Valganciclovir

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Generic Name of Valganciclovir - Learn More

Valganciclovir

Valganciclovir Precaution - What You Need to Know

Before starting Valganciclovir, it is crucial for patients to consult their healthcare provider, especially if they have any of the following conditions:
- Pregnancy and Breastfeeding: Valganciclovir is contraindicated during pregnancy due to its teratogenic effects. It is a category C drug, meaning it may cause birth defects. It should also be avoided during breastfeeding as it can pass into breast milk and potentially harm a nursing infant.
- Hematologic Conditions: Valganciclovir can cause bone marrow suppression, leading to conditions like neutropenia (low white blood cells), anemia, and thrombocytopenia (low platelets). Patients with pre-existing blood disorders should be closely monitored during treatment.
- Renal Impairment: Dosage adjustments are required for patients with renal impairment, as the drug is primarily excreted via the kidneys. Kidney function should be monitored regularly.
- HIV-infected Patients: For HIV-positive patients, particularly those with low CD4 counts, the risk of immune reconstitution inflammatory syndrome (IRIS) may increase, leading to an exaggerated inflammatory response.
- Fertility: Valganciclovir can affect sperm production and may cause temporary infertility. Both men and women should be advised to use effective contraception during treatment and for some time afterward.

Valganciclovir Indication - Uses and Benefits

Valganciclovir is primarily indicated for the treatment and prevention of cytomegalovirus (CMV) infections, including:
- CMV Retinitis: It is used for the treatment of CMV retinitis in patients with AIDS or other conditions that compromise the immune system.
- CMV Prophylaxis: Valganciclovir is used to prevent CMV infection in solid organ transplant recipients or patients undergoing hematopoietic stem cell transplantation.
- CMV Disease in Immunocompromised Patients: It is also used to treat other CMV infections in immunocompromised patients, such as those undergoing cancer treatment or with HIV/AIDS.
- Congenital CMV Infection: In certain cases, Valganciclovir may be used to treat congenital CMV infection in neonates, though this requires specialized medical guidance.

Valganciclovir Contraindications - Important Warnings

Valganciclovir should not be used in the following situations:
- Pregnancy: Due to the potential for causing birth defects, Valganciclovir is contraindicated during pregnancy. It is also contraindicated in breastfeeding, as it can pass into breast milk.
- Hypersensitivity: Patients with a known hypersensitivity to valganciclovir, ganciclovir, or any of its excipients should avoid its use.
- Severe Renal Impairment: Valganciclovir is not recommended for patients with severe renal impairment (creatinine clearance less than 10 mL/min) unless they undergo dose adjustments.
- Bone Marrow Suppression: It should not be used in patients with severe neutropenia, thrombocytopenia, or anemia without appropriate monitoring and adjustments.

Valganciclovir Side Effects - What to Expect

Valganciclovir can cause a range of side effects, from common and mild to severe:
- Common Side Effects:
- Gastrointestinal symptoms: Nausea, vomiting, and diarrhea are common, especially in the early stages of treatment.
- Headache: Some patients may experience headaches during treatment.
- Fever: A mild fever may occur, especially in immunocompromised individuals.
- Fatigue: Tiredness or fatigue is common, particularly in patients with underlying infections or other treatments.
- Severe Side Effects:
- Bone Marrow Suppression: Valganciclovir can lead to neutropenia, anemia, or thrombocytopenia, requiring regular blood monitoring.
- Renal Toxicity: The drug can cause renal dysfunction or acute kidney injury, especially in patients with pre-existing kidney disease.
- CNS Effects: Confusion, seizures, or psychosis have been reported, particularly in severely immunocompromised patients.
- Hematologic Toxicity: Patients may experience a drop in white blood cell count (neutropenia), which can increase the risk of infection.

Valganciclovir Pregnancy Category ID - Safety Information

3

Valganciclovir Mode of Action - How It Works

Valganciclovir is an antiviral agent that works by inhibiting the replication of cytomegalovirus (CMV). Once administered, it is converted into its active form, ganciclovir, within the body. Ganciclovir inhibits the viral DNA polymerase, an enzyme essential for CMV replication, thus preventing the virus from multiplying. This action reduces the viral load in the body and helps treat or prevent CMV infections in immunocompromised individuals.

Valganciclovir Drug Interactions - What to Avoid

Valganciclovir may interact with several other medications, affecting its efficacy or causing serious side effects:
- Immunosuppressants: Concurrent use with immunosuppressive drugs (e.g., cyclosporine, tacrolimus) may enhance the risk of nephrotoxicity. Renal function should be monitored.
- Zidovudine and Other Antiretrovirals: Valganciclovir, when used with zidovudine or other antiretroviral drugs, can increase the risk of hematologic toxicity, such as neutropenia or anemia. Monitoring blood counts is essential.
- Myelosuppressive Drugs: Combining Valganciclovir with other myelosuppressive agents increases the risk of bone marrow suppression. Caution should be exercised when used with chemotherapy or interferons.
- Probenecid: Concomitant use with probenecid may increase valganciclovir levels in the blood, which can enhance its side effects, particularly bone marrow suppression. Dose adjustments or close monitoring may be required.
- Other Renally Cleared Drugs: As Valganciclovir is excreted through the kidneys, use with other renally cleared drugs may increase the risk of renal toxicity.

Valganciclovir Adult Dose - Recommended Dosage

The recommended dosages of Valganciclovir for adults depend on the condition being treated:
- CMV Retinitis in patients with AIDS: The initial dose is 900 mg orally twice a day for 21 days, followed by 900 mg once daily for maintenance.
- Prevention of CMV Infection after organ transplant: The usual dose is 900 mg once daily, starting as early as 2-3 days post-transplant.
- CMV Prophylaxis in Hematopoietic Stem Cell Transplantation: The dose is usually 900 mg orally once daily, starting shortly after transplant.
- Congenital CMV Infection: Treatment is typically 16-18 mg/kg/dose every 12 hours for 6 weeks.

Valganciclovir Child Dose - Dosage for Children

For pediatric patients, the dosage of Valganciclovir depends on the condition and the patient's weight:
- Congenital CMV Infection in Infants: The recommended dose is typically 16 mg/kg/dose every 12 hours for 6 weeks.
- CMV Retinitis in HIV-positive children: The dose for children weighing over 40 kg is typically the same as adults. For children under 40 kg, dosing is based on body weight.
- Dosing adjustments are required for children with renal impairment, and therapy should be managed by a pediatric infectious disease specialist.

As always, it is crucial for patients to consult their healthcare provider before starting Valganciclovir to ensure that it is appropriate for their individual needs and health status.

Valganciclovir Renal Dose - Dosage for Kidney Conditions

Valganciclovir is primarily eliminated through the kidneys, so dose adjustments are necessary for patients with renal impairment:
- Creatinine Clearance 10-30 mL/min: The recommended dose is half of the standard dose.
- Creatinine Clearance <10 mL/min: Valganciclovir is not recommended unless closely monitored and adjusted by the healthcare provider.
- For patients undergoing dialysis, dose adjustments and careful monitoring of drug levels are required.