Comparative Pharmacology
Head-to-head clinical analysis: LETERMOVIR versus VALGANCICLOVIR HYDROCHLORIDE.
Peer-Reviewed Evidence
Head-to-head clinical analysis: LETERMOVIR versus VALGANCICLOVIR HYDROCHLORIDE.
LETERMOVIR vs VALGANCICLOVIR HYDROCHLORIDE
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Letermovir is an antiviral agent that inhibits the human cytomegalovirus (CMV) terminase complex, specifically the pUL56 subunit, thereby preventing viral DNA processing and packaging.
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.
480 mg orally once daily (two 240 mg tablets).
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
Clinical Note
moderateLetermovir + Teriflunomide
"The serum concentration of Teriflunomide can be increased when it is combined with Letermovir."
Clinical Note
moderateLetermovir + Haloperidol
"The metabolism of Haloperidol can be decreased when combined with Letermovir."
Clinical Note
moderateLetermovir + Clotrimazole
"The metabolism of Clotrimazole can be decreased when combined with Letermovir."
Clinical Note
moderateLetermovir + Dronedarone
The terminal elimination half-life is approximately 12 hours (range 10–18 hours) in healthy subjects, allowing once-daily dosing.
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).
Letermovir is primarily eliminated via biliary/fecal excretion (approximately 93% of the dose recovered in feces, with <2% as unchanged drug) and renal excretion accounts for <7% (mostly as metabolites, <1% unchanged).
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
"The metabolism of Dronedarone can be decreased when combined with Letermovir."