors (INSTIs) such as raltegravir, dolutegravir, and bictegravir do not significantly affect CYP3A4 activity. Therefore, the standard dose of maraviroc 300 mg twice daily should be used when Celsentri is co-administered with these agents in the absence of other potent CYP3A4 inhibitors or inducers.
Maraviroc does not inhibit or induce CYP3A4 at therapeutic concentrations and is therefore not expected to significantly alter the pharmacokinetics of co-administered medicines that are CYP3A4 substrates. However, it is a weak inhibitor of CYP2D6 and P-glycoprotein, and caution should be exercised when combining it with narrow therapeutic index substrates of these pathways, such as metoprolol or digoxin, respectively.
There are no specific studies on the interaction between alcohol and maraviroc. However, both alcohol and maraviroc can affect the liver, and excessive alcohol consumption may increase the risk of hepatotoxicity. Patients with hepatitis B or C co-infection should be particularly cautious. Discuss alcohol consumption with your healthcare provider.
What Is the Correct Dosage of Celsentri?
The standard adult dose of Celsentri is 150 mg, 300 mg, or 600 mg twice daily, depending entirely on the co-administered medications. The dose must be determined by a specialist physician experienced in the management of HIV infection.
The dosage of Celsentri is uniquely dependent on the other medications the patient is taking, because of the significant impact of CYP3A4 inhibitors and inducers on maraviroc pharmacokinetics. Unlike many other antiretroviral medicines, there is no single standard dose for all patients. The prescribing physician must carefully evaluate the complete antiretroviral regimen and all concomitant medications before determining the appropriate dose. Celsentri tablets should be taken with or without food, as maraviroc absorption is not significantly affected by a high-fat meal.
Adults
Standard Adult Dosage
300 mg twice daily — when co-administered with NRTIs (e.g., tenofovir, emtricitabine, abacavir, lamivudine), raltegravir, dolutegravir, bictegravir, enfuvirtide, nevirapine, or other medicinal products that are not potent CYP3A4 inhibitors or inducers.
150 mg twice daily — when co-administered with potent CYP3A4 inhibitors including ritonavir-boosted or cobicistat-boosted protease inhibitors (e.g., darunavir/r, lopinavir/r, atazanavir/r), ketoconazole, itraconazole, clarithromycin, or telithromycin.
600 mg twice daily — when co-administered with potent CYP3A4 inducers (without a potent CYP3A4 inhibitor) including efavirenz, rifampicin, carbamazepine, phenobarbital, or phenytoin.
Children and Adolescents
Paediatric Use (aged 2 years and older, weighing ≥10 kg)
The dose for children and adolescents is based on body weight and must also be adjusted according to concomitant medications, following the same CYP3A4 interaction principles as for adults. Only a physician experienced in the management of paediatric HIV infection should prescribe Celsentri for children. Available tablet strengths and oral solution formulations may be used to achieve the correct weight-based dose.
For children weighing 10 to <20 kg, the doses are lower than for adults and must be individually calculated. For adolescents weighing 40 kg or more, adult dosing recommendations generally apply. Refer to the approved prescribing information for complete weight-based dosing tables.
Elderly Patients
Geriatric Dosage Considerations
There is limited clinical experience with maraviroc in patients aged 65 years and older. Elderly patients may have reduced hepatic, renal, or cardiac function, and are more likely to be taking concomitant medications that affect CYP3A4 activity. No specific dose adjustment is recommended solely on the basis of age, but careful evaluation of concomitant medications and organ function is essential. Close monitoring for side effects, particularly postural hypotension, is advised in elderly patients.
Missed Dose
If you forget to take a dose of Celsentri, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and take the next one at the usual time. Do not take a double dose to make up for the one you missed. Maintaining consistent dosing is important to sustain adequate blood levels of maraviroc and prevent the development of drug resistance.
If you frequently forget doses, talk to your doctor or pharmacist about strategies to improve adherence, such as using a pill organiser, setting phone alarms, or incorporating medication-taking into daily routines. Poor adherence to antiretroviral therapy is one of the leading causes of virological failure and the emergence of drug-resistant HIV strains.
