Valganciclovir

C difficile risk
None
Oral Bioavailability
Excellent
Cost
$11-23/d

Dosing

Defined criteria for use and/or important safety considerations. See below for more information.

900 mg PO BID

900 mg PO daily

CrCl ≥ 60 mL/minCrCl 40 - 59 mL/minCrCl 25 - 39 mL/minCrCl 10 - 24 mL/minCrCl < 10 mL/minNo renal adjustment required450 mg PO BID450 mg PO daily450 mg PO q48hNot recommended

CrCl ≥ 60 mL/minCrCl 40 - 59 mL/minCrCl 25 - 39 mL/minCrCl 10 - 24 mL/minCrCl < 10 mL/minNo renal adjustment required450 mg PO daily450 mg PO q48h450 mg PO 2 x / weekNot recommended

Not recommended

General Information

CMV treatment and prophylaxis/maintenace

  • CBC for cytopenias

  • Creatinine

  • Cytopenias (usually responds to G-CSF)

  • Increased creatinine

  • Headache, insomnia, mental status changes

  • GI upset

  • Tremor

Mycophenolate can increase ganciclovir/valganciclovir concentration

  • Valganciclovir is the prodrug of ganciclovir

  • Resistance can occur; if suspected, consult ID/Microbiology

Antimicrobial class: Antiviral. Nucleoside analogue.

Pregnancy category: C

Average serum half life: 4 hours

CSF penetration: None

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