DrugindexOnline^{2nd edition}

Generic name: Valganciclovir
Brand names: Valcyte

Why is Valcyte prescribed?

Valcyte tablets are used in the treatment of an eye disease called cytomegalovirus (CMV) retinitis, one of the many infections that take hold when the immune system is undermined by AIDS.

Valcyte is also used to prevent CMV disease in people who've had a kidney, heart, or kidney-pancreas transplant. Valcyte is not approved for use in liver transplant patients.

Valcyte is very similar to the CMV medication Cytovene (ganciclovir).

Most important fact about Valcyte

To avoid an overdose, it is essential to take only the prescribed number of Valcyte tablets each day. These tablets are more potent than Cytovene capsules, and cannot be substituted on a one-for-one basis.

How should you take Valcyte?

Valcyte is usually taken twice a day for the first three weeks, then once a day. It should be taken with food.

Be careful to avoid breaking Valcyte tablets. If a tablet does break, keep the pieces out of direct contact with skin, eyes, and mouth. If contact is unavoidable, wash thoroughly with soap and water and rinse the eyes with plain water.

--If you miss a dose...

Take it as soon as you remember. If it is almost time for your next dose, skip the one you missed and go back to your regular schedule.

--Storage instructions...

Store at room temperature.

What side effects may occur?

Side effects cannot be anticipated. If any develop or change in intensity, inform your doctor as soon as possible. Only your doctor can determine if it is safe for you to continue taking Valcyte.

• More common side effects may include:
  Abdominal pain, anemia and other blood abnormalities, burning or prickling feeling, diarrhea, fever, graft rejection, headache, high blood pressure, insomnia, mental changes, nausea, retinal detachment, tremors, vision problems, vomiting

Why should Valcyte not be prescribed?

If Valcyte gives you an allergic reaction, or you've had an allergic reaction to Cytovene, you will not be able to use Valcyte.

You will not be able to use Valcyte if you are receiving hemodialysis.

Special warnings about Valcyte

Valcyte may cause low blood counts. You will need to have frequent blood tests to monitor for abnormalities. Your doctor will be especially cautious if you have pre-existing blood problems or if you are taking other medications that can reduce blood counts.

Valcyte can also affect the kidneys, so your doctor will check them frequently. You should be aware that Valcyte is also considered a potential cancer-causing agent, although this possible effect has not been studied.

Valcyte can diminish fertility in both men and women. It may also prove harmful to a developing baby. Women should use birth control while taking Valcyte, and men should use condoms during treatment and for 90 days thereafter.

Convulsions, sedation, dizziness, weakness, and confusion have been reported with the use of Valcyte tablets. If any of these symptoms occur, do not drive, operate machinery, or perform any other task that requires you to be alert.

Valcyte is not a cure for CMV retinitis and your disease may worsen during or following treatment. You should have an eye exam at least every 4 to 6 weeks while being treated with Valcyte tablets.

Possible food and drug interactions when taking Valcyte

If Valcyte is taken with certain other drugs, the effects of either could be increased, decreased, or altered. It is especially important to check with your doctor before combining Valcyte with the following:

Didanosine (Videx)
Mycophenolate mofetil (CellCept)
Probenecid
Zidovudine (Retrovir)

Special information if you are pregnant or breastfeeding

Valcyte may cause birth defects and should not be used during pregnancy. It's not certain whether Valcyte appears in breast milk, but it would cause serious side effects if it did. Breastfeeding is not recommended for women taking Valcyte--or for any woman with AIDS, since the disease can be passed to the infant through breast milk.

Recommended dosage

ADULTS

For the Treatment of CMV Retinitis

For active CMV retinitis, the recommended starting dosage is 900 milligrams (two 450-milligram tablets) twice a day for 21 days. The dose can then be decreased to 900 milligrams (two 450-milligram tablets) once a day. Take each dose with food.

Patients who have inactive CMV retinitis can start out at 900 milligrams once daily with food.

For the Prevention of CMV Disease in Heart, Kidney, and Kidney-pancreas Transplants

The recommended starting dosage is 900 milligrams (two 450-milligram tablets) once a day with food starting within 10 days of transplantation until 100 days posttransplantation.

If you have poor kidney function, your dose will be decreased. If you need hemodialysis, Valcyte cannot be used at all.

Overdosage

Any medication taken in excess can have serious consequences. A overdose of Valcyte can cause blood abnormalities, kidney failure, and liver disorders. If you suspect an overdose, seek medical attention immediately.

• Symptoms of Valcyte overdose may include:
  Abdominal pain, convulsions, diarrhea, vomiting, tremor