Valganciclovir

Excreted Unchanged %
>90
Half-Life (Normalesrd) Hours
4/10-67.5
Plasma Protein Binding %
1-2
Volume Of Distribution L/Kg
0.7
Dose For Normal Renal Function
900 mg bid (induction), 900 mg daily (maintenance)
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
See notes [A]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
See notes [A]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
See notes [A]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: Avoid
Supplement For Dialysis [Recommendation Level]: Pd
PD: Avoid
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: See notes
References
Czock D, Scholle C, Rasche FM, Schaarschmidt D, Keller F. Pharmacokinetics of valganciclovir and ganciclovir in renal impairment. Clin Pharmacol Ther. 2002; 72: 142-50. [PMID: 12189361]
Toxicity Notes
Valganciclovir is rapidly converted to ganciclovir (q.v.). Pharmokinetic data are for ganciclovir. HD reduces plasma concentration of ganciclovir by ~50%. Dosing recommended by manufacturer&#151; Induction: CrCl 40-59 mL/min, 450 mg bid; CrCl 25-39 mL/min, 450 mg qd; CrCl 10-24 mL/min, 450 mg q2d. Maintenance: CrCl 40-59 mL/min, 450 mg qd; CrCl 25-39 mL/min, 450 mg q2d; CrCl 10-24 mL/min, 450 mg twice weekly.