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Valcyte Patient, Information, Instructions - valganciclovir INFORMATION FOR PATIENTS
Valcyte tablets cannot be substituted for ganciclovir capsules on a one-to-one basis. Patients switching from ganciclovir capsules should be advised of the risk of overdosage if they take more than the prescribed number of Valcyte tablets (see OVERDOSAGE and DOSAGE AND ADMINISTRATION ).
Valcyte is changed to ganciclovir once it is absorbed into the body. All patients should be informed that the major toxicities of ganciclovir include granulocytopenia (neutropenia), anemia and thrombocytopenia and that dose modifications may be required, including discontinuation. The importance of close monitoring of blood counts while on therapy should be emphasized. Patients should be informed that ganciclovir has been associated with elevations in serum creatinine.
Patients should be instructed to take Valcyte tablets with food to maximize bioavailability.
Patients should be advised that ganciclovir has caused decreased sperm production in animals and may cause decreased fertility in humans. Women of childbearing potential should be advised that ganciclovir causes birth defects in animals and should not be used during pregnancy. Because of the potential for serious adverse events in nursing infants, mothers should be instructed not to breastfeed if they are receiving Valcyte tablets. Women of childbearing potential should be advised to use effective contraception during treatment with Valcyte tablets. Similarly, men should be advised to practice barrier contraception during and for at least 90 days following treatment with Valcyte tablets.
Although there is no information from human studies, patients should be advised that ganciclovir should be considered a potential carcinogen.
Convulsions, sedation, dizziness, ataxia and/or confusion have been reported with the use of Valcyte tablets and/or ganciclovir. If they occur, such effects may affect tasks requiring alertness including the patient's ability to drive and operate machinery.
Patients should be told that ganciclovir is not a cure for CMV retinitis, and that they may continue to experience progression of retinitis during or following treatment. Patients should be advised to have ophthalmologic follow-up examinations at a minimum of every 4 to 6 weeks while being treated with Valcyte tablets. Some patients will require more frequent follow-up.
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