Overdose
If you accidentally take more Celsentri than prescribed, contact your doctor, local poison control centre, or emergency department immediately. The most likely symptom of overdose is postural hypotension (a fall in blood pressure upon standing). In clinical studies, the highest dose administered was 1200 mg. A dose-limiting adverse effect at higher doses was postural hypotension. There is no specific antidote for maraviroc overdose. Treatment should be supportive and directed at maintaining blood pressure and monitoring cardiac function.
| Co-administered Medication | Celsentri Dose | Notes |
|---|---|---|
| NRTIs, raltegravir, dolutegravir, nevirapine | 300 mg twice daily | Standard dose; no potent CYP3A4 inhibitors or inducers present |
| Boosted PIs (ritonavir/cobicistat) | 150 mg twice daily | Potent CYP3A4 inhibition increases maraviroc levels |
| Ketoconazole, itraconazole | 150 mg twice daily | Potent CYP3A4 inhibitors; monitor for adverse effects |
| Efavirenz (without potent CYP3A4 inhibitor) | 600 mg twice daily | CYP3A4 induction reduces maraviroc levels significantly |
| Rifampicin | 600 mg twice daily | Potent CYP3A4 inducer; avoid combining with CYP3A4 inhibitor |
| Carbamazepine, phenytoin, phenobarbital | 600 mg twice daily | Anticonvulsants are potent CYP3A4 inducers |
What Are the Side Effects of Celsentri?
Like all medicines, Celsentri can cause side effects. Common side effects include nausea, diarrhoea, headache, and fatigue. A serious but uncommon side effect is hepatotoxicity (liver damage), which may be preceded by signs of a systemic allergic reaction. Contact your doctor immediately if you develop jaundice, dark urine, or persistent nausea.
The safety profile of maraviroc has been evaluated in extensive clinical trials, including the pivotal MOTIVATE-1 and MOTIVATE-2 studies in treatment-experienced patients and the MERIT study in treatment-naïve patients. Overall, Celsentri was generally well tolerated in these studies, with a side effect profile broadly comparable to the control groups. The majority of adverse reactions were mild to moderate in severity and did not lead to discontinuation of treatment.
It is important to recognise that many symptoms experienced by people living with HIV may be related to the underlying HIV infection, immune reconstitution, co-infections (particularly hepatitis B or C), or other concomitant antiretroviral medicines rather than to maraviroc specifically. Your doctor will help you determine whether any new symptoms are related to Celsentri or to other factors.
Hepatotoxicity is the most clinically significant adverse reaction associated with maraviroc. Cases of hepatotoxicity with allergic features have been reported, including elevated liver transaminases accompanied by rash, eosinophilia, and elevated IgE. These events may occur at any time during treatment but have typically been observed within the first few months. Liver function tests should be performed at baseline and periodically during treatment, particularly in patients with hepatitis B or C co-infection or pre-existing liver disease.
Very Common Side Effects
May affect more than 1 in 10 people
- Nausea
- Diarrhoea
- Fatigue and asthenia (weakness)
- Headache
Common Side Effects
May affect up to 1 in 10 people
- Abdominal pain and flatulence
- Decreased appetite
- Rash
- Dizziness
- Insomnia and sleep disorders
- Depression
- Cough
- Elevated liver enzymes (AST, ALT)
- Myalgia (muscle pain)
- Anaemia
Uncommon Side Effects
May affect up to 1 in 100 people
- Hepatotoxicity with allergic features (rash, eosinophilia, elevated IgE)
- Postural hypotension (drop in blood pressure on standing)
- Seizures and convulsions
- Stevens-Johnson syndrome (severe skin reaction)
- Myositis (muscle inflammation)
- Osteonecrosis (bone tissue death)
- Angina pectoris (chest pain)
- Renal failure
Rare Side Effects
May affect up to 1 in 1,000 people
- Toxic epidermal necrolysis
- Drug reaction with eosinophilia and systemic symptoms (DRESS)
- Hepatic cirrhosis or hepatic failure
- Severe hypersensitivity reactions
- Pancytopenia (reduction in all blood cell types)
Yellowing of the skin or eyes (jaundice), dark-coloured urine, pale stools, persistent nausea or vomiting, severe abdominal pain, unexplained fever with rash, swelling of the face, lips, tongue or throat, difficulty breathing, severe skin blistering, or signs of a serious allergic reaction. These may indicate hepatotoxicity or a severe hypersensitivity reaction requiring urgent medical assessment. Stop taking Celsentri and contact emergency services immediately.
