Ganciclovir prodrug
Valganciclovir
Brand names: Valcyte
Adult dose
Dose: CMV treatment: 900mg PO BD x21 days. Maintenance/prophylaxis: 900mg PO OD
Route: PO
Frequency: BD or OD
Dose adjustments
Renal
Reduce per CrCl
Clinical pearls
- CMV in transplant patients (prophylaxis/treatment)
- Strict pregnancy prevention; cytotoxic precautions
Contraindications
- Severe neutropenia
- Hypersensitivity
- Pregnancy/breastfeeding
Side effects
- Severe myelosuppression (boxed)
- Nephrotoxicity
- Carcinogenic / teratogenic
- GI upset
- Headache
- CNS effects
Interactions
- Other myelosuppressives
- Probenecid
- Imipenem (seizures)
- Mycophenolate
Monitoring
- FBC
- U&E
- CMV viral load
Reference: BNF; SmPC; UK transplant guidelines; https://bnf.nice.org.uk/drugs/valganciclovir/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Pathways
- Infective Endocarditis · ESC 2023 Infective Endocarditis Guidelines; NICE NG41
- Eczema Herpeticum · BAD; NICE CKS
- Suspected Bacterial Meningitis (Adult) · NICE NG240 (2024); NICE NG143 (paeds)
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021
- Returning Traveller — Fever · NaTHNaC; PHE; ESCMID 2018
- Malaria — Diagnosis & Management · PHE 2016; WHO 2023