Valganciclovir
Antiviral, Systemic · DNA polymerase inhibitor prodrug
Indications
Induction and maintenance treatment of cytomegalovirus retinitis in AIDS patients; prevention of cytomegalovirus disease following solid organ transplantation from a cytomegalovirus-positive donor.
Dosage
CMV retinitis: Adults: Induction, 900 mg twice daily for 21 days then 900 mg once daily; induction regimen may be repeated if retinitis progress. Prevention of cytomegalovirus disease following solid organ transplantation: (Starting within 10 days of transplantation), Adults: 900 mg once daily for 100 days. Children: Not recommended.
Adverse Effects
Diarrhoea, nausea, vomiting, dyspepsia, abdominal pain, constipation, flatulence, dysphagia, hepatic dysfunction, dyspnoea, chest pain, cough, headache, insomnia, convulsions, dizziness, neuropathy, depression, anxiety, confusion, abnormal thinking, fatigue, weight loss, anorexia, infection, fever, night sweats, anaemia, leucopenia, thrombocytopenia, pancytopenia, renal impairment, myalgia, arthralgia; macular oedema, retinal detachment, vitreous floaters, eye pain, ear pain, taste disturbance, dermatitis, pruritus, injection-site reactions, less commonly mouth ulcers, pancreatitis, arrhythmias, hypotension, anaphylactic reactions, psychosis, tremor, male infertility, haematuria, disturbances in hearing and vision and alopecia. Blood dyscrasias, night sweats, conjunctivitis.
Risk Factor (Pregnancy/Lactation)
Pregnancy: Risk cannot be ruled out. Lactation: Contraindicated or not recommended. Contraindications: Ensure effective contraception during treatment and barrier contraception for men during and for at least 90 days after treatment. Hypersensitivity to ganciclovir or acyclovir, abnormally low haemoglobin, neutrophil, or platelet counts. Precautions: Close monitoring of full blood count; history of cytopenia; low platelet count; potential carcinogen and teratogen; renal impairment; radiotherapy; ensure adequate hydration during intravenous administration; vesicant-infuse into vein with adequate flow preferably using plastic cannula; children (possible risk of long-term carcinogenic or reproductive toxicity-not for neonatal or congenital cytomegalovirus disease). Elderly.
Interactions
Imipenem-cilastatin, didanosine, myelosuppresants, drugs affecting renal function, probenecid, mycophenolate mofetil, drugs inhibiting mitosis, zidovudine.
Advice to Patient
Take with meals. Regular laboratory tests and eye examinations are required during therapy. Contact prescriber if there is chills, fever, unusual bruising or bleeding, unrecovered sores, infection, vaginal discharge, white plaques in mouth, confusion, nightmares, hallucinations, weakness, no sensation in nerves or muscles. Take sufficient amount of fluids (2-3 litres per day) to maintain hydration, unless restricted by the prescriber. Avoid highly crowded places to prevent infections. Do not get vaccinated without consulting prescriber. Avoid direct sunlight, wear sunscreen, proper eyewear and protective clothing to prevent photosensitivity.
Pharmacokinetics
Absorption: Well absorbed. Metabolism: Converted to ganciclovir by intestinal mucosal cells and hepatocytes. Bioavailability: With food: 60%; similar in paediatric patients 4 mths-16 yrs; neonates: Initial data: 54%. Half-life elimination: Paediatric patients (heart, kidney, or liver transplant): Mean range: 4 mths-2 yrs: 2.8-4.5 hrs. 2-12 yrs: 2.8-3.8 hrs. 12-16 yrs: 4.9-6 hrs. Adults: Ganciclovir: 4.08 hrs; prolonged with renal impairment. Severe renal impairment: Up to 68 hrs. Heart, kidney, kidney-pancreas, or liver transplant patients: Mean range: 6.18-6.77 hrs. Time to peak: Ganciclovir: 1.7-3 hrs. Excretion: Urine (80%-90%)
Brands with this active ingredient
Compiled by Healify Pharmacy from published drug references. How we compile it →
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