valganciclovir
Valganciclovir (Valcyte) is an oral antiviral medication used for cytomegalovirus (CMV) infections. If you're taking it to prevent an infection, you typically take it just once daily. But if you're taking it to treat a CMV infection, you'll likely need to take it twice daily for a few weeks in the beginning of treatment. Some common side effects of valganciclovir (Valcyte) include diarrhea, fever, and fatigue. Valganciclovir (Valcyte) comes as both a tablet and an oral solution, and is available as a lower-cost generic.
What is Valganciclovir (Valcyte)?
What is Valganciclovir (Valcyte) used for?
Prevention of cytomegalovirus (CMV) infection after organ transplant
Treatment of CMV eye infection in adults with acquired immunodeficiency syndrome (AIDS)
How Valganciclovir (Valcyte) works
Valganciclovir (Valcyte) is metabolized (broken down) by the body to an active antiviral medication called ganciclovir. Ganciclovir stops an enzyme called DNA polymerase. Without this enzyme, the virus can't make copies of itself.
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What are the side effects of Valganciclovir (Valcyte)?
Common Side Effects
- Diarrhea (41%)
- Fever (31%)
- Nausea (30%)
- Headache (22%)
- Low blood cell counts (up to 22%)
- Vomiting (21%)
- Difficulty sleeping (16%)
- Stomach pain (15%)
- Labs suggesting kidney problems (up to 12%)
- Labs suggesting kidney problems (up to 50%)
- Low blood cell counts (up to 31%)
- Diarrhea (30%)
- Shakiness (28%)
- Nausea (23%)
- Headache (22%)
- Difficulty sleeping (20%)
- Vomiting (16%)
- Fever (13%)
Other Side Effects
- Nerve pain in hands and feet
- Tingling or prickling sensation
- Eye pain
- Chills
- Not feeling as hungry
- Back pain
- Muscle pain
- Cough
- Night sweats
Serious Side Effects
- Retinal detachment: sudden changes in vision, floaters, flashes of light
- Blood and bone marrow problems
- Kidney injury: urinating less often than usual, swelling in your feet, ankles, or hands, unexplained weight gain
Source: FDA
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Aplastic anemia—unusual weakness or fatigue, dizziness, headache, trouble breathing, increased bleeding or bruising
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Unusual bruising or bleeding
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
Pros and cons of Valganciclovir (Valcyte)
Pros
First-choice medication for CMV treatment and prevention
Available as a lower-cost generic
Taken by mouth, compared ganciclovir (Cytovene IV) that's injected into the veins
Comes as an oral solution for children or people who have a hard time swallowing the tablet
Maintenance dose is typically just once daily
Cons
Might not be a good choice for people with kidney problems
Can cause fertility problems in males and females
Can cause certain anemias and other low blood cell counts
Causes a lot of stomach-related problems, such as diarrhea, nausea, and vomiting
Must take with food
Pharmacist tips for Valganciclovir (Valcyte)
You should take valganciclovir (Valcyte) at the same time every day with food.
Swallow the valganciclovir (Valcyte) tablet whole. Don't break, chew, or crush the tablets.
If you're taking valganciclovir (Valcyte) oral solution, your pharmacist can mix it for you at the pharmacy. Once it's mixed, you need to store the solution in the refrigerator. Keep in mind that the oral solution is only good for up to 49 days after it has been mixed. Don't take the medication past 49 days, even if you have some left in the bottle.
If you're taking the valganciclovir (Valcyte) oral solution, measure the dose carefully using a medication measuring cup or oral syringe. Don't use any household spoons to measure your medication because the dose might not be accurate. Don't mix the valganciclovir (Valcyte) oral solution with any other liquid.
Drink enough fluids to stay hydrated while you are taking valganciclovir (Valcyte). It can help prevent kidney problems.
Valganciclovir (Valcyte) can cause fertility problems and might also harm the unborn baby of those who become pregnant while taking this medication. Females should use an effective birth control method while they are taking valganciclovir (Valcyte) and for at least 30 days after they stop the medication. Males with female partners who may become pregnant should use condoms while they are taking valganciclovir (Valcyte) and for at least 90 days after they stop the medication.
Valganciclovir (Valcyte) is an antiviral medication and will only work to treat and prevent infections caused by CMV. Don't use it for an infection caused by bacteria or any other types of viruses.
Frequently asked questions about Valganciclovir (Valcyte)
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What are the risks and warnings for Valganciclovir (Valcyte)?
Valganciclovir (Valcyte) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Low blood cell count and bone marrow problems
Risk factors: Taking other medications that affect blood cell count | Kidney problems
Valganciclovir (Valcyte) can lower your blood cell counts and damage your bone marrow. This can make it harder for your body to fight new infections and raise your risk of bruising and prolonged bleeding. Your provider will order blood tests regularly and might change your dose of valganciclovir (Valcyte) or stop it altogether if your blood counts become too low. The blood counts typically start to improve 3 to 7 days after stopping the medication.
Let your provider know if you experience any of the following symptoms:
Fertility problems
Valganciclovir (Valcyte) at prescribed doses can cause fertility problems in both males and females. Sometimes, this can be permanent. If you're thinking about having a child in the future, talk to your healthcare provider about family planning before you begin treatment.
Harm to unborn baby
Valganciclovir (Valcyte) can cause harm to an unborn baby if taken during pregnancy. This harm is also true for males taking the medication who have female partners who can become pregnant. For this reason, females should use an effective birth control method while they are taking valganciclovir (Valcyte) and for at least a month after they stop the medication. Males should use condoms while taking valganciclovir (Valcyte) and for at least 3 months after they stop the medication.
Cancer risk
Based on animal studies valganciclovir (Valcyte) has the potential to cause cancer in humans. Make sure to tell your provider about your entire medical history before starting this medication.
Kidney problems
Risk factors: Dehydration | Older adults | Using other medications that harm the kidneys
Valganciclovir (Valcyte) can cause serious harm to the kidneys, especially in older adults. The risk is also higher if you become dehydrated or take other medications that can harm the kidneys. Stay hydrated while taking valganciclovir (Valcyte) and talk to your provider before taking any medications. Your provider might order regular lab tests to monitor your kidneys. If your labs show changes in your kidney health, your provider may lower your dose of valganciclovir (Valcyte).
Valganciclovir (Valcyte) dosage forms
Typical dosing for Valganciclovir (Valcyte)
Treatment of CMV eye infection
Adults: The typical dose is to take 900 mg by mouth twice daily for 3 weeks. After that, your provider will typically lower your dose to 900 mg by mouth once daily.
Prevention of CMV infection after transplant
Adults (kidney, heart, or kidney-pancreas transplant): The typical dose is to take 900 mg by mouth once daily, starting within 10 days of organ transplant. You'll continue to take this medication for 100 to 200 days after your transplant, or as directed by your provider.
Children (kidney or heart transplant): Your child's provider will determine your child's dose based on their height, weight, age, and kidney health. Typically, your child will start this medication within 10 days of organ transplant. They'll continue taking it for 100 to 200 days after their transplant, or as directed by their provider.
Your dose of valganciclovir (Valcyte) might be different depending on your kidney health.
How much does Valganciclovir (Valcyte) cost?
Valganciclovir (Valcyte) contraindications
Serious allergic reaction to ganciclovir (Cytovene IV)
What are alternatives to Valganciclovir (Valcyte)?
Prevention of cytomegalovirus (CMV) infection after organ transplant
Treatment of CMV eye infection in adults with acquired immunodeficiency syndrome (AIDS)
Cytomegalovirus (CMV) retinitis in people with AIDs
Treatment of viral eye infection (CMV retinitis) in adults with weakened immune systems
Prevention of CMV disease in adults who received a transplant
Valganciclovir (Valcyte) images
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References
Best studies we foundActavis Pharma, Inc. (2023). VALGANCICLOVIR HYDROCHLORIDE FOR ORAL- valganciclovir hydrochloride powder, for solution [package insert]. DailyMed.
Aurobindo Pharma Limited. (2022). VALGANCICLOVIR HYDROCHLORIDE tablet [package insert]. DailyMed.
Aurobindo Pharma Limited. (2022). VALGANCICLOVIR- valganciclovir hydrochloride powder, for solution [package insert]. DailyMed.
Azevedo, L. S., et al. (2015). Cytomegalovirus infection in transplant recipients. Clinics.
Centers for Disease Control and Prevention. (2020). About cytomegalovirus (CMV).
Kotton, C. N., et al. (2018). The third international consensus guidelines on the management of cytomegalovirus in solid-organ transplantation. Transplantation.
National Human Genome Research Institute. (2023). Enzyme.
National Kidney Foundation. (2015). 6 tips to be "water wise" for healthy kidneys.
National Organization for Rare Disorders. (2009). Cytomegalovirus infection.
Vemulakonda, G. A. (2023). What is cytomegalovirus retinitis? American Academy of Ophthalmology.
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