Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Prodrug Antiviral — CMV Prevention and Treatment (Oral)

Valganciclovir

Brand names: Valcyte

Valganciclovir is an oral prodrug of ganciclovir used to prevent and treat cytomegalovirus (CMV) infection in immunocompromised and transplant patients.

Dosing — being independently re-sourced

ClinCalc Pro is rebuilding its dose data from primary open sources — the manufacturer SmPC (eMC), the WHO Model Formulary and other official references — under clinician review. This drug's structured dose is not yet published here. Confirm all doses against the product SmPC and your local formulary before prescribing.

US labelling (FDA)

Reference — US labelling, may differ from UK

Pediatric Dosage ( 2.3 ) Prevention of CMV disease in kidney transplant patients 4 months to 16 years of age Dose once a day within 10 days of transplantation until 200 days post-transplantation according to dosage algorithm (note the calculation of creatinine clearance using a modified Schwartz formula in children) Prevention of CMV disease in heart transplant patients 1 month to 16 years of age Dose once a day within 10 days of transplantation until 100 days post-transplantation according to dosage algorithm (note the calculation of creatinine clearance using a modified Schwartz formula in children) Valganciclovir for oral solution should be taken with food. ( 2.1 , 12.3 ) 2.1 General …

Source: US FDA prescribing information (openFDA / DailyMed), label dated 2026-01-19. Accessed 2026-06-12. US dosing and indications can differ from UK practice — use UK sources for prescribing decisions.

Clinical monograph

How it works

It is rapidly converted to ganciclovir, which is phosphorylated to a triphosphate that inhibits viral DNA polymerase and so blocks CMV DNA replication.

Prescribing in practice

  • Myelosuppression (neutropenia, anaemia and thrombocytopenia) is the key risk — monitor full blood count regularly and withhold or adjust if counts fall.
  • Considered potentially teratogenic and carcinogenic; handle tablets with care (avoid crushing/broken tablets) and ensure effective contraception in those of childbearing potential and in men.
  • Dose must be reduced in renal impairment and adjusted for dialysis, as clearance is renally dependent.

Monitoring

Monitor full blood count frequently, especially early in treatment and in those with marrow suppression or renal impairment, and check renal function regularly to guide dosing.

Counselling the patient

  • Attend for blood tests as arranged, as the drug can lower blood counts and increase infection or bleeding risk.
  • Use reliable contraception during and for a period after treatment, and seek advice about pregnancy and fertility.
  • Report fever, sore throat, unusual bruising or bleeding, or marked tiredness promptly.

Evidence & guidelines

Oral valganciclovir provides ganciclovir exposure comparable to intravenous dosing and is standard for CMV prophylaxis and treatment in transplantation, supported by UK transplant guidance.

Reference: PV-16000 Trial; BHIVA Guidelines; Transplant Society (TTS) CMV Guidelines; NICE Solid Organ Transplant Guidance; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways