Comparative Pharmacology
Head-to-head clinical analysis: HEPSERA versus VALGANCICLOVIR HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: HEPSERA versus VALGANCICLOVIR HYDROCHLORIDE.
HEPSERA vs VALGANCICLOVIR HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Acyclic nucleotide analog of adenosine monophosphate; inhibits hepatitis B virus (HBV) DNA polymerase by competing with the natural substrate dATP, causing DNA chain termination after incorporation into viral DNA.
Valganciclovir is an L-valyl ester prodrug of ganciclovir. After oral administration, it is rapidly hydrolyzed to ganciclovir, which is a synthetic guanosine analog. Ganciclovir is phosphorylated to ganciclovir triphosphate, which competitively inhibits viral DNA polymerase and incorporates into viral DNA, causing termination of viral DNA elongation.
10 mg orally once daily.
Oral: 900 mg twice daily for cytomegalovirus (CMV) retinitis induction in immunocompromised patients; for prevention in transplant recipients: 900 mg once daily starting within 10 days of transplant.
None Documented
None Documented
Terminal elimination half-life is approximately 6-9 hours in patients with normal renal function. In renal impairment, half-life is prolonged (up to 18 hours in moderate impairment, >30 hours in severe impairment). Steady-state is achieved within 5-7 days.
Terminal elimination half-life of ganciclovir after valganciclovir administration is approximately 4-5 hours in patients with normal renal function. In renal impairment, half-life is significantly prolonged, up to 30-40 hours in severe impairment (CrCl <10 mL/min).
Primarily renal; 70-90% of an oral dose is excreted unchanged in urine via active tubular secretion and glomerular filtration. Biliary/fecal elimination accounts for <5%.
Primarily renal excretion of unchanged drug (approximately 90%), with the remainder as ganciclovir. Biliary/fecal elimination accounts for <5%.
Category C
Category D/X
Antiviral
Antiviral