valganciclovir hydrochloride at a glance
Medicine class
Systemic antiviral; an oral prodrug of ganciclovir.
Main licensed uses
CMV retinitis treatment in adults with AIDS and CMV prevention after certain solid-organ transplants.
Food
Take with food whenever possible to improve and stabilise absorption.
Monitoring
Regular blood counts and kidney-function checks are important because treatment can suppress bone marrow and is cleared through the kidneys.
What is valganciclovir hydrochloride used for?
The selected products are licensed for:
Induction and maintenance treatment of CMV retinitis in adults with AIDS.
Prevention of CMV disease in CMV-negative adults and children from birth to 18 years who receive a solid organ from a CMV-positive donor.
Non-licensed context: specialist paediatric services may use valganciclovir for symptomatic congenital CMV infection; this is not an indication licensed for the selected products.
How does valganciclovir hydrochloride work?
Valganciclovir is rapidly converted into ganciclovir. In CMV-infected cells, ganciclovir is activated to a form that blocks viral DNA production, limiting further viral replication rather than removing latent virus from the body.
valganciclovir hydrochloride preparations and strengths
Oral solution
Route: Oral
Strengths: 50 mg/mL
Tablet
Route: Oral
Strengths: 450 mg
How to take valganciclovir hydrochloride
Follow the transplant, HIV or specialist team's instructions exactly and take valganciclovir with food whenever possible.
Swallow tablets whole; do not break or crush them.
The oral solution should normally be prepared by a pharmacist. Shake the closed bottle before use and measure it only with the supplied oral dispenser.
Give the measured solution directly into the mouth without mixing it into another liquid.
Wash the dispenser after use with distilled or boiled water and allow it to air-dry.
Avoid skin or eye contact with damaged tablets, powder or solution. Wash exposed skin with soap and water and rinse exposed eyes thoroughly.
valganciclovir hydrochloride side effects
Common or expected effects
- Diarrhoea, nausea, vomiting or abdominal pain
- Headache, tiredness or fever
- Reduced appetite
- Cough or shortness of breath
- Thrush or upper respiratory infection
- Anaemia or neutropenia detected on blood testing
- Skin inflammation or rash
Get urgent medical advice
- Severe allergic reaction with swelling or breathing difficulty
- Severe infection associated with low white-cell counts
- Anaemia causing marked breathlessness, palpitations or pallor
- Low platelets causing unusual bruising or bleeding
- Bone-marrow failure or severe reduction in multiple blood-cell types
- Acute kidney failure
- Seizures, hallucinations or loss of contact with reality
- Pancreatitis causing severe abdominal pain spreading to the back
valganciclovir hydrochloride in pregnancy
Safety in pregnancy has not been established, and ganciclovir crosses the placenta. Valganciclovir should be used only when a specialist judges that maternal benefit outweighs potential fetal harm. Effective contraception is required during treatment and for the product-specified period afterwards; discuss pregnancy, pregnancy plans and fertility before treatment.
valganciclovir hydrochloride while breastfeeding
Breastfeeding is contraindicated during treatment because serious effects in a breastfed infant cannot be excluded. A prescriber and infant-feeding specialist should help plan an alternative before treatment starts.
valganciclovir hydrochloride interactions
Tell the specialist team about all prescribed, over-the-counter and complementary products. Important examples include:
Imipenem–cilastatin
Concurrent use has been associated with seizures and is generally avoided unless benefit clearly outweighs risk.
Probenecid
Can reduce ganciclovir clearance and increase exposure, requiring closer toxicity monitoring.
Didanosine
Didanosine exposure may rise, increasing toxicity risk such as pancreatitis.
Zidovudine and other marrow-suppressing medicines
Combined treatment can increase anaemia, neutropenia and other blood-cell toxicity.
Common questions about valganciclovir hydrochloride
Answers are fully visible for fast scanning and source review.
What is valganciclovir used for after an organ transplant?
It can prevent CMV disease in CMV-negative adults and children who receive a solid organ from a CMV-positive donor.
Is valganciclovir an antibiotic or an antiviral?
It is an antiviral. It is converted into ganciclovir, which limits CMV DNA replication.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.