Valganciclovir (Oral)

Valganciclovir, Better Known as Valcyte

Valcyte prevents multiplication of cells that are viral and cause infection.

Overview

Valganciclovir is an antiviral medication used to treat and prevent cytomegalovirus (CMV) retinitis an infection in the eye). This medication has serious long-term effects. To get the best results for the duration of your treatment do frequent check-ins with your doctor. Your visits may consist of blood tests to check if you are developing any life-threatening reactions that affect bone marrow or blood cells. As of today there are no reports that Valcyte causes other diseases such as cancer in humans; there have been cases of Valganciclovir causing cancer in animals.

Talk with your doctor and let them know if you are pregnant or plan to get pregnant within 3-6 months after treatment. Valganciclovir medication may cause birth defects and cause men to become sterile.

Condition(s) treated

  • cytomegalovirus (CMV) Retinitis
  • CMV disease prevention/postoperative organ transplant
  • Heart transplant
  • Kidney transplant
  • Kidney-pancreas transplant

Type of medicine

  • Antiviral
  • Available in a pill or liquid form

Side Effects

All medication has some sort of side effect, but not all side effects require medical attention. You may be able to handle some of the milder reactions without batting an eye, but some are more serious and debilitating than others. The degree of severity differentiates from one patient to the next. Reactions depend on how bad the infection is, how old the patient is, how much the patient weighs, how long they've had the infection, the type of transplant they've had, and underlying medical conditions. Check with your doctor to learn about ways to minimize your side effects before taking the medicine through diet, exercise, and lifestyle changes.

Side effects may get worse after the first dose. They become less severe after the body adjusts to the new medication. There have been cases where the side effects completely disappear after a few consistent doses. Some side effects are more common than others.

  • nervousness
  • feverish
  • back pain
  • dizzy spells
  • bloody urine
  • scratchy horse voice
  • chills
  • persistent cough
  • black stool
  • headache
  • sore throat
  • trembling hands
  • irregular heartbeat(too fast or too slow)
  • pain when urinating
  • red rash that looks like tiny pinpoints
  • light flashes
  • shortness of breath
  • extreme fatigue
  • body weakness
  • easy bruising
  • excess bleeding
  • spots in mouth
  • labored breathing
  • sores
  • ulcers
  • chills
  • diarrhea
  • throwing up
  • pain or weakness in hands and feet
  • sharp abdominal pain
  • partial blindness
  • pounding sound/feeling in ears

The following side effects were reported, but are not common:

  • irrational beliefs
  • blocked nasal passages
  • swollen facial parts and tongue
  • skin rash and itch
  • voices in your head
  • sensations that aren't real
  • irregular breathing
  • hallucinations
  • tight feeling in chest
  • discolored face
  • seizures
  • runny nose
  • foggy mind
  • confusion

Dosage

The dosage of Valcyte is determined on a case by case basis. Only the doctor can determine who gets what. Consult with your doctor and follow all instructions given by the pharmacist. The amount depends on the reason you are prescribed the medicine, age, weight, underlying medical conditions and strength of the medication.

For treatment of CMV retinitis in adults, the oral dosage( liquid or pill) begins at 900 mg daily(in 2 450 mg pills) for 21 days. Once the symptoms weaken your doctor may change the dose to one 900 mg dose per day. Consult a doctor to determine the dose for children suffering from CMV of the eyes.

To prevent CMV in transplant patients it differs depending on the type of transplant you received. For adults, if you had a heart transplant it starts at 900 milligrams (mg) (two 450 mg tablets) once a day starting within 10 days of transplantation until 100 days postoperative. If you had a kidney-pancreas transplant you take 900 milligrams (mg) (two 450 mg tablets) once a day starting within 10 days of transplantation until 100 days postoperative. If you had a kidney transplant the recommended dosage is 900 mg (two 450 mg tablets) once a day starting within 10 days of transplantation until 200 days postoperative.

For children, dosage depends on the doctor's orders, type of transplant, weight, other health issues, and creatinine levels. Children who have received a kidney transplant ages 4 months to 16 years old get a 900mg dose once a day within 10 days postoperative until 200 days after the transplant. Those under 4 months old are given a dosage based strictly on the doctor's orders.

Children who have received a heart transplant from age 1 month to 16 years old get one 900 mg dose a day within 10 days of the transplant and until 100 days after. Those younger than one-month-old are prescribed a dose strictly by the doctor's orders.

No matter which type of transplant you have, the achieve the full benefit of the medicine make sure you follow the doctor's instructions. Do not try to create your own regimen for the medicine. Don't attempt to break a 900 mg dosage down to three or four in a day. If it says one dose only take one dose. If it says to take 2 450 mg doses then only take 2 450 mg doses. Any alteration from the doctor's orders may make the medicine less effective, and the treatment null and void.

