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valGANciclovir HCl
ValGANciclovir HCl (brand name: Valcyte) is an antiviral medication used to treat and prevent infections caused by cytomegalovirus (CMV), particularly in people with weakened immune systems, such as those undergoing organ transplantation or individuals with HIV/AIDS. It is commonly used to prevent CMV infections in kidney, heart, and other transplant recipients. ValGANciclovir is a prodrug of ganciclovir, meaning it converts into ganciclovir in the body to exert its antiviral effects by inhibiting viral DNA replication.
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Frequently Asked Questions
How long do I need to take ValGANciclovir after a transplant?
ValGANciclovir is typically prescribed for 100 days after a kidney or heart transplant to prevent CMV infection. In high-risk kidney transplant patients, it may be continued for 200 days.
Can ValGANciclovir cure CMV infection?
ValGANciclovir does not cure CMV infection but helps to manage and control it by reducing viral replication and preventing disease progression, particularly in people with weakened immune systems.
Can ValGANciclovir affect fertility?
Yes, ValGANciclovir can reduce sperm production in men and may affect fertility. Men are advised to use contraception during and for at least 90 days after treatment.
What should I do if I miss a dose of ValGANciclovir?
If you miss a dose, take it as soon as you remember, unless it is close to the time for your next dose. Do not double up on doses to make up for the missed one.
Is ValGANciclovir safe during pregnancy?
ValGANciclovir is not recommended during pregnancy due to the risk of harm to the fetus. Women of childbearing potential should use effective contraception during treatment.
Comprehensive Drug Guide
How Does valGANciclovir HCl Work?
ValGANciclovir is a prodrug that converts into ganciclovir in the body. Ganciclovir inhibits viral DNA polymerase, which prevents the cytomegalovirus (CMV) from replicating and spreading. This helps to manage CMV infections, particularly in people with weakened immune systems, by slowing the progression of the infection and reducing viral load.
Common Dosages
- 450 mg oral tablets.
- Oral solution (50 mg/mL), typically used in pediatric patients or individuals who cannot swallow tablets.
Typical Dosing
- For CMV prevention in transplant recipients: The usual dose is 900 mg once daily starting within 10 days post-transplant and continuing for 100 days (or 200 days in high-risk kidney transplant patients).
- For CMV retinitis treatment: The usual dose is 900 mg twice daily for 21 days, followed by a maintenance dose of 900 mg once daily.
Typical Dosing
FDA Approved Indications
- Prevention of cytomegalovirus (CMV) infection in kidney, heart, or other solid organ transplant recipients.
- Treatment of CMV retinitis (an eye infection caused by CMV) in patients with AIDS.
Off-Label Uses
Who Shouldn't Take valGANciclovir HCl?
- Hypersensitivity to ganciclovir, valGANciclovir, or any components of the formulation.
- Severe neutropenia, thrombocytopenia, or anemia, as valGANciclovir can worsen these conditions.
- Pregnancy: ValGANciclovir can cause harm to the fetus and should not be used during pregnancy unless absolutely necessary.
Advice From The Pharmacist
- Take ValGANciclovir with food to improve absorption and reduce stomach upset.
- Follow your dosing schedule exactly as prescribed to ensure the medication’s effectiveness in preventing or treating CMV infections.
- Regular blood tests will be necessary to monitor kidney function, white blood cell counts, and platelet levels while taking ValGANciclovir.
- Avoid direct contact with the tablets or oral solution if broken or damaged, as ValGANciclovir can be harmful if it comes into contact with your skin.
- Store ValGANciclovir at room temperature, away from moisture and heat. If using the oral solution, store it in the refrigerator.
Side Effects of valGANciclovir HCl
Common Side Effects
- Nausea or vomiting
- Diarrhea
- Headache
- Fatigue or weakness
- Abdominal pain
Uncommon/Severe Side Effects
- Bone marrow suppression leading to anemia, neutropenia, or thrombocytopenia.
- Kidney problems (reduced urine output, swelling, or fatigue).
- Fertility issues, as ValGANciclovir may reduce sperm production in men.
Risks and Warnings of valGANciclovir HCl
- Bone Marrow Suppression: ValGANciclovir can cause serious blood disorders, including anemia, neutropenia (low white blood cell count), and thrombocytopenia (low platelet count). Regular blood monitoring is necessary, and dose adjustments may be needed based on blood cell counts.
- Kidney Impairment: Individuals with kidney impairment may require dose adjustments, as ValGANciclovir is eliminated by the kidneys. Regular kidney function tests will be performed to monitor for potential issues.
- Reproductive Toxicity: ValGANciclovir may cause infertility in both men and women. Men should use effective contraception during treatment and for at least 90 days after stopping ValGANciclovir due to potential sperm toxicity.
Interactions with valGANciclovir HCl
Common Drug Interactions
- Mycophenolate mofetil: When used together with ValGANciclovir, the risk of low white blood cell counts increases, so careful monitoring is necessary.
- Zidovudine: Combining ValGANciclovir with zidovudine increases the risk of bone marrow suppression, leading to anemia or low white blood cell counts.
- Nephrotoxic drugs (e.g., NSAIDs, aminoglycosides): These drugs can increase the risk of kidney problems when taken with ValGANciclovir.
Common Food Interactions
Alternatives to valGANciclovir HCl
- Ganciclovir: The active form of ValGANciclovir, available in intravenous form for more severe cases of CMV infection.
- Foscarnet: An antiviral used to treat CMV retinitis and other serious CMV infections, particularly in patients who do not respond to ganciclovir.
- Cidofovir: Another antiviral used to treat CMV infections in immunocompromised patients.
