From the FDA Drug Label
1 INDICATIONS & USAGE 1.1 Adult Patients Treatment of Cytomegalovirus (CMV) Retinitis: Valganciclovir tablets, USP are indicated for the treatment of CMV retinitis in patients with acquired immunodeficiency syndrome (AIDS) [see Clinical Studies ( 14. 1)]. Prevention of CMV Disease: Valganciclovir tablets, USP are indicated for the prevention of CMV disease in kidney, heart, and kidney-pancreas transplant patients at high risk (Donor CMV seropositive/Recipient CMV seronegative [D+/R-]) [see Clinical Studies ( 14.1)].
The treatment for cytomegalovirus (CMV) infection is valganciclovir tablets, which are indicated for the:
- Treatment of CMV retinitis in patients with acquired immunodeficiency syndrome (AIDS)
- Prevention of CMV disease in kidney, heart, and kidney-pancreas transplant patients at high risk (Donor CMV seropositive/Recipient CMV seronegative [D+/R-]) 1
From the Research
Introduction to Cytomegalovirus (CMV) Infection Treatment
CMV infection is a significant concern in immunocompromised patients, including those with AIDS or undergoing solid organ transplantation. The treatment of CMV infection involves the use of antiviral medications.
Antiviral Medications for CMV Infection
The primary antiviral medications used to treat CMV infection include:
- Ganciclovir, which has been shown to have clinical efficacy against CMV disease, as well as an in vivo antiviral effect 2
- Valganciclovir, an orally administered prodrug of ganciclovir, which is as effective as intravenous ganciclovir for the treatment of AIDS-related CMV retinitis 3
- Foscarnet, which can be used in combination with ganciclovir for the treatment of relapsed CMV retinitis in patients with AIDS 4
- Cidofovir, which is also used to treat CMV infection, although its use is limited by potential toxicities 5
Treatment Regimens for CMV Infection
Treatment regimens for CMV infection may involve:
- Induction therapy with intravenous ganciclovir, followed by maintenance therapy with oral valganciclovir 6
- Combination therapy with ganciclovir and foscarnet for the treatment of relapsed CMV retinitis in patients with AIDS 4
- Sequential treatment with a short course of intravenous ganciclovir, followed by oral valganciclovir, which may provide effective exposure and therapeutic response in the treatment of CMV infection in solid organ transplant patients 6
Dosage and Duration of Treatment
The dosage and duration of treatment for CMV infection may vary depending on the specific medication and treatment regimen used. For example:
- Ganciclovir may be administered at a dosage of 5 mg/kg intravenously every 12 hours for 2 weeks, followed by maintenance therapy at a dosage of 10 mg/kg per day 4
- Valganciclovir may be administered at a dosage of 900 mg orally twice daily for 16 days, following an initial 5-day course of intravenous ganciclovir 6
Caveats and Considerations
The treatment of CMV infection requires careful consideration of potential toxicities and resistance. For example: