VALGANCICLOVIR
(Valcyte)Standard Prescription
valganciclovir__mg PO Q__H
Dosages
Organ transplant recipients aged 4 months to 16 yrs:
CMV PROPHYLAXIS: Dose (mg) = 7 x BSA x CrCl to a maximum dose of 900 mg per day, where: BSA = body surface area (m2 ; see m2 calculation inside front cover of hard copy) and CrCl is calculated as per the new modified Schwartz equation: CrCL (mL/min/1.73 m2 ) = [0.413 x height (cm) x 88.4]/[serum creatinine (umol/L)]. Use a maximum of 120 mL/min/1.73 2 m2 in the dosing calculation, if calculated CrCl exceeds this.
CMV TREATMENT: Same dose as for prophylaxis, given BID
Organ transplant recipients >16 yrs:
CMV PROPHYLAXIS: 900 mg PO once daily
CMV TREATMENT: (in children with mild or asymptomatic CMV infection): 900 mg PO BID
CONGENITAL CMV Infection in INFANTS:
16 mg/kg/dose BID, adjusted for renal function.
For renal impairment (adolescents > 16 yrs, adults):
CrCl 40-59 mL/min/1.73m2 : 450 mg PO once daily.
CrCl 25-39 mL/min/1.73m2 : 450 mg PO every second day
CrCl 10-24 mL/min/1.73m2 : 450 mg PO twice weekly
CrCl < 10 mL/min/1.73m2 or hemodialysis or CVVH: not recommended, refer to ganciclovir dosing.
CMV PROPHYLAXIS: Dose (mg) = 7 x BSA x CrCl to a maximum dose of 900 mg per day, where: BSA = body surface area (m2 ; see m2 calculation inside front cover of hard copy) and CrCl is calculated as per the new modified Schwartz equation: CrCL (mL/min/1.73 m2 ) = [0.413 x height (cm) x 88.4]/[serum creatinine (umol/L)]. Use a maximum of 120 mL/min/1.73 2 m2 in the dosing calculation, if calculated CrCl exceeds this.
CMV TREATMENT: Same dose as for prophylaxis, given BID
Organ transplant recipients >16 yrs:
CMV PROPHYLAXIS: 900 mg PO once daily
CMV TREATMENT: (in children with mild or asymptomatic CMV infection): 900 mg PO BID
CONGENITAL CMV Infection in INFANTS:
16 mg/kg/dose BID, adjusted for renal function.
For renal impairment (adolescents > 16 yrs, adults):
CrCl 40-59 mL/min/1.73m2 : 450 mg PO once daily.
CrCl 25-39 mL/min/1.73m2 : 450 mg PO every second day
CrCl 10-24 mL/min/1.73m2 : 450 mg PO twice weekly
CrCl < 10 mL/min/1.73m2 or hemodialysis or CVVH: not recommended, refer to ganciclovir dosing.
Mechanism of Action
Antiviral pro-drug, converted to ganciclovir in the body.
Forms Supplied
tablet: 450 mg
solution: 50 mg/mL
solution: 50 mg/mL
Comments
Valganciclovir is rapidly converted to ganciclovir in the body.
Hazardous drug: (medium level) valganciclovir is a potential teratogen and carcinogen; use chemotherapy precautions when handling and disposing.
See "CMV prophylaxis and treatment regimens" in the BC Transplant guidelines (available online at: www.transplant.bc.ca)
Monitor: CBC with differential, ALT and creatinine.
Oral solution contains sodium benzoate, a metabolite of benzyl alcohol which may be toxic in neonates.
Give with food (enhances absorption).
Consult Infectious Diseases for questions.
Hazardous drug: (medium level) valganciclovir is a potential teratogen and carcinogen; use chemotherapy precautions when handling and disposing.
See "CMV prophylaxis and treatment regimens" in the BC Transplant guidelines (available online at: www.transplant.bc.ca)
Monitor: CBC with differential, ALT and creatinine.
Oral solution contains sodium benzoate, a metabolite of benzyl alcohol which may be toxic in neonates.
Give with food (enhances absorption).
Consult Infectious Diseases for questions.
References
6, 9, 44, 100, 137
Last Edited
2022-09-13 06:18:43