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Valcyte Side Effects Center

Medical Editor: John P. Cunha, DO, FACOEP

Valcyte (valganciclovir hydrochloride) treats cytomegalovirus (CMV) infection of the eye in patients with acquired immunodeficiency syndrome (AIDS). Valcyte also prevents CMV infection in patients who have received an organ transplant (kidney, heart, or kidney-pancreas). It is an antiviral drug. Common side effects include diarrhea, upset stomach, dizziness, drowsiness, unsteadiness, or shaking (tremors).

Dose of Valcyte varies depending on the infection being treated, the patient's medical condition, and other factors. Valcyte and ganciclovir (Cytovene) must never be taken together. Valcyte may interact with zidovudine, didanosine, mycophenolate, drugs that weaken your immune system (such as cancer medicine or steroids), or probenecid. Tell your doctor all prescription and over-the-counter medications you use. Women who are pregnant or who may become pregnant should not handle this medication. During pregnancy, Valcyte should be used only when prescribed. It may harm a fetus. Men and women should consult their doctors about use of birth control. It is unknown if this medication passes into breast milk. It may have undesirable effects on a nursing infant. Breast-feeding while using this drug is not recommended. If you have HIV, do not breast-feed because breast milk can transmit HIV.

Our Valcyte (valganciclovir hydrochloride) Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What is Patient Information in Detail?

Easy-to-read and understand detailed drug information and pill images for the patient or caregiver from Cerner Multum.

Valcyte in Detail - Patient Information: Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using valganciclovir and call your doctor at once if you have a serious side effect such as:

  • pale skin, feeling light-headed or short of breath, rapid heart rate, trouble concentrating;
  • fever, chills, body aches, flu symptoms, sores in your mouth and throat;
  • easy bruising, unusual bleeding (nose, mouth, vagina, or rectum), purple or red pinpoint spots under your skin;
  • urinating less than usual or not at all;
  • drowsiness, confusion, mood changes, increased thirst, loss of appetite, nausea and vomiting;
  • swelling, weight gain, feeling short of breath; or
  • seizure (convulsions).

Less serious side effects may include:

  • dizziness, loss of balance or coordination;
  • diarrhea, constipation;
  • tremor (shaking); or
  • cold symptoms such as stuffy nose, sneezing, sore throat, and cough.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Read the entire detailed patient monograph for Valcyte (Valganciclovir Hcl) »

What is Patient Information Overview?

A concise overview of the drug for the patient or caregiver from First DataBank.

Valcyte Overview - Patient Information: Side Effects

SIDE EFFECTS: See also Warning section.

Diarrhea, upset stomach, dizziness, drowsiness, unsteadiness, or shaking (tremors) may occur. If any of these effects persist or worsen, tell your doctor or pharmacist promptly.

Remember that your doctor has prescribed this medication because he or she has judged the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor immediately if any of these unlikely but serious side effects occur: mental/mood changes (such as confusion, hallucinations), change in the amount of urine, seizures.

A very serious allergic reaction to this drug is rare. However, seek immediate medical attention if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US -

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Read the entire patient information overview for Valcyte (Valganciclovir Hcl)»

What is Prescribing information?

The FDA package insert formatted in easy-to-find categories for health professionals and clinicians.

Valcyte FDA Prescribing Information: Side Effects
(Adverse Reactions)


The following serious adverse events are discussed in greater detail in other sections of the labeling:

The most common adverse events and laboratory abnormalities reported in at least one indication by ≥ 20% of adult patients treated with Valcyte tablets are diarrhea, pyrexia, nausea, tremor, neutropenia, anemia, graft rejection, thrombocytopenia, and vomiting. The most common reported adverse events and laboratory abnormalities reported in > 10% of pediatric solid organ transplant recipients treated with Valcyte for oral solution or tablets are diarrhea, pyrexia, hypertension, upper respiratory tract infection, vomiting, anemia, neutropenia, constipation, nausea, and cough.

Clinical Trial Experience in Adult Patients

Valganciclovir, a prodrug of ganciclovir, is rapidly converted to ganciclovir after oral administration. Adverse events known to be associated with ganciclovir usage can therefore be expected to occur with Valcyte.