Missed Dose

Don't take double doses. If you miss a dose take it as soon as possible but if it's time for the next dose already, just skip the one you missed and return to your regular regiment. Do not take Valcyte on an empty stomach. Take Valcyte with food and swallow the whole pill. Do not chew, break or crush to add to liquid and drink. Follow the instructions on the bottle or container. Don't miss doses so you can get the full effects. Don't skip doses and get off schedule. Take the medicine as prescribed until the doctor tells you to stop. If you feel ill, still take the medicine but notify your doctor so you can be immediately seen.Avoid caffeine and alcohol while taking this medicine. Follow the instructions from your doctor on handling the pills and wash your hands frequently.

Do not get Valcyte, in liquid or tablet form on your skin, eyes, nose, or mouth. If contact is made with those areas rinse with plain water until it's all gone.

Interactions

Tell your doctor about any medications you are taking including vitamins, herbal supplements, or over the counter medicines. Different medications interact with Valcyte in different ways and the active ingredients in one may cancel out the active ingredients in another. To ensure that you will receive the full effect of Valcyte to treat your particular case, allow the doctor to determine whether or not the meds can be mixed. Your doctor may determine you are not a candidate for this treatment based on any medications you're taking or underlying health conditions. Notify your doctor if you take any of the following medications:

  • Iron Sulfate
  • Keppra
  • Tylenol
  • Co-trimoxazole
  • Vitamin B12
  • Bactrim
  • Lantus Solostar
  • Zantaz
  • Vitamin D3
  • Demerol

Take a complete list of all medications even if it is not on this list.

Warnings

Check in frequently with your doctor while taking Valcyte. Blood, urine, and other tests can be run to make sure the medicine is working as it should, and there are no adverse effects. Make regular follow up appointments, this medicine can have life-threatening results. Women should use birth control(condoms, pills, etc.) to prevent pregnancy while on this medication because it can cause birth defects. Continue using birth control for at least one month after you stop the Valganciclovir. Men should continue to use condoms for a minimum of 90 days after the medicine is stopped to prevent pregnancy. Contact the doctor immediately in the event you might be pregnant while taking Valcyte. Please note, there have been cases where this medication caused infertility in women.

Valganciclovir has the ability to lower the number of your white blood cell count. Lower white cell blood count means the immune system isn't working at 100%. This will increase the chance of infection. It also lowers the number of platelets necessary for proper blood clotting. When your white blood cell count is low there are precautions you can take to keep your chances of infection at a minimum:

  1. Stay out of dirty or dusty areas
  2. Stay out of hospitals and away from sick people
  3. Clean, dress, and cover minor cuts and bruises, they carry risk of getting infected
  4. Incorporate light exercise into your routine
  5. Change your eating habits to an immune system boosting healthy diet
  6. Shower as soon as you come in from outside to kill germs
  7. Change bedsheets regularly
  8. Clean your house regularly with bacteria-fighting cleaner, bleach, Lysol etc.
  • Be careful who you are around and avoid people with infections. Contact your doctor when you've been exposed to an infection. In the event of exposure, you may experience painful urination, become hoarse, lower back pain, side pain, chills, cough or fever as a symptom of infection.
  • If you see any red spots the size of the point of a pin, bruising, bloody stool, bloody urine, black stools, or unusual bleeding call your doctor and schedule an appointment to be seen.
  • You may not be able to use a regular toothbrush or dental floss. Check with your doctor and dentist for safe and effective alternative methods for dental hygiene. They may advise a new toothbrush, new dental rinse, and gentle, thorough cleaning. Notify your dentist that you are taking Valganciclovir.
  • Carefully shave, remove body hair, clip toenails and fingernails. The slightest exposure opens you up to the possibility of infection. Don't cut yourself or cause an open sore or burn.
  • No participation in any contact sports or rigorous activity. Any contact sports increase the chance of infections.

If you don't see improvements in your health after starting this treatment call your doctor to schedule an appointment to be re-evaluated.

Don't take other people's prescriptions and don't share yours.

Give a list of all your meds to your doctor and keep a list of you at all times, this includes vitamins and herbal supplements.

Talk with the doctor before starting any new drug, including prescription or OTC, natural products, or vitamins.

Call your poison control center or get medical care right away if you suspect an overdose. Share information with emergency responders. Don't be afraid to tell them what was taken, how much was taken, and when it was taken.

