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Valganciclovir

Valganciclovir hydrochloride (Valcyte®) is an antiviral medication used to treat cytomegalovirus infections. As the L-valyl ester of ganciclovir, it is actually a prodrug for ganciclovir. After oral administration, it is rapidly converted to ganciclovir by intestinal and hepatic esterases. more...

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Administration

Orally, available in 450 mg pink tablets. Dosing is calculated to provide appropriate doses of ganciclovir; 900 mg of valganciclovir orally every 12 hours is equivalent to 5 mg per kilogram of body weight of intravenous ganciclovir, also every 12 hours.

Pharmacokinetics

Oral bioavailability is approximately 60%. Fatty foods significantly increase the bioavailability and the peak level in the serum.
It takes about 2 hours to reach maximum concentrations in the serum.
Valganciclovir is eliminated as ganciclovir in the urine, with a half-life of about 4 hours in people with normal kidney function.

Side effects

Blood: neutropenia, anemia, low platelets. Myelosuppression is one of the main side effects that may limit prolonged use of valganciclovir.
Gastrointestinal: diarrhea, nausea, vomiting, abdominal pain.
Central nervous system: fever, headache, insomnia, paresthesia, and peripheral neuropathy.
Ocular: retinal detachment

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Effective drugs against viral disease
From Nurse Practitioner, 8/1/02 by Risser, Nancy

Literature Review

Drugs for Non-HIV viral infections. The Medical Letter 2002;44(1123):9-16

This issue updates recommendations regarding drugs for nonhuman immunodeficiency viral infections, including a table that outlines drugs of choice, dosages, and costs. Oral acyclovir or famciclovir decrease the symptomatic frequency of genital herpes and reduce asymptomatic herpes simplex virus shedding. If begun within 24 hours after rash onset, acyclovir decreases varicella severity. You can use both drugs to treat localized or disseminated zoster.

For the treatment of chronic hepatitis C virus, researchers state that treatment with parenteral interferon alfa and oral ribavirin (Rebetol, Virazole) has higher response rates than therapy with either drug alone. Newer pegylated interferons (alfa-2a or alfa2b) have a longer half-life, require fewer doses, and are more effective than standard alfa interferon. In one study, interferon alfa-2b treatment prevented most chronic infections in patients with acute hepatitis C virus. The authors also review amantadine, cidofovir, fomivirsen, foscarnet, ganciclovir, lamivudine, oseltamivir, penciclovir, valacyclovir, trifluridine, valganciclovir, and zanamivir.

Nancy Risser, MN, RN,C, ANP

Mary Murphy, CPNP, PhD

Literature Review Editors

Literature Review offers succinct summaries of articles published in recent clinical journals.

The journals reviewed include: American Family Physician - American Journal of Medicine - American Journal of Psychiatry - American Journal of Respiratory and Critical Care Medicine - Annals of Internal Medicine - Archives of Pediatric and Adolescent Medicine - CA: A Cancer Journal for Clinicians - Cancer - Clinical Pediatrics - Journal of Emergency Medicine - Journal of the American Geriatrics Society - Journal of the American Medical Association - Journal of Pediatric Health Care - Obstetrics and Gynecology - Lancet - Mayo Clinic Proceedings - MCN: The American Journal of Maternal/Child Nursing - The Medical Letter Morbidity and Mortality Weekly Report - Now England Journal of Medicine - Pediatric Annals Pediatric Nursing - Pediatrics - Pediatrics in Review

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