Valganciclovir
Pronunciation: (val-GAN-si-kloe-veer).
- Generic name
- valganciclovir
- Brand names
- Valganciclovir Accord, Valcivir, Valcept, Valcyte, Valgan, Valganciclovir Sandoz
- Drug class
- Infectious & Communicable Diseases
Availability and supply rules vary by country
Trade names by country: United States · Canada
Australia: · Full directory
What valganciclovir is and how it works
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how valganciclovir works
Valganciclovir is a prodrug of ganciclovir. After oral administration, it is rapidly converted to ganciclovir by intestinal and hepatic esterases. Ganciclovir is phosphorylated by viral and cellular kinases to its active triphosphate form, which inhibits viral DNA polymerase, resulting in termination of viral DNA elongation and inhibition of viral replication. It is primarily active against cytomegalovirus (CMV) and has activity against other herpesviruses. (1)
What valganciclovir is used for
Cytomegalovirus (CMV) retinitis in patients with AIDS
Cytomegalovirus (CMV) retinitis in patients with AIDS (1)
Prevention of CMV disease in high-risk adult kidney, heart, and pancreas transplant recipients
Prevention of CMV disease in high-risk adult kidney, heart, and pancreas transplant recipients (1)
Prevention of CMV disease in high-risk pediatric kidney and heart transplant recipients
Prevention of CMV disease in high-risk pediatric kidney and heart transplant recipients (1)
Before taking valganciclovir
Do not take / not appropriate for
- Contraindicated in patients with hypersensitivity to valganciclovir or ganciclovir, severe neutropenia (<500 cells/μL), severe thrombocytopenia (<25,000/μL), or severe anemia. (Contraindication) (1)
- Pregnancy and breastfeeding are not recommended due to teratogenicity and potential toxicity. (Contraindication) (1)
Tell your clinician about
(1)How to take valganciclovir
- General Instructions: Take valganciclovir exactly as prescribed, usually with food to improve absorption. Do not crush or break tablets.. Adult Dosing: For CMV retinitis (induction): 900 mg orally twice daily for 21 days. Maintenance: 900 mg once daily. For CMV prophylaxis in transplant patients: 900 mg once daily, starting within 10 days of transplantation and continuing for up to 100-200 days, depending on organ type.. Pediatric Dosing: Dosing in children is based on body surface area and kidney function. Always follow pediatric specialist instructions.. Administration: Swallow tablets whole with food. For oral solution, use the provided dosing syringe for accurate measurement.. When To Seek Review: Do not stop taking valganciclovir without your doctor’s advice, even if you feel better. Stopping early may cause the infection to return or worsen.. Storage: Store tablets at room temperature, away from moisture and heat. Oral solution should be refrigerated and discarded after 49 days.
- This page does not provide a dose calculator. Dosing must follow the prescriber, pharmacist, or product label.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1)
Missed dose
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 resume your regular schedule. do not take an extra dose to catch up.
Overdose
If you suspect an overdose, seek emergency medical attention or call your local poison control center immediately. Symptoms may include bone marrow suppression, kidney failure, or seizures. (1)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms to a healthcare professional.
Diarrhea
Incidence: Reported in the clinician-authored database; frequency not established
Nausea
Incidence: Reported in the clinician-authored database; frequency not established
Vomiting
Incidence: Reported in the clinician-authored database; frequency not established
Anemia
Incidence: Reported in the clinician-authored database; frequency not established
Neutropenia
Incidence: Reported in the clinician-authored database; frequency not established
Thrombocytopenia
Incidence: Reported in the clinician-authored database; frequency not established
Fever
Incidence: Reported in the clinician-authored database; frequency not established
Headache
Incidence: Reported in the clinician-authored database; frequency not established
Signs of low blood counts: unusual bruising or bleeding, signs of infection (fever, chills, sore throat), or unusual tiredness
(1)Signs of reduced kidney function: significant decrease in urination, swelling
(1)Serious warnings
FDA BOXED WARNING — Valganciclovir carries several serious risks flagged by the FDA's strongest safety warning — serious
Symptoms: FDA BOXED WARNING — Valganciclovir carries several serious risks flagged by the FDA's strongest safety warning: (1) Hematologic toxicity: severe leukopenia, neutropenia, anemia, thrombocytopenia, pancytopenia, and bone marrow failure including aplastic anemia have been reported. (2) Impairment of fertility: based on animal data and limited human data, valganciclovir may cause temporary or permanent inhibition of sperm production in males and suppressed fertility in females. (3) Fetal toxicity: based on animal data, valganciclovir has the potential to cause birth defects in humans — effective contraception should be used. (4) Mutagenesis and carcinogenesis: based on animal data, valganciclovir has the potential to cause cancers in humans.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
