Cochrane Adam B
University of Chicago Hospitals, 5841 South Maryland Avenue, Mail Code 5026, Chicago, IL 60637, USA.
Am J Health Syst Pharm. 2006 Oct 1;63(19 Suppl 5):S17-21. doi: 10.2146/ajhp060379.
The implications of the findings from clinical studies and pharmacokinetic analyses of the antiviral agent valganciclovir for dosing of the drug to prevent cytomegalovirus (CMV) disease in solid organ transplant recipients are reviewed.
Valganciclovir, an oral prodrug of ganciclovir, is as effective as oral ganciclovir for preventing CMV disease, although prophylaxis with either agent may delay CMV disease. Dosage reduction is required for both drugs in patients with renal impairment to prevent high plasma ganciclovir concentrations and toxicity. A valganciclovir dosage of 900 mg/day is required in patients with normal renal function, especially those at high risk for CMV disease, to provide adequate systemic ganciclovir exposure. Some studies suggest that a lower dosage might suffice for patients at a low risk for CMV disease.
Valganciclovir dosing should be based on renal function to avoid toxicity.
综述抗巨细胞病毒（CMV）药物缬更昔洛韦的临床研究和药代动力学分析结果对实体器官移植受者预防CMV疾病给药的意义。
缬更昔洛韦是更昔洛韦的口服前体药物，在预防CMV疾病方面与口服更昔洛韦效果相同，尽管使用这两种药物进行预防都可能延迟CMV疾病。肾功能不全患者两种药物均需降低剂量，以防止血浆中更昔洛韦浓度过高和出现毒性。肾功能正常的患者，尤其是CMV疾病高危患者，需要900毫克/天的缬更昔洛韦剂量，以提供足够的全身更昔洛韦暴露量。一些研究表明，CMV疾病低风险患者使用较低剂量可能就足够了。
缬更昔洛韦的给药应基于肾功能，以避免毒性。
