Uses
What is valganciclovir used for?
Valganciclovir is commonly used for the prevention of cytomegalovirus (CMV) disease in people who have received transplants and for the treatment of CMV retinitis, a viral eye infection, in people with AIDS.

Valganciclovir may not be appropriate for some of the infections listed above, depending on which germs are causing the infection. Viruses in some locations may have developed resistance to valganciclovir, which will make it not work as well.

Valganciclovir may also be used for other conditions as determined by your healthcare provider.

How does valganciclovir work (mechanism of action)?
Valganciclovir prevents the cytomegalovirus from multiplying in the body by disrupting its ability to create DNA. 

How is valganciclovir supplied (dosage forms)?
Brands and other names

• Valcyte

Dosage forms and strengths

• 50 mg/mL powder for oral solution
• 450 mg oral tablets

How should I store valganciclovir?
Oral Tablet. Valganciclovir oral tablets should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.

Oral Liquid. Your pharmacy will mix valganciclovir oral liquid for you before you pick it up. Valganciclovir oral liquid should be stored in the refrigerator, between 36 F to 46 F (2 C to 8 C). Throw away any unused medicine by the discard date your pharmacy has written on the bottle or after 49 days if no date is provided. Do not freeze.

Side Effects
What are the most common side effects of valganciclovir?
The most common side effects of valganciclovir are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

• Diarrhea
• Fever
• Tiredness
• Nausea or vomiting
• Tremor (in adults)
• Infection in the nose or throat, sore throat, or common cold symptoms (in children)
• Blood disorders (see below)
• Headache
• Trouble sleeping (in adults)
• Kidney or bladder infection

There may be other side effects of valganciclovir that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of valganciclovir?
While less common, the most serious side effects of valganciclovir are described below, along with what to do if they happen.

Severe Allergic Reactions. Valganciclovir may cause allergic reactions, which can be serious. Stop taking valganciclovir and get help right away if you have any of the following symptoms of a serious allergic reaction.

• Breathing problems or wheezing
• Racing heart
• Fever or general ill feeling
• Swollen lymph nodes
• Swelling of the face, lips, mouth, tongue, or throat
• Trouble swallowing or throat tightness
• Itching, skin rash, or pale red bumps on the skin called hives
• Nausea or vomiting
• Dizziness, feeling lightheaded, or fainting
• Stomach cramps
• Joint pain

Blood Disorders. Valganciclovir can cause blood disorders, such as anemia, low platelet levels (thrombocytopenia), low neutrophil levels (neutropenia), aplastic anemia, and low white blood cell levels (leukopenia). Stop taking valganciclovir and get help right away if you have any of the following symptoms of blood disorders.

• Fever
• Shortness of breath
• Pale or yellowish skin
• Easy bruising or bleeding
• Frequent infection
• Unusual weakness or tiredness
• Dizziness, lightheadedness, or feeling like you are about to pass out
• Headache
• Fast or abnormal heartbeat

Kidney Damage. Kidney damage can happen when taking valganciclovir. People who are dehydrated, 65 years of age or older, or taking certain medicines are at greater risk of having kidney damage while taking valganciclovir. Call your healthcare provider right away if you have any of the following symptoms of kidney damage.

• Reduced need to pee
• Swelling in your feet, ankles, or legs
• Weakness or unusual tiredness
• Difficulty catching your breath or chest pain/pressure
• Confusion
• Nausea
• Seizures

Cancer. Valganciclovir may cause a new cancer to develop or cause a previously treated cancer to recur. Tell your healthcare provider about any new symptoms that you may get.

Warnings & Precautions
Who should not use valganciclovir?
Allergies to Ingredients. People who are allergic to any of the following should not take valganciclovir.

• Valganciclovir
• Valcyte
• Ganciclovir
• Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific valganciclovir products they stock.

What should I know about valganciclovir before using it?
Do not take valganciclovir unless it has been prescribed to you by a healthcare provider. Take it as prescribed.

Do not share valganciclovir with other people, even if they have the same condition as you. It may harm them.