May impair kidney function — serious
Symptoms: May impair kidney function; dose adjustment based on creatinine clearance is required (see the renal dosing note below). Increases risk of infections due to immune suppression. Handle tablets and oral solution with care; avoid direct contact with broken tablets or spilled solution.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
Contraindications recorded in the clinician database — serious
Symptoms: Contraindications recorded in the clinician database: Contraindicated in patients with hypersensitivity to valganciclovir or ganciclovir, severe neutropenia (<500 cells/μL), severe thrombocytopenia (<25,000/μL), or severe anemia. Use with caution in patients with pre-existing hematologic disorders, renal impairment, or those receiving other myelosuppressive or nephrotoxic drugs. Pregnancy and breastfeeding are not recommended due to teratogenicity and potential toxicity.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Recorded interactions | Valganciclovir may interact with other medications that affect bone marrow (such as zidovudine, mycophenolate mofetil), nephrotoxic drugs (like cyclosporine, tacrolimus), and drugs that affect renal excretion. Always inform your healthcare provider of all medicines and supplements you are taking. | (1) |
Pregnancy, breastfeeding, kidney/liver function, age
Pregnancy
This is covered by the FDA boxed warning above: based on animal data, valganciclovir has the potential to cause birth defects in humans, and it may also affect fertility. Women of childbearing potential should use effective contraception during treatment and for at least 30 days after the last dose; men should use barrier contraception during treatment and for at least 90 days after the last dose. Discuss pregnancy planning and contraception with the treating clinician before starting valganciclovir. (1)
Breastfeeding
Breastfeeding is not recommended during valganciclovir treatment. The FDA label states there are no data on valganciclovir/ganciclovir in human milk, its effects on the breastfed infant, or effects on milk production, though animal data show ganciclovir is excreted in the milk of lactating rats; given the boxed-warning risks (hematologic toxicity, carcinogenicity, teratogenicity), breastfeeding is not recommended during treatment. (1)
Children
Frequency: Twice daily for initial treatment. Weight Based: 15 mg/kg/dose orally twice daily for 21 days, not to exceed 900 mg per dose.. Max Daily Dose: 1800 mg. Max Single Dose: 900 mg. Age Restrictions: Not recommended for pediatric use (1)
Renal_impairment
FDA label: adult dosing must be adjusted based on creatinine clearance (renal function) — see the specific dose table in the renal dosing note below; dosing has not been established for patients on hemodialysis, so valganciclovir is not recommended in that population. The safety and efficacy of valganciclovir have not been studied in patients with hepatic impairment, so no specific hepatic dose-adjustment schedule exists; use in significant liver disease should be individually assessed by the treating clinician. (1)
Hepatic_impairment
FDA label: adult dosing must be adjusted based on creatinine clearance (renal function) — see the specific dose table in the renal dosing note below; dosing has not been established for patients on hemodialysis, so valganciclovir is not recommended in that population. The safety and efficacy of valganciclovir have not been studied in patients with hepatic impairment, so no specific hepatic dose-adjustment schedule exists; use in significant liver disease should be individually assessed by the treating clinician. (1)
Monitoring
(1)Storage
Store valganciclovir tablets at controlled room temperature, 20-25°C (68-77°F), with excursions permitted to 15-30°C (59-86°F). If a reconstituted oral solution is dispensed, that specific formulation should be refrigerated at 2-8°C (36-46°F) for no longer than 49 days and not frozen — follow the product label/pharmacist's instructions for the exact formulation dispensed.
Professional information
Clinician-facing context only. This section does not replace current product labeling.
General
Indication: Cytomegalovirus (CMV) retinitis in patients with AIDS
Dose summary: Initial dose of 900 mg orally twice daily for 21 days, followed by 900 mg once daily for maintenance.
Renal context: FDA label: adult dose must be reduced based on creatinine clearance (CrCl) for maintenance/induction dosing: CrCl >=60 mL/min - 900 mg once daily; CrCl 40-59 mL/min - 450 mg once daily; CrCl 25-39 mL/min - 450 mg every 2 days; CrCl 10-24 mL/min - 450 mg twice weekly; CrCl <10 mL/min or on hemodialysis - dosing has not been established and valganciclovir is not recommended. (Induction dosing follows a parallel, twice-the-maintenance-frequency pattern per the full label — confirm the exact regimen with the prescriber/pharmacist.) (1)
Hepatic guidance
FDA label: the safety and efficacy of valganciclovir have not been studied in patients with hepatic impairment, so no specific hepatic dose-adjustment schedule is defined. Use in significant hepatic impairment should be individually assessed by the treating clinician.
