Valganciclovir medication belong to Antiviral agent class. Valganciclovir is a prodrug of ganciclovir, which inhibits cytomegalovirus (CMV) replication by inhibition of viral DNA synthesis. Valganciclovir is metabolized to ganciclovir. Protein binding of ganciclovir is about 1% to 2%. Vd of ganciclovir is about 0.703 L/kg.



How to Take Valganciclovir

Take Valganciclovir exactly as prescribed by health care provider. Valganciclovir is generally available in market in the form Tablets 500 mg , Tablets 1 g. Ensure that reduced dose is administered to patient with renal impairment (Ccr less than 60 mL/min) following manufacturer's recommendations. Do not administer to patient if absolute neutrophil count is less than 500/mm 3 , platelet count is less than 25,000/mm 3 , or hemoglobin is less than 8 g/dL.

Dosage Instructions for Valganciclovir Drug

Treatment of CMV retinitis in patients with AIDS; prevention of CMV disease in kidney, heart, and kidney-pancreas transplant patients at high risk (donor CMV seropositive/recipient CMV seronegative.

Contraindications of Valganciclovir Drug

Hypersensitivity to ganciclovir or valganciclovir.

Interactions of Valganciclovir with other drugs

Interaction studies have not been conducted; however, because valganciclovir is converted to ganciclovir, interactions associated with ganciclovir are expected to occur for valganciclovir.

Amphotericin B, cyclosporine, nephrotoxic drugs: May increase serum creatinine.

Cytotoxic drugs: May increase the risk of toxicity.

Didanosine: Plasma levels of didanosine may be increased, while didanosine may decrease levels of ganciclovir.

Imipenem-cilastatin: May cause generalized seizures.

Probenecid: May reduce renal Cl and increase serum levels of ganciclovir.

Zidovudine: Both ganciclovir and zidovudine can cause granulocytopenia.

What are the Side Effects of Valganciclovir

Like other medicines, Valganciclovir can cause side effects. Some of the more common side effects of Valganciclovir include

* Hypertension (18%); hypotension (at least 5% or serious adverse events).

* Headache (22%); insomnia (20%); peripheral neuropathy (9%); paresthesia (8%); dizziness, convulsions, depression, psychosis, hallucinations, confusion, agitation (at least 5% or serious adverse events).

* Dermatitis, pruritus, acne

* Diarrhea (41%); nausea (30%); vomiting (21%); abdominal pain (15%); constipation, dyspepsia, abdominal distention, ascites

* Neutropenia (27%); anemia (26%); leukopenia (14%); thrombocytopenia (including life-threatening bleeding) (6%); pancytopenia, bone marrow depression, aplastic anemia (at least 5% or serious adverse events).

* Back pain, arthralgia, muscle cramps, limb pain (at least 5% or serious adverse events).

* Pyrexia (31%); tremors (28%); graft rejection (24%); catheter-related infections (3%); hypersensitivity, fatigue, pain, edema, peripheral edema, weakness, local and systemic infections and sepsis, postoperative pain, wound infection and complications, increased wound drainage, wound dehiscence (at least 5% or serious adverse events).

Warnings and precautions before taking Valganciclovir

* Toxicity includes granulocytopenia, anemia, and thrombocytopenia. In animal studies, ganciclovir was carcinogenic, teratogenic, and caused aspermatogenesis.

* Advise patient not to chew, crush, break, or split tablets. If direct contact with broken or crushed tablets occurs, advise patient to wash thoroughly with soap and water and rinse eyes thoroughly with plain water.

* Advise patient that if a dose is missed to take as soon as remembered and to take the next dose at the usual time. However, if it is nearing the time for the next dose, to skip the dose and take the next dose at the regularly scheduled time.

* Advise patient that this drug is not a cure for CMV retinitis and that retinitis may continue to progress during or following treatment.

* Advise patient that valganciclovir is converted to ganciclovir in the body and that it may cause infertility and birth defects. Advise men to use barrier contraception during and for at least 90 days following treatment and women to use effective contraception during treatment.

* Advise men before taking Valganciclovir that drug may cause temporary or permanent infertility.

* Advise patient before taking Valganciclovir that drug may cause sedation, dizziness and/or confusion and to use caution while performing tasks requiring alertness, including driving and operating machinery.

* Advise patient to immediately report any of the following to health care provider: fever or other signs of infection, sore throat, unusual bruising or bleeding.

* Advise patient before taking Valganciclovir that diarrhea, nausea, vomiting, and headache are common side effects and to inform health care provider if they occur and are intolerable.

* Advise women before taking Valganciclovir to notify health care provider if pregnant, planning to become pregnant, or breastfeeding. Advise HIV-infected mothers not to breastfeed infants to avoid risk of HIV transmission to the infant

* Advise patient before taking Valganciclovir not to change brands of medicine.

What if Overdose of Valganciclovir ?

If you think you or anyone else taken overdose of Valganciclovir , immediately telephone your doctor or contact your local or regional Poisons Information Centre Seek medical attention immediately. You may need urgent medical attention. Pancytopenia, bone marrow depression, medullary aplasia, leukopenia, neutropenia, granulocytopenia, hepatitis, liver function disorder, worsening of hematuria, acute renal failure, elevated creatinine, abdominal pain, diarrhea, vomiting, generalized tremor, convulsion are may be the overdose symptoms of Valganciclovir .

What if Missed Dose of Valganciclovir ?

If you miss a dose of Valganciclovir medicine and you remember within an hour or so, take the dose immediately. If you do not remember until later, skip the dose you missed and go back to your regular schedule. Do not double doses.

Storage Conditions for Valganciclovir

* Valganciclovir tablets cannot be substituted for ganciclovir capsules on a one-to-one basis.

* Administer Valganciclovir with food to maximize absorption.

* Have patient swallow tablet whole. Do not crush, break, split, or chew tablets.

* If broken or crushed tablet comes in contact with skin or mucus membranes, wash thoroughly with soap and water and rinse eyes thoroughly with plain water.

* Store Valganciclovir at controlled room temperature (59? to 86'F).