Valganciclovir

Renal impairment

For CMV prophylaxis only (post solid organ transplant):

Note: dose ranges use creatinine clearance, rather than eGFR.

(from Oxford Transplant Centre Virus Management module available at http://ouh.oxnet.nhs.uk/RTU/Pages/OxfordTransplantCentre.aspx)

For other indications: 

For renal dosing in other indications, please refer to product literature and discuss with a pharmacist.

Hepatic impairment

No information available.

Pregnancy

Avoid use in pregnancy unless benefits for mother outweigh risks to the child. The active metabolite of valganciclovir is ganciclovir which readily crosses the placenta and can have a teratogenic effect to the child. 

Breastfeeding

Discuss with pharmacy.

• Valganciclovir is only available by the oral route (as a tablet or powder for reconstitution).
• Valganciclovir powder for reconstitution contains 0.188mg/mL of sodium.
• Severe leucopenia, neutropenia, anaemia, thrombocytopenia, pancytopenia, bone marrow depression and aplastic anaemia are associated with valganciclovir. Therefore, check FBC before starting valganciclovir and monitor regularly during therapy.
• Patients with renal impairment need more frequent haematological monitoring.  
• For further monitoring advice see product literature. 

1. Summary of Product Characteristics (SPC) for Valcyte 450mg Film-Coated Tablets. Accessed via www.medicines.org.uk 26/03/18. Last updated 20/09/2006
2. OUH clinical guideline: virus management in solid organ transplant recipients and islet cell transplant recipients v 3.1; valid from April 2019
3. BNF online accessed via www.medicinescomplete.com 15/1/19; last updated 31/5/18