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Cytomegalovirus (CMV)

Updated : September 17, 2022





Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

 

valganciclovir 

900

mg

Tablet

Orally 

every 12 hrs

21

days

After induction therapy or in people with inactive CMV retinitis, maintenance dosage is 900 mg orally per day.



letermovir 

Indicated for Cytomegalovirus infection prophylaxis The recommended dose is 480 mg PO/IV once a day, and treatment should begin within 28 days after transplantation, either before or after engraftment, and should continue until Day 100



cytomegalovirus immune globulin (CMV IG) 

Kidney Transplant
Administer intravenous infusion of 150 mg/kg within 72 hours after the transplant, after that 100 mg/kg at 2-, 4-, 6-, and 8 weeks post-transplantation, and then 50 mg/kg at 12 and 16 weeks post-transplantation
Liver, Pancreas, Heart, Lung Transplant
Administer intravenous infusion of 150 mg/kg within 72 hours after the transplant, after that 2-, 4-, 6-, and 8 weeks post-transplantation, and then 100 mg/kg at 12 and 16 weeks post-transplantation
CMV Pneumonia (Orphan)
For use in conjunction with ganciclovir sodium for the treatment of cytomegalovirus pneumonia in bone marrow transplant patients
Renal Impairment
Use carefully



maribavir 

Take dose of 400 mg orally two times a day with or without meal
Dosage Modifications
Coadministration with anticonvulsants
Raise the dose up to 800 mg, twice a day and if carbamazepine is also being taken
Phenobarbital or phenytoin administered concurrently: the dosage be increased to 1200 mg twice a day
Renal impairment
Mild-to-severe: No dose adjustment necessary
End-stage renal disease: No study performed
Hepatic impairment
Mild-to-moderate: No dosage adjustment necessary
Severe: No study performed



maribavir 

Take dose of 400 mg orally two times a day with or without meal
Dosage Modifications
Coadministration with anticonvulsants
Raise the dose up to 800 mg, twice a day and if carbamazepine is also being taken
Phenobarbital or phenytoin administered concurrently: the dosage be increased to 1200 mg twice a day
Renal impairment
Mild-to-severe: No dose adjustment necessary
End-stage renal disease: No study performed
Hepatic impairment
Mild-to-moderate: No dosage adjustment necessary
Severe: No study performed



 

maribavir 

Take dose of 400 mg orally twice a day with or without meal
Dosage Modifications
Coadministration with anticonvulsants
Raise the dose up to 800 mg, twice a day and if carbamazepine is also being taken
Phenobarbital or phenytoin administered concurrently: the dosage be increased to 1200 mg twice a day
Renal impairment
Mild-to-severe: No dose adjustment necessary
End-stage renal disease: No study performed
Hepatic impairment
Mild-to-moderate: No dose adjustment necessary
Severe: No study performed



 

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References

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Cytomegalovirus (CMV)

Updated : September 17, 2022




valganciclovir 

900

mg

Tablet

Orally 

every 12 hrs

21

days

After induction therapy or in people with inactive CMV retinitis, maintenance dosage is 900 mg orally per day.



letermovir 

Indicated for Cytomegalovirus infection prophylaxis The recommended dose is 480 mg PO/IV once a day, and treatment should begin within 28 days after transplantation, either before or after engraftment, and should continue until Day 100



cytomegalovirus immune globulin (CMV IG) 

Kidney Transplant
Administer intravenous infusion of 150 mg/kg within 72 hours after the transplant, after that 100 mg/kg at 2-, 4-, 6-, and 8 weeks post-transplantation, and then 50 mg/kg at 12 and 16 weeks post-transplantation
Liver, Pancreas, Heart, Lung Transplant
Administer intravenous infusion of 150 mg/kg within 72 hours after the transplant, after that 2-, 4-, 6-, and 8 weeks post-transplantation, and then 100 mg/kg at 12 and 16 weeks post-transplantation
CMV Pneumonia (Orphan)
For use in conjunction with ganciclovir sodium for the treatment of cytomegalovirus pneumonia in bone marrow transplant patients
Renal Impairment
Use carefully



maribavir 

Take dose of 400 mg orally two times a day with or without meal
Dosage Modifications
Coadministration with anticonvulsants
Raise the dose up to 800 mg, twice a day and if carbamazepine is also being taken
Phenobarbital or phenytoin administered concurrently: the dosage be increased to 1200 mg twice a day
Renal impairment
Mild-to-severe: No dose adjustment necessary
End-stage renal disease: No study performed
Hepatic impairment
Mild-to-moderate: No dosage adjustment necessary
Severe: No study performed



maribavir 

Take dose of 400 mg orally two times a day with or without meal
Dosage Modifications
Coadministration with anticonvulsants
Raise the dose up to 800 mg, twice a day and if carbamazepine is also being taken
Phenobarbital or phenytoin administered concurrently: the dosage be increased to 1200 mg twice a day
Renal impairment
Mild-to-severe: No dose adjustment necessary
End-stage renal disease: No study performed
Hepatic impairment
Mild-to-moderate: No dosage adjustment necessary
Severe: No study performed



maribavir 

Take dose of 400 mg orally twice a day with or without meal
Dosage Modifications
Coadministration with anticonvulsants
Raise the dose up to 800 mg, twice a day and if carbamazepine is also being taken
Phenobarbital or phenytoin administered concurrently: the dosage be increased to 1200 mg twice a day
Renal impairment
Mild-to-severe: No dose adjustment necessary
End-stage renal disease: No study performed
Hepatic impairment
Mild-to-moderate: No dose adjustment necessary
Severe: No study performed



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