Valcyte® (valganciclovir hydrochloride)

• Full Prescribing Information including boxed WARNING
• Healthcare Provider Letters

  1 letter

  Pediatric Dosing of Valcyte
• Material Safety Data Sheets

Indication

Adult Patients:

Valcyte® (valganciclovir hydrochloride) tablets are indicated for the treatment of cytomegalovirus (CMV) retinitis in patients with acquired immunodeficiency syndrome (AIDS).

Valcyte tablets are indicated for the prevention of CMV disease in kidney, heart, or kidney-pancreas transplant patients at high risk (Donor CMV seropositive/Recipient CMV seronegative[D+/R-]).

Pediatric Patients:

Valcyte® (valganciclovir hydrochloride) for oral solution and tablets are indicated for the prevention of CMV disease in kidney or heart transplant patients (4 months to 16 years of age) at high risk.

Limitations of Use:

• Valcyte is not indicated for use in either adult or pediatric liver transplant patients
• The safety and efficacy of Valcyte have not been established for:
• Prevention of CMV disease in solid organ transplants other than those indicated
• Prevention of CMV disease in pediatric solid organ transplant patients <4 months of age
• Treatment of congenital CMV disease

IMPORTANT DOSING INFORMATION

• Adult patients should use Valcyte tablets, not Valcyte for oral solution
• Valcyte should be taken with food
• The bioavailability of ganciclovir for Valcyte is significantly higher than from ganciclovir capsules. Therefore, Valcyte tablets cannot be substituted for ganciclovir capsules on a one-to-one basis
• Valcyte tablets should not be broken or crushed
• Valcyte for oral solution must be prepared by the pharmacist prior to dispensing to patient

Important Safety Information Including Boxed WARNING

WARNING: HEMATOLOGIC TOXICITY, CARCINOGENICITY, TERATOGENICITY, AND IMPAIRMENT OF FERTILITY

• Clinical toxicity of Valcyte, which is metabolized to ganciclovir, includes granulocytopenia, anemia, and thrombocytopenia
• In animal studies, ganciclovir was carcinogenic, teratogenic, and caused aspermatogenesis

CONTRAINDICATION

Valcyte is contraindicated in patients who have had a demonstrated clinically significant hypersensitivity reaction to valganciclovir, ganciclovir, or any component of the formulation.

WARNINGS AND PRECAUTIONS

•  Severe leukopenia, neutropenia, anemia, thrombocytopenia, pancytopenia, bone marrow aplasia, and aplastic anemia have been observed
• Do not administer if the absolute neutrophil count is <500 cells/uL, the platelet count is <25,000/IuL, or the hemoglobin is <8 g/dl
•  Use with caution in patients with pre-existing cytopenias, or who have received or who are receiving myelosuppressive drugs or irradiation
• Advise women of childbearing potential to use effective contraception during treatment and for at least 30 days following treatment with Valcyte. Advise men to practice barrier contraception during and for at least 90 days following treatment
• Acute renal failure may occur in:
• Elderly patients with or without reduced renal function
• Patients receiving potential nephrotoxic drugs
• Patients without adequate hydration

ADVERSE REACTIONS

Adult Patients: The most common adverse events and laboratory abnormalities reported in at least one indication by >20% of patients treated with Valcyte tablets are diarrhea, pyrexia, nausea, tremor, neutropenia, anemia, graft rejection, thrombocytopenia, and vomiting.

Pediatric Patients: The most common adverse events and laboratory abnormalities reported in >10% of solid organ transplant recipients treated with Valcyte for oral solution or tablets are diarrhea, pyrexia, hypertension, upper respiratory tract infection, vomiting, anemia, neutropenia, constipation, nausea, and cough.

Please see the full Prescribing Information, including Boxed WARNING, for additional Important Safety Information at www.valcyte.com.