Frequently asked questions
What is valganciclovir used for?
Valganciclovir is used to treat and prevent cytomegalovirus (CMV) infections, especially in people with weakened immune systems, such as organ transplant recipients and those with HIV/AIDS.
How should I take valganciclovir?
Take valganciclovir exactly as prescribed, usually with food. Swallow the tablets whole and use the provided syringe for the oral solution. Do not crush or break the tablets.
What are the most common side effects?
Common side effects include diarrhea, nausea, vomiting, headache, fever, and decreased appetite. Serious side effects can include low blood cell counts and kidney problems.
Can valganciclovir be used during pregnancy?
Valganciclovir can cause birth defects and should not be used during pregnancy unless absolutely necessary. Effective contraception is required during treatment and for at least 90 days after stopping.
What should I do if I miss a dose?
Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose. do not take an extra dose to make up for a missed dose.
Are there any foods or medicines I should avoid?
Avoid medicines that can affect your bone marrow or kidneys unless approved by your doctor. There are no specific food restrictions, but always take valganciclovir with food.
How long will I need to take valganciclovir?
The duration depends on your condition. For CMV retinitis, you may need long-term maintenance therapy. For CMV prevention after transplant, treatment typically lasts 100-200 days. Always follow your doctor’s instructions.
What happens if I take too much Valganciclovir?
Taking too much Valganciclovir can lead to severe side effects, including bone marrow suppression, kidney problems, and neurological issues. Symptoms may include unusual bleeding, fatigue, or seizures. If an overdose is suspected, seek immediate emergency medical attention. Do not attempt to induce vomiting or self-treat.
Can I drink alcohol while taking Valganciclovir?
It is generally advisable to limit or avoid alcohol consumption while taking Valganciclovir. Both Valganciclovir and alcohol can potentially affect the liver and kidneys. Combining them may increase the risk of liver damage or worsen kidney function. Always consult your healthcare provider for personalized advice regarding alcohol intake with your medication.
Is Valganciclovir safe during pregnancy?
Valganciclovir is classified in Pregnancy Category C, meaning animal reproduction studies have shown an adverse effect on the fetus, but there are no adequate and well-controlled studies in humans. It should only be used during pregnancy if the potential benefit justifies the potential risk to the fetus. Always consult your doctor to discuss the risks and benefits.
What is the mechanism of action of valganciclovir?
Valganciclovir is a prodrug of ganciclovir. After oral administration, it is rapidly converted to ganciclovir by intestinal and hepatic esterases. Ganciclovir is phosphorylated by viral and cellular kinases to its active triphosphate form, which inhibits viral DNA polymerase, resulting in termination of viral DNA elongation and inhibition of viral replication. It is primarily active against cytomegalovirus (CMV) and has activity against other herpesviruses. (1)
What is the generic name of Valganciclovir?
The generic name is valganciclovir. It is sold under brand names including Valganciclovir Accord, Valcivir, Valcept, Valcyte, Valgan, Valganciclovir Sandoz.
What class of drug is valganciclovir?
Valganciclovir is classed as: Infectious & Communicable Diseases.
References
- Valganciclovir — prescribing informationU.S. National Library of Medicine (DailyMed) · United States · dated unresolved · accessed 2026-08-07 · source 1
- VALGANCICLOVIR TABLET, FILM COATED [GOLDEN STATE MEDICAL SUPPLY, INC.] — US prescribing information (DailyMed SPL)U.S. National Library of Medicine (DailyMed) · US · accessed 2026-08-14 · source 2
- Valganciclovir — patient drug information (MedlinePlus)U.S. National Library of Medicine (MedlinePlus) · US · accessed 2026-08-14 · source 3
- Valganciclovir hydrochloride for Oral — FDA approval record (Drugs@FDA ANDA205220)U.S. Food and Drug Administration · US · accessed 2026-08-14 · source 4
- valganciclovir — RxNorm normalized drug concept (RXCUI 275891)U.S. National Library of Medicine (RxNorm) · US · accessed 2026-08-14 · source 5
Brand names by country
Single-ingredient valganciclovir names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Valcyte450 mg, 50 mg/mL · h2-pharma, llc
Canada
- VALCYTE