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Drug Interactions between probenecid and valganciclovir

This report displays the potential drug interactions for the following 2 drugs:

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Interactions between your drugs

Moderate

probenecid valGANciclovir

Applies to: probenecid and valganciclovir

MONITOR: The coadministration of probenecid and ganciclovir may result in elevated plasma concentrations of ganciclovir. In 10 subjects with HIV infection, probenecid (500 mg orally every 6 hours) increased the peak plasma concentration and area under the concentration-time curve of ganciclovir (1 gram orally every 8 hours) by an average of 40% and 53%, respectively. Renal clearance decreased an average of 22%. The mechanism of the interaction is competitive inhibition of ganciclovir renal tubular secretion by probenecid.

MANAGEMENT: Caution is advised if ganciclovir or its prodrug, valganciclovir, must be used concomitantly with probenecid. Close monitoring for toxicities associated with ganciclovir such as myelosuppression is recommended during concurrent therapy.

References (3)
  1. (2002) "Product Information. Cytovene (ganciclovir)." Genentech
  2. (2001) "Product Information. Valcyte (valganciclovir)." Roche Laboratories
  3. Cimoch PJ, Lavelle J, Pollard R, et al. (1998) "Pharmacokinetics of oral ganciclovir alone and in combination with zidovudine, didanosine, and probenecid in HIV-infected subjects." J Acquire Immune Defic Hum Retrovirol, 17, p. 227-34

Drug and food interactions

Moderate

valGANciclovir food

Applies to: valganciclovir

ADJUST DOSING INTERVAL: Food increases the bioavailability of ganciclovir from the prodrug, valganciclovir. In 16 HIV-positive subjects, the administration of valganciclovir 875 mg once daily with a high-fat meal containing approximately 600 calories resulted in a 30% increase in the steady-state area under the plasma concentration-time curve (AUC) and a 14% increase in the peak plasma concentration (Cmax) of ganciclovir, with no delay in the time to reach peak plasma concentration (Tmax). The mechanism is unknown.

MANAGEMENT: The manufacturer recommends that valganciclovir be taken with meals.

References (2)
  1. (2001) "Product Information. Valcyte (valganciclovir)." Roche Laboratories
  2. Brown F, Banken L, Saywell K, Arum I (1999) "Pharmacokinetics of valganciclovir and ganciclovir following multiple oral dosages of valganciclovir in HIV- and CMV-seropositiv volunteers." Clin Pharmacokinet, 37, p. 167-76

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

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Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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