Valganciclovir

Generic Name (active ingredient): Valganciclovir
Brand Name: Valcyte, Valixa, Cymeval

Valganciclovir is an antiviral prodrug used to treat cytomegalovirus infections.

How does the medication work?
Valganciclovir is a L-valyl ester of ganciclovir that is, after oral administration, quickly transformed into ganciclovir under the influence of intestinal and hepatic esterases. Ganciclovir inhibits the replication of the viruses of herpes group in vitro and in vivo. Human viruses sensitive to ganciclovir are cytomegalovirus (CMV), herpes simplex virus type 1 and type 2, human herpes virus (HHV-6, HHV-7, HHV-8), Epstein-Barr virus, Varicella zoster and hepatitis B.

When Valganciclovir is prescribed?

  • Treatment of CMV retinitis in AIDS patients
  • Prevention of CMV infection in patients after organ transplantation

What should I know before taking Valganciclovir ?
Do not use this medication if you are allergic to Valgancyclovir or to any other medicines such as:

  • ganciclovir
  • acyclovir

Do not take Valganciclovir if any of the below conditions apply to you:

  • absolute neutrophil count below 500/mm
  • platelet count less than 25 000/mkl
  • hemoglobin levels below 80 g/l
  • creatinine clearance <10 ml/min
  • children under 12 years
  • pregnancy
  • breastfeeding

Before taking Valganciclovir, tell your health care provider about any other medicines you take or if you have any of the following disorders:

  • renal failure
  • elderly patients

If you are pregnant, plan to become pregnant, or breastfeed, you should take Valganciclovir only under a strict control of your doctor. Valganciclovir belongs to a pregnancy category C meaning that during pregnancy administration of the drug should be avoided unless the potential positive effects for the mother justifies the potential risk to the fetus. Nursing mothers should discontinue breastfeeding while on the therapy.

How to take Valganciclovir:
Valganciclovir is available in the form of coated tablets

Dosage of Valganciclovir is prescribed individually by physician.

Take the entire amount of Valganciclovir prescribed by your doctor, even if you feel better before the end of the treatment. If you stop taking medication too early, symptoms may return.
If you missed the scheduled dose, take the medication as soon as you remember, but skip the dose if it is almost the time for the following dose. Do not take two doses at once.

What are the side effects of Valganciclovir?
Valganciclovir may cause the following side effects:

  • The most frequent adverse events in patients with CMV retinitis and AIDS: diarrhea, neutropenia, fever, oral candidiasis, headache and weakness
  • The most frequent adverse effects in patients after organ transplantation: diarrhea, tremor, transplant rejection, nausea, headache, edema of the lower extremities, constipation, insomnia, back pain, hypertension, vomiting
  • The most common adverse effects in patients after transplantation of solid organs: leukopenia, diarrhea, nausea, neutropenia
  • Adverse events that occurred in patients after transplantation with a frequency ≥ 2% and were not observed in patients with CMV retinitis: hypertension, hypercreatininemia, hyperkalemia, abnormal liver function

Adverse effects identified in more than 5% of patients with CMV retinitis and after transplantation:

  • digestive system: diarrhea, nausea, vomiting, abdominal pain, constipation, pain in upper abdomen, indigestion, abdominal enlargement, ascites, abnormal liver function
  • systemic: fever, weakness, swelling of the lower extremities, peripheral edema, weight loss, decreased appetite, anorexia, cachexia, dehydration, transplant rejection
  • hemopoietic system: neutropenia, anemia, thrombocytopenia, leukopenia; rare - pancytopenia, suppression of bone marrow function, aplastic anemia, life threatening bleeding
  • infectious complications: oral cavity candidiasis
  • central nervous system and peripheral nervous system: headache, insomnia, peripheral neuropathy, paresthesia, tremor, dizziness, depression; rare-seizures, mental disorders, hallucinations, confusion, agitation
  • dermatological reactions: rash, increased sweating (in the night), itching, acne
  • respiratory system: dyspnea, productive cough, nasal discharge, pleural effusion, pharyngitis, nasopharyngitis, sinusitis, upper respiratory tract infection, pneumonia, pneumocystis pneumonia
  • visual organs: retinal detachment, blurred vision
  • musculoskeletal system: back pain, arthralgia, pain in the limbs, cramps in the muscles
  • urinary system: kidney failure, dysuria, urinary tract infections
  • cardiovascular system: hypertension, hypotension
  • laboratory values: hypercreatininemia, hyperkalemia, hypokalemia, hypomagnesemia, hyperglycemia, hypophosphataemia, hypocalcemia
  • other: in the postoperative period-complications, pain after surgery, infectious complications of postoperative wound, increased wound drainage, poor wound healing

If you experience any side effect that last long or becomes bothersome, please inform your doctor as dose adjustment or treatment discontinuation may be required.

Which are Valgancyclovir overdose symptoms?
If you overdose Valgancyclovir, seek immediate medical attention. Overdose symptoms include: bone marrow suppression, nephrotoxicity, hematological toxicity, hepatotoxicity, gastrointestinal toxicity (abdominal pain, diarrhea, vomiting), neurotoxicity (generalized tremors, convulsions)

Which other medicines may affect Valganciclovir ?
Valganciclovir may interact with the following groups of drugs:

  • antibiotics
  • drugs for HIV treatment
  • immunosuppressive agents
  • myelotoxic or nephrotoxic drugs
  • anti-gout drugs
  • folic acid synthesis inhibitors

For a complete list of possible interactions ask your doctor or pharmacist. Before taking Valganciclovir, let your doctor know what other medicines, including OTC, you currently take.

How should I store Valganciclovir?
The drug should be stored out of reach of children at temperature below 30 ° C (86F).

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