Infectious Disease Compendium

Valganciclovir (Valcyte®)

Dosing

CrCl Formula

CrCl > 80: 900 mg po bid for induction, 900 qd for prevention and maintenance.

CrCl Induction Dose (mg) Maintenance Dose (mg)
60 900 bid 900 qd
40-59 450 bid 450 qd
25-39 450 qd 450 q 2d
10-24 450 q 2d 450 q week

If giving for CMV prophylaxis in transplant, if you under-dose as the GFR improves, there is an increased chance of CMV (Pubmed).

Hemodialysis:

Peritoneal dialysis:

Important side effects

Abdominal pain, diarrhea, nausea, vomiting, anemia, neutropenia (very common), thrombocytopenia, headache, insomnia.

Important drug interactions

Probenecid, zidovudine.

Rants and Screeds

I would avoid where absorption may be an issue, such as colitis.

Pearls

Treatment of choice

Use for

CMV retinitis. Perhaps other manifestations of CMV, it achieves blood levels nearly as good as iv.

Don't use for

Class

Last update 11/30/19