Valcyte Disease Interactions

Severe leukopenia, neutropenia, anemia, thrombocytopenia, pancytopenia, bone marrow aplasia, and aplastic anemia have been reported in patients treated with valganciclovir. The use of this agent should be avoided if the absolute neutrophil count is less than 500 cells/µL, the platelet count is less than 25,000/µ/L, or the hemoglobin is less than 8 g/dL. Complete blood counts with differential and platelet counts should be performed frequently, especially in patients that developed leukopenia after using a nucleoside analog, or in whom neutrophil counts are less than 1000 cells/µL at the beginning of treatment. Therapy with this agent should be administered with caution in patients with bone marrow depression. Increased monitoring is recommended.

Acute renal failure has been documented in elderly patients (with or without reduced renal function), patients who receive concomitant nephrotoxic drugs, or inadequately hydrated patients. Adequate hydration, dose reduction and close monitoring of renal function are recommended when using valganciclovir in these patients. The tablet form of valganciclovir should not be used in adult patients on hemodialysis (CrCl less than 10 mL/min).

Monitoring is recommended when using valganciclovir in patients with hepatic impairment as the safety and efficacy of this agent has not been studied in these patients.