CMV terminase inhibitor
Letermovir
Brand names: Prevymis
Adult dose
Dose: 480mg PO/IV OD (240mg with ciclosporin) post-allogeneic HSCT
Route: PO/IV
Frequency: OD
Clinical pearls
- CMV prophylaxis after allogeneic stem cell transplant
- Specialist haematology
Contraindications
- Concurrent pimozide/ergot alkaloids/dabigatran
- Pitavastatin/simvastatin (with ciclosporin)
Side effects
- GI upset
- Hypersensitivity
- Headache
- Hepatotoxicity
Interactions
- P-gp/OATP/CYP3A4 substrates — many
- Voriconazole (lowered levels — increase voriconazole)
- Statins
Monitoring
- CMV PCR
- LFTs
Reference: BNF; NICE TA591; SmPC; https://bnf.nice.org.uk/drugs/letermovir/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- SMART Risk Score for Recurrent CVD · Cardiovascular Risk
- PCSK9 Inhibitor Eligibility Assessment · Lipid Management
- Immune-Related Adverse Events (irAE) -- GI Toxicity Colitis Grading · Oncology-Related GI
- irAE Hepatitis Grading (CTCAE) · Immunotherapy
- DIPSS — Dynamic International Prognostic Scoring System for Myelofibrosis · Cancer Prognosis
- BALL Score for Relapsed/Refractory CLL · Leukaemia
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Isoniazid (INH) overdose · TOXBASE/NPIS; AACT/EAPCCT; BNF
- Major Haemorrhage / Massive Transfusion · BCSH; RCOA; RCEM; RCS — BCSH Guidelines
- Anaemia Investigation · BSH / NICE
- Deep Vein Thrombosis Diagnosis and Treatment · NICE CG144 / NICE NG158
- Sickle Cell Crisis · BSH 2021 / BCSH