Valcyte

Generic name: valganciclovir

Drug class: Purine nucleosides

Dosage form: Tablets, oral solution

Root of administration: Oral

Dose: Adults: 900 mg once daily for CMV retinitis; 450 mg once daily for CMV disease prevention post-transplant. Children (4 months to 16 years): 16 mg/kg once daily for CMV disease prevention post-transplant. Dosing may vary based on individual factors; consult prescribing information for detailed guidance.

Mechanism of action: Valganciclovir is converted to ganciclovir in the body, which inhibits DNA replication in cytomegalovirus (CMV), thereby slowing its growth and spread.

Drug usage cases:

• Treatment of CMV retinitis in adults with acquired immunodeficiency syndrome (AIDS)
• Prevention of CMV disease in adults post-heart, kidney, or kidney-pancreas transplant
• Prevention of CMV disease in children (4 months to 16 years) post-heart or kidney transplant

Drug contra indications:

• Hypersensitivity to valganciclovir, ganciclovir, or any component of the formulation
• Severe neutropenia (absolute neutrophil count < 500 cells/mm³)
• Severe thrombocytopenia (platelet count < 25,000 cells/mm³)
• Severe anemia (hemoglobin < 8 g/dL)
• Concurrent use with other myelosuppressive agents
• Active infections not controlled by appropriate therapy
• Pregnancy (due to teratogenic potential)

Side effects:

• Hematologic: Neutropenia, anemia, thrombocytopenia, pancytopenia
• Gastrointestinal: Nausea, vomiting, diarrhea, abdominal pain
• Neurological: Headache, tremors, insomnia, seizures, confusion
• Renal: Elevated serum creatinine, renal failure
• Hematologic: Leukopenia, neutropenia, agranulocytosis, granulocytopenia
• Infections: Upper respiratory tract infection
• Renal: Renal failure
• Nervous system disorders: Seizure, dysguesia (taste disturbance), confusional state, agitation, psychotic disorder, hallucinations
• Allergic reactions: Anaphylactic reaction
• Other reactions: Pyrexia, limb pain, abdominal pain, tremor, hematuria, blood creatinine increased

Warnings:

• Bone marrow suppression: Regular monitoring of blood counts is recommended
• Renal toxicity: Dose adjustments may be necessary in patients with renal impairment
• Neurological effects: Use caution when operating vehicles or machinery
• Carcinogenic and teratogenic potential: Avoid use during pregnancy; use effective contraception during treatment and for at least 30 days after discontinuation in women, and for at least 90 days in men
• Fertility effects: May affect fertility in both men and women
• Drug interactions: Potential interactions with other myelosuppressive agents and nephrotoxic drugs

Use during pregnancy or breastfeeding: Valganciclovir is contraindicated during pregnancy due to potential teratogenic effects. Women of childbearing potential should use effective contraception during treatment and for at least 30 days after discontinuation. Men should use effective contraception during treatment and for at least 90 days after discontinuation. It is not known whether valganciclovir is excreted in human milk; breastfeeding is not recommended during treatment.