Secondary prophylaxis in adults

Choice of antiviral therapy for secondary prophylaxis after an episode of active CMV disease is based on factors including CMV resistance, response to treatment and drug contraindications.

When secondary prophylaxis is indicated (see c_abg16-c21-s3.html#abg16-c21-s3__tabg16-c21-tbl2), use:

1 valganciclovir 900 mg orally, daily. For dosage adjustment in adults with kidney impairment, see valganciclovir prophylaxis dosage adjustment cytomegalovirus disease, secondary prophylaxis (adult) valganciclovir

OR

2 ganciclovir 5 mg/kg intravenously, daily. Switch to oral valganciclovir (see dosage above) when possible. For dosage adjustment in adults with kidney impairment, see ganciclovir prophylaxis dosage adjustment ¹ cytomegalovirus disease, secondary prophylaxis (adult) ganciclovir

OR

3 foscarnet 90 to 120 mg/kg intravenously, daily. For dosage adjustment in adults with kidney impairment, see foscarnet dosage adjustment cytomegalovirus disease, secondary prophylaxis (adult) foscarnet

OR

4 cidofovir 5 mg/kg intravenously, every 2 weeks; administer with probenecid (see cidofovir product information for dosage of probenecid)². For dosage adjustment in adults with kidney impairment, see cidofovir dosage adjustment. cytomegalovirus disease, secondary prophylaxis (adult) cidofovir

For information about duration of therapy, see c_abg16-c21-s3.html#abg16-c21-s3__tabg16-c21-tbl2.

¹ Ganciclovir regimens in local guidelines vary; some centres reduce the frequency of administration (eg to 5 days a week, or use a higher dose 3 times a week)—seek expert advice or refer to local protocols and guidelines.Return

² Cidofovir does not penetrate the CNS and should not be used to treat CMV encephalitis.Return