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Formulation
Tablet: 450 mg
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Dose
CMV retinitis treatment:
900 mg orally twice a day for 2–4 weeks
CMV colitis or oesophagitis
Valganciclovir may be considered if symptoms are not severe enough to prevent oral absorption (not licensed)
CMV retinitis maintenance:
900 mg orally once a day
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Side Effects
Myelosuppression – neutropenia, thrombocytopenia; rash; CNS effects including fitting, confusion, anxiety; abnormal LFTs; psychological effects including depression
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Interactions
Additive toxicity with other myelosuppressive drugs e.g. cotrimoxazole, zidovudine, and trimetrexate
Didanosine increases plasma concentrations; probenecid delays renal excretion
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Renal
Dose in renal impairment GFR (ml/min)
40–59:induction/treatment 450 mg twice a day
Maintenance/prophylaxis 450 mg daily
25–39:Induction/treatment 450 mg daily every 24 hours
Maintenance/prophylaxis 450 mg every 48 hours
10–24: induction/treatment 450 mg every 48 hours
Maintenance/prophylaxis 450 mg twice weekly
<10: Avoid
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Hepatic
No data in patients with hepatic impairment
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Pregnancy
Compatible – Maternal Benefit >> Embryo-Foetal Risk
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Other Information
Drug Characteristics