Valcyte may cause kidney failure. Patients that are elderly are at a high risk, especially if they have conditions of the kidneys. Rapid weight gain, nausea, seizures, depression, urinating less, headaches, dizzy spells, hostile behavior, acting irritable, lethargy, bipolar disorder, swollen hands, swollen, ankles, swollen, feet and coma are all side effects that are cause for concern. Immediately notify your doctor and arrange to be seen for re-evaluation or consider a trip to the emergency room.

Before you drive, operate machinery, or do anything that requires motor skills or cognitive thinking test your body's reaction to the medication. It can cause drowsiness, uncontrollable movements, and dizzy spells. It can also cause disorientation. Experience of these side effects merits a consultation with your doctor to create a schedule that suits your lifestyle and allows you to take the medicine and function daily. You may have to take it at certain times of the day or during the night. Don't try to force your motor skills to work once they've been affected by the medicine, Do not drive or operate machinery as it may cause you to have an accident and hurt yourself or others.

Report any pain or side effects you experience that is not on this list to your doctor. You may experience something that is not on this list, but it may still be within the normal range of side effects. If it is out of the normal range of these side effects your doctor may advise alternative methods to treat your specific medical situation. Follow the doctor's instructions about any lifestyle changes concerning diet, exercise, or anything else that may improve your health while on this medication and after the duration of treatment. Follow doctor's instructions regarding lifestyle changes, diet and health after the medication are done to prevent a flare-up of the disease. Pay attention to your body and any lingering side effects up to 90 days after the last dose and report any unusual circumstances to your doctor immediately.

Notify the doctor if your side effects become too debilitating, painful, or if you have an allergic reaction to any of the ingredients in the medication. The doctor may change the dosage or completely alter your treatment. Adverse reactions may permanently affect you or kill you if you don't immediately seek treatment. You may be advised to completely cease your treatment.

You will bleed more, bruise easily, and feel generally experience more exhaustion while taking this medication. Don't be alarmed. Continue your prescription until it is all gone unless the doctor instructs you to stop. Following the instructions from your doctor are vital to your treatment while on this medicine. Any deviation from the regiment like missed doses will affect the duration of the treatment as well as the effectiveness. The longer you are on Valcyte, the longer you are more susceptible to catching other infections. It is in the best interest of the patient to stick to the directions.

Do not mix medications unless the doctor has prescribed medicines that can be taken at the same time. Do not take over the counter medicine, herbal supplements or vitamin supplements.

At your initial consultation inform the doctor of any of the following:

  • pregnancy
  • kidney conditions
  • blood cell condition
  • currently breastfeeding
  • future breastfeeding
  • currently undergoing treatments with radiation
  • cancer diagnosis
  • vitamins
  • herbal supplement
  • any non-prescription medication

Follow up with your doctor once treatment is complete. Make a note of your experience while on the medication to share with your doctor at the visit. Take a list of any side effects, anything that helped ease your mind and body while on the medicine, the food you ate, yoga, exercise you tried, and anything you did to ease any discomfort experienced while on Valcyte. Attend all follow-up appointments with your doctor and any other recommended follow up check-ups to make sure the disease has not come back. Exercise, eat healthily and take any other medications as prescribed once the duration of your Valcyte treatment is complete. Contact your doctor immediately at the first sign of the resurgence of CMV.

Storage

All medications should be stored in a safe place like a medicine cabinet or designated drawer away from children. A person that does not have CMV that takes Valcyte may experience adverse effects and severe side effects. Make sure you check the number of pills or amount of liquid medicine you have left after every dose to make sure nobody else is taking your meds. Don't share the medication with anyone. You never know what kind of reaction a person may have to Valcyte. A body that doesn't have the disease that Valcyte treats may have an adverse reaction or cause a life-threatening reaction.

  • Take all medication during the designated time by your doctor
  • Dispose of any unused medication
  • Don't take any remaining old medicine that's hanging around the medicine cabinet
  • Store anything you are directed by the doctor to keep at room temperature in a closed container
  • Keep medicine in a cool dry place, out of direct light
  • Do not freeze
  • Keep all medications away from children
  • Check local listings for medicine buyback or community disposal programs
  • Any oral liquids should be refrigerated
  • Dispose of any remaining pills or liquid after 49 days

Summary

Valcyte is a life-saving medication. It can only be administered through the advice of a licensed physician. A compromised immune system is a life-threatening condition that can only be diagnosed and treated by a doctor. Never attempt to self-diagnose CMV or other life-threatening diseases. Do not attempt to diagnose others and share medications. Never self-medicate or take other people's prescribed medications such as Valcyte for CMV, HIV, or other people's medicine for any other disease. Always consult your doctor and get a full exam with the required tests before taking a medication such as Valcyte. Your doctor determines if you're the right fit.

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Last Reviewed:
December 24, 2017
Last Updated:
April 23, 2018
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