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Selzentry
Selzentry (generic name: maraviroc) is a prescription medication used to treat HIV-1 infection in combination with other antiretroviral drugs. It is classified as a CCR5 antagonist, which works by blocking the CCR5 receptor on white blood cells, preventing HIV from entering and infecting these cells. Selzentry is used as part of combination antiretroviral therapy (ART) for patients who are infected with CCR5-tropic HIV-1, a specific strain of the virus that uses the CCR5 co-receptor to enter cells. It is not effective against other strains of HIV that use the CXCR4 co-receptor or both CCR5 and CXCR4.
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Frequently Asked Questions
How does Selzentry work?
Selzentry blocks the CCR5 receptor on the surface of immune cells, preventing the HIV virus from entering and infecting the cells. It only works against CCR5-tropic HIV-1, so your doctor will test your virus to see if it uses the CCR5 receptor.
Can Selzentry cure HIV?
No, Selzentry cannot cure HIV. It is used to help control the infection by lowering the viral load and improving immune function when used in combination with other antiretroviral medications.
How long do I need to take Selzentry?
Selzentry is a long-term treatment and should be taken as prescribed by your healthcare provider. Stopping treatment can lead to a rise in viral load and the development of drug resistance.
What should I do if I miss a dose of Selzentry?
If you miss a dose, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and take the next dose at your regular time. Do not take two doses at once.
Can I take Selzentry with food?
Yes, Selzentry can be taken with or without food. Follow your doctor's instructions regarding the timing of doses and other medications.
Comprehensive Drug Guide
How Does Selzentry Work?
Selzentry works by binding to the CCR5 receptor on the surface of immune cells, such as CD4 T-cells. By blocking this receptor, it prevents the HIV virus from entering the cells, thus stopping the replication process and reducing the viral load in the body. It is only effective against CCR5-tropic HIV-1 and will not work on viruses that use the CXCR4 receptor or dual/mixed tropic strains.
Common Dosages
- 150 mg tablets
- 300 mg tablets
Typical Dosing
- Adults: The typical dose of Selzentry is 300 mg twice daily, taken with or without food. The dose may be adjusted to 150 mg twice daily when taken with certain other medications that affect liver enzymes (e.g., protease inhibitors).
- Children aged 2 years and older (weighing at least 10 kg): The dose is based on body weight and other medications the child is taking. Selzentry is dosed twice daily, and the healthcare provider will determine the appropriate dose.
Typical Dosing
FDA Approved Indications
- CCR5-tropic HIV-1 infection in adult and pediatric patients aged 2 years and older, weighing at least 10 kg.
Who Shouldn't Take Selzentry?
- Known hypersensitivity to maraviroc or any component of the formulation.
- Severe liver problems or those who have had an allergic reaction related to liver problems while on Selzentry.
Advice From The Pharmacist
- Selzentry must be taken as part of a combination therapy with other antiretroviral drugs to effectively manage HIV-1 infection.
- Always take Selzentry as prescribed, even if you feel well. Skipping doses may cause the virus to become resistant to treatment.
- Inform your healthcare provider of any other medications you are taking, as Selzentry may interact with several drugs, including those used to treat infections, high blood pressure, or heart conditions.
- Be aware of signs of liver problems, such as yellowing of the skin or eyes, dark urine, or severe stomach pain. If you experience these symptoms, contact your healthcare provider immediately.
- Store Selzentry at room temperature and keep it away from moisture and heat.
Side Effects of Selzentry
Common Side Effects
- Cough
- Dizziness
- Fever
- Rash
- Upper respiratory infections
Uncommon/Severe Side Effects
- Liver problems, such as jaundice (yellowing of the skin or eyes) or dark urine
- Severe allergic reactions, such as rash, difficulty breathing, or swelling of the face or throat
- Postural hypotension (low blood pressure when standing)
- Heart problems, including heart attack in patients with a history of heart disease
Risks and Warnings of Selzentry
- Liver Toxicity: Selzentry can cause serious liver problems, especially in patients who develop an allergic reaction. Patients should be monitored for symptoms of liver dysfunction, such as yellowing of the skin or eyes, dark urine, or upper stomach pain.
- Cardiovascular Risk: Selzentry may increase the risk of cardiovascular events, particularly in patients with pre-existing heart conditions. Monitor for signs of heart problems, such as chest pain or shortness of breath.
- Postural Hypotension: Patients taking Selzentry may experience low blood pressure when standing up (postural hypotension). This risk is higher in individuals with renal impairment or those taking blood pressure-lowering medications.
- Immune Reconstitution Syndrome: Patients who start antiretroviral therapy may experience a strong immune response as their immune system recovers. This can lead to symptoms of previously undiagnosed infections, which may require medical attention.
Interactions with Selzentry
Common Drug Interactions
- Protease Inhibitors (e.g., ritonavir): These medications can increase the blood levels of Selzentry, requiring a dose adjustment to 150 mg twice daily.
- CYP3A4 inducers (e.g., rifampin, carbamazepine): These drugs may lower the effectiveness of Selzentry by reducing its levels in the bloodstream, possibly requiring dose adjustments.
- Blood pressure medications: Combining Selzentry with antihypertensives may increase the risk of postural hypotension (low blood pressure upon standing).
Alternatives to Selzentry
- Tivicay (dolutegravir): An integrase inhibitor used in combination with other antiretrovirals for the treatment of HIV-1 infection.
- Biktarvy (bictegravir/emtricitabine/tenofovir alafenamide): A single-tablet regimen used for the treatment of HIV-1 infection in treatment-naïve patients.
- Isentress (raltegravir): An integrase strand transfer inhibitor used in combination with other antiretrovirals for the treatment of HIV-1 infection.
- Trogarzo (ibalizumab-uiyk): A monoclonal antibody used for multidrug-resistant HIV-1 infection in combination with other antiretroviral therapies.