You are encouraged to report any suspected side effects to your healthcare provider or to your national pharmacovigilance authority. In the EU, reports can be submitted via the national reporting system listed in the EMA website. In the US, reports can be submitted to the FDA MedWatch programme. Reporting side effects helps regulatory agencies and pharmaceutical companies monitor the ongoing safety of medicines and identify previously unrecognised adverse reactions.
How Should You Store Celsentri?
Store Celsentri at room temperature below 30°C (86°F) in the original packaging. Keep out of reach and sight of children. Do not use after the expiry date printed on the packaging.
Celsentri film-coated tablets should be stored at a temperature not exceeding 30°C (86°F). The tablets should be kept in the original blister packaging to protect them from moisture and light. Do not remove tablets from the blister pack until you are ready to take them, as exposure to environmental conditions may affect the stability of the active ingredient.
Keep Celsentri and all medicines out of the reach and sight of children. Store the medication in a secure location, such as a locked cabinet. Accidental ingestion of antiretroviral medicines by children is a medical emergency and requires immediate medical attention. If a child accidentally takes Celsentri, contact your local poison control centre or emergency department immediately.
Do not use Celsentri after the expiry date stated on the packaging. The expiry date refers to the last day of that month. Regularly check the expiry dates of all your medications and return any unused or expired tablets to your pharmacist for safe disposal. Do not dispose of medicines via wastewater or household waste, as this can cause environmental contamination.
Do not dispose of Celsentri via wastewater or household waste. Return any unused tablets to your pharmacy for safe disposal through a medication take-back programme. Proper disposal of antiretroviral medicines is important to prevent environmental contamination and to reduce the risk of accidental exposure to others.
What Does Celsentri Contain?
Each Celsentri 25 mg film-coated tablet contains 25 mg of the active substance maraviroc, along with pharmaceutical excipients that support the tablet's structure, stability, and film coating.
The active ingredient in each film-coated tablet is maraviroc 25 mg. Maraviroc is a selective, slowly reversible, small-molecule antagonist of the CCR5 chemokine co-receptor. Its chemical name is 4,4-difluoro-N-{(1S)-3-[exo-3-(3-isopropyl-5-methyl-4H-1,2,4-triazol-4-yl)-8-azabicyclo[3.2.1]oct-8-yl]-1-phenylpropyl}cyclohexanecarboxamide. The molecular formula is C29H41F2N5O, with a molecular weight of approximately 513.67 g/mol.
In addition to the active ingredient, Celsentri tablets contain the following inactive ingredients (excipients): microcrystalline cellulose, dibasic calcium phosphate (anhydrous), sodium starch glycolate, and magnesium stearate in the tablet core. The film coating consists of polyvinyl alcohol, titanium dioxide (E171), macrogol 3350, and talc. These excipients serve various pharmaceutical functions including binding, filling, disintegration, lubrication, and coating.
If you have known allergies or intolerances to any pharmaceutical excipients, inform your doctor or pharmacist before starting Celsentri. The tablets are blue and biconvex. The 25 mg tablets may bear identification markings to distinguish them from other strengths. The complete list of excipients is available in the patient information leaflet included in the packaging or from the EMA product information.
Maraviroc is well absorbed following oral administration, with peak plasma concentrations reached within 0.5 to 4 hours. The absolute bioavailability of the 100 mg dose is approximately 23% and is predicted to be 33% at 300 mg. Maraviroc is bound approximately 76% to human plasma proteins and shows moderate affinity for albumin and alpha-1 acid glycoprotein. The volume of distribution is approximately 194 litres, indicating extensive tissue distribution.
Frequently Asked Questions About Celsentri
Celsentri (maraviroc) is used in combination with other antiretroviral medicines to treat CCR5-tropic HIV-1 infection. It works by blocking the CCR5 co-receptor on human immune cells, preventing the virus from entering and infecting those cells. It is indicated for adults and children aged 2 years and older weighing at least 10 kg. Before starting treatment, a tropism test must confirm that the patient's virus uses the CCR5 co-receptor for cell entry.
A tropism test is essential because Celsentri only works against HIV-1 that uses the CCR5 co-receptor (known as R5-tropic virus) to enter human cells. Some HIV strains use the CXCR4 co-receptor instead, or use both (dual/mixed-tropic). If your virus is not R5-tropic, Celsentri will not be effective. The tropism test analyses your virus to determine which co-receptor it uses, ensuring that Celsentri is the right treatment for you.
