Maraviroc and Darunavir: Interaction Details
AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Darunavir
No brand names on recordMaraviroc
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
What happens
Increased maraviroc exposure
Interaction Deep Dive
Concomitant use of maraviroc (a CYP3A substrate) with darunavir (a CYP3A inhibitor) resulted in a 4-fold increase in maraviroc AUC. The concomitant use of maraviroc with darunavir is contraindicated in adult and pediatric patients with CrCl less than 30 mL/min and in those with ESRD on regular hemodialysis. In adults with CrCl 30 mL/min or greater taking maraviroc and darunavir (with or without a strong CYP3A inducer), reduce the maraviroc dose to 150 mg orally twice daily. In pediatric patients with CrCl 30 mL/min or greater, reduce the dose as follows: 50 mg twice daily for those 10 to less than 20 kg, 75 mg (if taking the tablet) or 80 mg (if taking oral solution) twice daily for those 20 to less than 30 kg), 100 mg twice daily for those 30 to less than 40 kg, and 150 mg twice daily for those 40 kg or greater1. When used in combination with darunavir/ritonavir, the dose of maraviroc should be 150 mg twice daily 2.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism of maraviroc
Literature reports
4 reports — tap to read
a) In a retrospective review of HIV infected adults receiving maraviroc-containing antiretroviral regimens (n=66), maraviroc 300 mg once daily administered concomitantly with darunavir 800 mg/ritonavir 100 mg had favorable pharmacokinetics compared with maraviroc 300 mg twice daily with emtricitabine 200 mg and tenofovir 245 mg. Median maraviroc trough concentrations were 70 nanograms (ng)/mL (interquartile range (IQR), 49 to 97 nanograms/mL) and 43 ng/mL (IQR, 35 to 55 ng/mL) in patients receiving maraviroc 300 mg or 150 mg once daily, respectively, concomitantly with darunavir/ritonavir 800/100 mg compared with the median trough concentration of 46 ng/mL (IQR, 33 to 61 ng/mL) in patients receiving maraviroc 300 mg twice daily in combination with emtricitabine/tenofovir. Median maraviroc peak concentrations in patients receiving maraviroc 300 mg or 150 mg once daily with darunavir/ritonavir were 728 ng/mL (IQR, 378 to 935 ng/mL) and 364 nanograms/mL (IQR, 104 to 624 ng/mL), respectively, compared with 378 ng/mL (IQR, 350 to 640 ng/mL) in patients receiving maraviroc 300 mg twice daily with emtricitabine/tenofovir 3.
b) When maraviroc 150 mg twice daily was coadministered with darunavir 600 mg/ritonavir 100 mg twice daily (N=12), the maraviroc AUC increased 4-fold and Cmax increased 2.3-fold 1.
c) When maraviroc 150 mg twice daily was coadministered with darunavir 600 mg/ritonavir 100 mg plus etravirine 200 mg twice daily (N=10), the maraviroc AUC increased 3-fold and Cmax increased 1.77-fold 1.
d) In a drug interaction study (n=12) performed with darunavir/ritonavir (600/100 mg twice daily) and maraviroc (150 mg twice daily), the plasma concentrations of maraviroc were increased. The least mean square ratio of maraviroc AUC, Cmax and Cmin with or without darunavir were 4.05 (90% CI, 2.94 to 5.59), 2.29 (90% CI, 1.46 to 3.59) and 8 (90% CI, 6.35 to 10.1) respectively. In another drug interaction study (n=10) performed with darunavir/ritonavir (600/100 mg twice daily) with etravirine (200 mg twice daily) and maraviroc (150 mg twice daily), the least mean square ratio of maraviroc AUC, Cmax and Cmin with or without darunavir were 3.1 (90% CI, 2.57 to 3.74), 1.77 (90% CI, 1.2 to 2.6) and 5.27 (90% CI, 4.51 to 6.15) respectively 2.
Common questions
Can I take Maraviroc and Darunavir together?
Increased maraviroc exposure Always confirm with your pharmacist or prescriber before making any change.
How serious is the Maraviroc and Darunavir interaction?
It is rated contraindicated. These should generally not be used together.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How strong is the evidence for this interaction?
The evidence is graded "probable". Good supporting evidence, though not definitively proven.
Questions for your pharmacist
- Does my dose of Maraviroc or Darunavir need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Product Information: SELZENTRY(R) oral tablets, oral solution, maraviroc oral tablets, oral solution. Viiv Healthcare (per FDA), Research Triangle Park, NC, 2018. DailyMed
- Product Information: PREZISTA(R) oral suspension, oral tablets, darunavir oral suspension, oral tablets. Janssen Products, LP (per FDA), Horsham, PA, 2023. DailyMed
- Okoli C, Siccardi M, Thomas-William S, et al: Once daily maraviroc 300 mg or 150 mg in combination with ritonavir-boosted darunavir 800/100 mg. J Antimicrob Chemother 2012; 67(3):671-674. PubMed
Keep reading about Darunavir
Keep reading about Maraviroc
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