Comparative Pharmacology
Head-to-head clinical analysis: VALGANCICLOVIR HYDROCHLORIDE versus ZOVIRAX.
Peer-Reviewed Evidence
Head-to-head clinical analysis: VALGANCICLOVIR HYDROCHLORIDE versus ZOVIRAX.
VALGANCICLOVIR HYDROCHLORIDE vs ZOVIRAX
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
After intracellular phosphorylation to acyclovir triphosphate, selectively inhibits viral DNA polymerase and incorporates into viral DNA, causing chain termination.
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.
Herpes simplex: 200 mg orally 5 times daily for 10 days; or 400 mg orally 3 times daily for 5-10 days. Herpes zoster: 800 mg orally 5 times daily for 7-10 days. IV: 5-10 mg/kg every 8 hours for immunocompromised patients with HSV/VZV.
None Documented
None Documented
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).
Terminal elimination half-life is 2.5-3.3 hours in adults with normal renal function; prolonged to 19.5 hours in anuria (creatinine clearance <10 mL/min).
Primarily renal excretion of unchanged drug (approximately 90%), with the remainder as ganciclovir. Biliary/fecal elimination accounts for <5%.
Renal excretion of unchanged drug via glomerular filtration and tubular secretion accounts for 76-82% of elimination; fecal excretion is less than 2%.
Category D/X
Category C
Antiviral
Antiviral