maribavir at a glance
Medicine class
Direct-acting antiviral and CMV UL97 protein-kinase inhibitor
Licensed role
Refractory CMV infection or disease in adult stem-cell or solid-organ transplant recipients
Specialist use
Treatment should be started by a clinician experienced in transplant care
Food and administration
May be taken with or without food; tablets may be swallowed whole or crushed
What is maribavir used for?
The selected product is licensed for specialist treatment of:
CMV infection or disease that is refractory, with or without resistance, to one or more previous therapies including ganciclovir, valganciclovir, cidofovir or foscarnet, in adults following haematopoietic stem-cell or solid-organ transplantation.
How does maribavir work?
Maribavir competitively blocks the CMV UL97 protein kinase. This disrupts stages needed for viral DNA replication, packaging and movement from the cell nucleus, limiting production of new CMV.
maribavir preparations and strengths
Tablet
Route: Oral
Strengths: 200 mg
How to take maribavir
Take maribavir exactly as directed by the transplant team.
It may be taken with or without food.
The tablet may be swallowed whole or crushed.
A crushed tablet can be given through a nasogastric or orogastric tube by an appropriately trained person.
maribavir side effects
Common or expected effects
- Changed, reduced or lost sense of taste
- Nausea, vomiting or diarrhoea
- Tiredness
- Headache
- Upper abdominal pain
- Reduced appetite or weight loss
- Raised blood levels of some transplant immunosuppressants
Get urgent medical advice
- Severe or persistent vomiting or diarrhoea, especially with dehydration or inability to retain other medicines
- Signs of severe allergy, including facial or throat swelling, breathing difficulty or collapse
- Symptoms suspected to result from excessive immunosuppressant exposure; urgent assessment should be coordinated with the transplant team
maribavir in pregnancy
Human pregnancy data are unavailable, and reproductive toxicity occurred in animal studies. Maribavir is not recommended during pregnancy or for someone who could become pregnant without contraception; discuss pregnancy or plans for pregnancy promptly with the specialist team.
maribavir while breastfeeding
It is unknown whether maribavir enters human milk, and risk to a breastfed child cannot be excluded. The product information advises stopping breastfeeding during treatment; the prescriber and maternity or transplant team should help plan feeding support using an individual risk assessment.
maribavir interactions
The transplant team should review all prescription, non-prescription and herbal products before treatment.
Ganciclovir or valganciclovir
Concurrent use is contraindicated because maribavir can oppose the UL97-dependent activation and antiviral effect of these medicines.
Tacrolimus, ciclosporin, sirolimus or everolimus
Maribavir can raise concentrations, so levels require frequent monitoring when maribavir is started and stopped.
Rifampicin, rifabutin or St John’s wort
These can substantially reduce maribavir exposure and effectiveness; concurrent use is not recommended.
Common questions about maribavir
Answers are fully visible for fast scanning and source review.
Why is maribavir prescribed after a transplant?
It treats CMV infection or disease in adults after a stem-cell or solid-organ transplant when specified previous antiviral treatment has not worked, with or without confirmed resistance.
Can maribavir be taken with food?
Yes. It may be taken with or without food.
Can maribavir tablets be crushed?
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.