Based on theoretical considerations darunavir/cobicistat is expected to increase maraviroc plasma concentrations (CYP3A inhibition). The recommended dose of maraviroc is 150 mg twice daily when co-administered with darunavir/cobicistat. For further details, consult the maraviroc Summary of Product Characteristics.

Coadministration is expected to increase concentrations of maraviroc. Maraviroc is a substrate of CYP3A. When co-administered with darunavir/cobicistat, patients should receive maraviroc 150 mg twice daily.

This interaction has not been studied. Cobicistat is a potent CYP3A inhibitor. Maraviroc dose should be decreased to 150 mg twice daily when co-administered with a cobicistat containing regimen. In adult patients with a creatinine clearance of <80 mL/min, who are also receiving potent CYP3A4 inhibitors, the dose interval of maraviroc should be adjusted to 150 mg once daily. In addition, maraviroc should be used with caution in adult patients with severe renal impairment (CLcr <30 mL/min) who are receiving potent CYP3A4 inhibitors. An increased risk of postural hypotension may occur in patients with severe renal insufficiency who are treated with potent CYP3A inhibitors or boosted protease inhibitors (PIs) and maraviroc due to potential increases in maraviroc maximum concentrations when maraviroc is co-administered with potent CYP3A inhibitors or boosted PIs in these patients.

The recommended dose of maraviroc when coadministered with protease inhibitors (except tipranavir/ritonavir) is 150 mg twice daily. No additional maraviroc dose adjustment when coadministered with potent CYP3A inhibitors is required in patients with CrCl 30-80 mL/min. Maraviroc is contraindicated in patients with severe renal impairment (<30 mL/min) or ESRD on regular hemodialysis who are receiving potent CYP3A inhibitors.