VALGANCICLOVIR

Indications & Dose:

• BY MOUTH

Adult

• Treatment of CMV retinitis:

P0 900 mg bid with meals for 21 days; follow with maintenance treatment, P0 900mg qd with meals

• Renal function impairment (dosage for CrCl in mi/mm):

CrC1 60 P0 900 mg bid (induction) and 900 mg qd (maintenance); CrCl 40-59 P0 450 mg bid (induction) and 450 mg qd (maintenance); CrCI 25-39 P0 450 mg qd (induction) and 450 mg every 2 days (maintenance);

• CrCl 10-24 P0 450 mg every 2 days (induction) and 450 mg twice weekly (maintenance)

• Prevention of CMV

disease in selected transplant recipients: P0 900 mg qd with food, starting within 10 days of transplant until 100 days posttransplant 

Contraindications:

Side Effects:

CNS: Agitation, confusion, convulsion, headache (22%), insomnia (16%), paresthesia (8%), peripheral neuropathy, psychosis
EENT: Retinal detachment
Gl: Abdominal pain (15%),diarrhea (41%), nausea (30%), vomiting (21%)
GU: Increase in BUN, creatinine
HEME: Agranulocytosis, thrombocytopenia (6%), neutropenia (27%), anemia (26%)
MISC: Pyrexia (31%) 

Cautions:

Precautions:

Renal insufficiency (CrC1 <10 ml/min or dialysis patient), do not administer valganciclovir if the absolute neutrophil count is less than 500 cells/pl, the platelet count is less than 25,000/Ill, or the hemoglobin is less than 8 g/d 

Interaction:

Drugs

Didanosine: Didanosine may increase valganciclovir level; increased hematological toxicity possible

Mycophenolate: Mycophenolate may increase valganciclovir level; valganciclovir may increase mycophenolate level; increased hematologicaltoxicity possible

Probenecid: Probenecid reduces ganciclovir clearance; increased hematological toxicity possible

Zidovudine: Additive hematological toxicity 

Warnings:

Adverse Effects:

Lactations:

Pregnancy category C

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: