万赛维用法用量

For oral administration, it should be taken with food. Vansavir can be rapidly and massively converted into ganciclovir. The bioavailability of Vancevir tablets as measured by ganciclovir is 10 times higher than that of ganciclovir capsules, so the Vancevir dosage and usage instructions described below should be strictly adhered to.

Induction therapy of CMV retinitis: For patients with active CMV retinitis, the recommended dose is 900 mg (two 450 mg tablets) twice daily for 21 days. Prolonged induction therapy may increase the risk of bone marrow toxicity.

Maintenance treatment of CMV retinitis: After induction therapy, or in patients with inactive CMV retinitis, the recommended dose is 900 mg (two 450 mg tablets) once daily. Induction therapy may be repeated in patients with worsening retinitis.

Prophylaxis of CMV Infection in Transplant Patients: For patients who have received a solid organ transplant, the recommended dose is 900 mg (two 450 mg tablets) once daily, starting within 10 days after transplantation and continuing until 100 days after transplantation.

Specific Dosage Guidelines

Patients with renal insufficiency: Serum creatinine or creatinine clearance levels should be monitored closely. Dosage adjustments should be made based on creatinine clearance as shown below.

For CrCl ≥ (greater than or equal to) 60 mL/min, the induction dose is 900 mg, twice a day; the maintenance dose is 900 mg, once a day.

If the CrCl is 40-59 mL/min, the induction dose is 450 mg, twice a day; the maintenance dose is 450 mg, once a day.

If the CrCl is 25-39 mL/min, the induction dose is 900 mg, once a day; the maintenance dose is 900 mg, once every other day.

If the CrCl is 10-24 mL/min, the induction dose is 900 mg, once every other day; the maintenance dose is 900 mg, twice a week.

The creatinine clearance rate can be estimated based on serum creatinine according to the following formula:

Male = [140-age (years) x weight (kg) ÷ (72) x [0.011 x serum creatinine (umol/L)].

Female = 0.85 × male value.

Patients undergoing hemodialysis: For patients undergoing hemodialysis (CrCl<10 mL/min), no recommended dosage can be given, so valganciclovir hydrochloride tablets cannot be used for such patients.

Patients with severe leukopenia, neutropenia, anemia, thrombocytopenia and pancytopenia: Patients treated with valganciclovir hydrochloride tablets (or cyclovir) have cases of severe leukopenia, neutropenia, anemia, thrombocytopenia, pancytopenia, bone marrow suppression and aplastic anemia. Do not initiate treatment with Valganciclovir Hydrochloride Tablets if the absolute neutrophil count is less than 500/uL, the platelet count is less than 25,000/uL, or the hemoglobin is less than 8 g/dl.

Medication for pregnant and lactating women: 1. Since valganciclovir is rapidly converted into ganciclovir in large quantities, studies on its reproductive toxicity have not been repeated. In animal experiments, ganciclovir caused reduced fertility and teratogenic effects. It is recommended that women of childbearing potential use effective contraceptive measures during treatment. Male patients are advised to use barrier contraception during treatment with valganciclovir hydrochloride tablets and for at least 90 days after discontinuation of treatment. 2. There are no safety data of valganciclovir hydrochloride tablets during human pregnancy. Pregnant women should avoid using valganciclovir hydrochloride tablets unless the benefits to the mother far outweigh the potential harm to the fetus. 3. The effects of valganciclovir or cyclovir on the perinatal and postpartum period have not been studied, but it must be considered that ganciclovir may be secreted into breast milk and cause serious adverse reactions in infants. Therefore, the decision to discontinue medication or discontinue breastfeeding should be made taking into account possible benefits to the nursing mother.