No, Celsentri does not cure HIV infection or AIDS. It is used as part of combination antiretroviral therapy (cART) to reduce the amount of virus in the blood and increase the number of CD4+ T-cells, which strengthens the immune system. Patients must continue taking all prescribed antiretroviral medicines consistently, attend regular medical appointments, and take precautions to prevent transmitting HIV to others.
Maraviroc is metabolised in the liver by the enzyme CYP3A4. Medicines that inhibit CYP3A4 (such as ritonavir-boosted protease inhibitors, ketoconazole) cause maraviroc blood levels to rise significantly, so the dose must be reduced to 150 mg twice daily to avoid side effects. Conversely, medicines that induce CYP3A4 (such as efavirenz, rifampicin) cause maraviroc blood levels to drop, so the dose must be increased to 600 mg twice daily to maintain effectiveness. Your specialist will determine the correct dose based on your complete medication list.
Yes, Celsentri and Selzentry are the same medicine containing the active substance maraviroc. Celsentri is the brand name used in the European Union, while Selzentry is the brand name used in the United States. Both are manufactured by ViiV Healthcare and contain the same active ingredient at the same strengths. The choice of brand name depends on the country or region where the medicine is marketed.
Yes, Celsentri can be taken with or without food. Clinical studies have shown that while a high-fat meal may slightly reduce the rate of absorption, the overall exposure to maraviroc is not significantly affected. You do not need to time your doses around meals, which may make it easier to incorporate Celsentri into your daily routine. The tablets should be swallowed whole with water.
References and Sources
This article is based on internationally recognised medical and pharmaceutical guidelines. All information has been reviewed by qualified healthcare professionals and follows evidence-based principles.
- European Medicines Agency (EMA). Celsentri (maraviroc) – Summary of Product Characteristics. EMA, 2024. Available at: www.ema.europa.eu
- U.S. Food and Drug Administration (FDA). Selzentry (maraviroc) – Prescribing Information. FDA, 2024. Available at: www.fda.gov
- Gulick RM, Lalezari J, Goodrich J, et al. Maraviroc for previously treated patients with R5 HIV-1 infection. N Engl J Med. 2008;359(14):1429–1441. doi:10.1056/NEJMoa0803152
- Cooper DA, Heera J, Goodrich J, et al. Maraviroc versus efavirenz, both in combination with zidovudine-lamivudine, for the treatment of antiretroviral-naive subjects with CCR5-tropic HIV-1 infection. J Infect Dis. 2010;201(6):803–813. doi:10.1086/650697
- British National Formulary (BNF). Maraviroc: Drug Monograph. NICE, 2024. Available at: bnf.nice.org.uk
- World Health Organization (WHO). Consolidated Guidelines on HIV Prevention, Testing, Treatment, Service Delivery and Monitoring. Geneva: WHO, 2024.
- Panel on Antiretroviral Guidelines for Adults and Adolescents. Guidelines for the Use of Antiretroviral Agents in Adults and Adolescents with HIV. Department of Health and Human Services (DHHS), 2024.
- European AIDS Clinical Society (EACS). Guidelines for the Clinical Management and Treatment of HIV-Infected Adults in Europe, Version 12.0. EACS, 2023.
About the Medical Editorial Team
This article has been written and reviewed by iMedic's Medical Editorial Team, consisting of licensed physicians and specialists in clinical pharmacology with expertise in antiretroviral therapy, drug safety, pharmacovigilance, and evidence-based medicine.
iMedic Medical Editorial Team – specialists in clinical pharmacology and infectious disease pharmacotherapy. All content is researched and written using peer-reviewed sources and international pharmaceutical guidelines including EMA SmPC, FDA prescribing information, and WHO recommendations.
iMedic Medical Review Board – independent panel of qualified physicians who review all drug information content for accuracy, completeness, and clinical relevance according to EMA, FDA, WHO, and EACS standards.
Editorial Standards: All pharmaceutical content on iMedic follows strict editorial standards based on the GRADE evidence framework. We do not accept any form of pharmaceutical industry sponsorship or advertising. Our content is independent, evidence-based, and written for patients and caregivers. Read more about our editorial standards.