Keep valganciclovir out of the reach of children. If you are using the oral liquid which should be kept in a refrigerator, take special precautions to keep it away from children who also use the refrigerator.

Keep all follow up-appointments while you are being treated with valganciclovir. Your healthcare provider may need to monitor your bloodwork. If you are being treated for an eye infection, your healthcare provider may need to check your eyes regularly.

Always take valganciclovir with food to help the medicine get absorbed into your body.

You should stay well hydrated by drinking plenty of fluids while taking valganciclovir.

Do not break or crush valganciclovir tablets. Avoid contact with your skin or eyes. If you do accidently make contact with the tablet or the oral liquid, wash your skin thoroughly with soap and water or rinse your eyes thoroughly with plain water.

If you are taking valganciclovir oral liquid, use the oral dispenser that comes with the medicine to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Talk to your pharmacist if your oral dispenser is lost or damaged. They can recommend an appropriate measuring device.

Valganciclovir can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how valganciclovir affects you.

Women of childbearing age should use effective birth control during treatment with valganciclovir and for at least 30 days after finishing treatment. Men should use barrier contraception (such as a condom) during treatment with valganciclovir and for at least 90 days after finishing treatment.

Valganciclovir may cause temporary or permanent fertility problems (infertility) in men and women, which can make it more difficult to have a baby.

People who are 65 and older can be at greater risk for some side effects from valganciclovir. Talk to your healthcare provider about your risks if you are in this age group.

What should I tell my healthcare provider before using valganciclovir?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if valganciclovir is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

• Low white blood cell levels 
• Low neutrophil levels 
• Low red blood cell levels
• Low platelet levels 
• Any condition being treated with radiation, such as cancer
• Kidney problems, including if you are receiving dialysis

Other Medicines and Supplements. Valganciclovir may interact with other medicines and supplements. Before taking valganciclovir, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how valganciclovir could affect pregnancy or harm an unborn baby. Valganciclovir causes birth defects in animals and may also cause birth defects in humans. Tell your healthcare provider if you are or plan to become pregnant.

Breastfeeding. It is not known if valganciclovir passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take valganciclovir while breastfeeding.

Interactions
Does valganciclovir interact with foods or drinks?
There are no known interactions between valganciclovir and foods or drinks.

There are no known interactions between valganciclovir and alcohol, but heavy drinking can slow your immune response and make it harder for your body to fight infection. 

Does valganciclovir interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

In particular, make sure that you discuss if you are using any of the following before taking valganciclovir.

• Zidovudine (Retrovir), which is a medicine used to treat HIV
• Probenecid, which is a medicine commonly used for gout 
• Imipenem-cilastin (Primaxin) or sulfamethoxazole/trimethoprim (Bactrim, Septra, Sulfatrim), which is an antibiotic used to treat a variety of infections
• Cyclosporine (Gengraf, Neoral, Sandimmune, and others), mycophenolate mofetil (Cellcept, Myfortic, Myhibbin), or tacrolimus (Astagraf XL, Envarsus XR, Prograf), which is a medicine to suppress your immune system
• Amphotericin B (Abelcet, AmBisome) or flucytosine (Ancobon), which is a medicine used to treat fungal infections
• Dapsone, which is a medicine used to treat leprosy and dermatitis herpetiformis
• Pentamidine (Pentam), which is a medicine used to treat Pneumocystis pneumonia
• Doxorubicin (Doxil), vincristine, or vinblastine, which is a medicine used to treat some cancers
• Hydroxyurea (Xromi, Hydrea, Syklos), which is a medicine used to treat sickle cell disease and some cancers

This may not be a complete list of medicines that can interact with valganciclovir. Always check with your healthcare provider.

Overdose/Missed Dose
What should I do if I accidentally use too much valganciclovir?
If you or someone else has used too much valganciclovir, get medical help right away, or contact a Poison Control center.

What should I do if I miss a dose of valganciclovir?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.

It is important to complete your prescribed course of valganciclovir, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to valganciclovir or other similar medicines.