Because clinical trials are conducted under widely varying conditions, adverse event rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect rates observed in practice.

Treatment of CMV Retinitis in AIDS Patients

In a clinical study for the treatment of CMV retinitis in HIV-infected patients, the adverse events reported by patients receiving Valcyte tablets (n=79) or intravenous ganciclovir (n=79) for 28 days of randomized therapy (21 days induction dose and 7 days maintenance dose), respectively, included diarrhea (16%, 10%), nausea (8%, 14%), headache (9%, 5%), and catheter-related infections (3%, 11%). The incidence of adverse events was similar between the group who received Valcyte tablets and the group who received intravenous ganciclovir, with the exception of catheter-related infections, which occurred with greater frequency in patients randomized to receive intravenous ganciclovir. The frequencies of neutropenia (ANC < 500/μL) were 11% for patients receiving Valcyte tablets compared with 13% for patients receiving intravenous ganciclovir. Anemia (Hgb < 8 g/dL) occurred in 8% of patients in each group. Other laboratory abnormalities occurred with similar frequencies in the two groups.

Adverse events and abnormal laboratory values data are available for 370 patients who received maintenance therapy with Valcyte tablets 900 mg once daily in two open-label clinical trials. Approximately 252 (68%) of these patients received Valcyte tablets for more than nine months (maximum duration was 36 months). Table 2 and Table 3 show the pooled adverse event data and abnormal laboratory values from these patients.

Table 2 : Pooled Selected Adverse Events Reported in ≥ 5% of Patients who Received Valcyte Tablets Maintenance Therapy for CMV Retinitis

Adverse Events According to Body System Patients with CMV Retinitis
Valcyte Tablets
Gastrointestinal system
  Diarrhea 41
  Nausea 30
  Vomiting 21
  Abdominal pain 15
Body as a whole
  Pyrexia 31
  Headache 22
Central and peripheral nervous system
  Insomnia 16
  Peripheral neuropathy 9
  Paresthesia 8
  Special senses Retinal detachment 15

Table 3 : Pooled Laboratory Abnormalities Reported in Patients Who Received Valcyte Tablets Maintenance Therapy for the Treatment of CMV Retinitis

Laboratory Abnormalities Patients with CMV Retinitis
Valcyte Tablets
Neutropenia: ANC/μL
   < 500 19
  500 - < 750 17
  750 - < 1000 17
Anemia: Hemoglobin g/dL
   < 6.5 7
  6.5 - < 8.0 13
  8.0 - < 9.5 16
Thrombocytopenia: Platelets/μL
   < 25000 4
  25000 - < 50000 6
  50000 - < 100000 22
Serum Creatinine: mg/dL
   > 2.5 3
   > 1.5 - 2.5 12

Prevention of CMV Disease in Selected Solid Organ Transplantation

Table 4 shows selected adverse events regardless of severity and drug relationship with an incidence of ≥ 5% from a clinical trial (up to 28 days after study treatment) where heart, kidney, kidney-pancreas and liver transplant patients received Valcyte tablets (N=244) or oral ganciclovir (N=126) until Day 100 post-transplant. The majority of the adverse events were of mild or moderate intensity.

Table 4 : Percentage of Selected Grades 1-4 Adverse Events Reported in ≥ 5% of Patients From a Study of Selected Solid Organ Transplant Patients

Adverse Event Valcyte Tablets
Oral Ganciclovir
Diarrhea 30 29
Tremors 28 25
Graft rejection 24 30
Nausea 23 23
Headache 22 27
Insomnia 20 16
Hypertension 18 15
Vomiting 16 14
Pyrexia 13 14

The overall safety profile of Valcyte did not change with the extension of prophylaxis until Day 200 post-transplant in high risk kidney transplant patients (see Table 5).

Table 5 : Percentage of Selected Grades 1-4 Adverse Events Reported in ≥ 5% of Patients from a Study of Kidney Transplant Patients

Adverse Event Valcyte Tablets Day 100 Post-transplant
Valcyte Tablets Day 200 Post-transplant
Diarrhea 26 31
Tremors 12 17
Hypertension 13 12
Nausea 11 11
Pyrexia 12 9
Transplant rejection 9 6
Headache 10 6
Insomnia 7 6
Vomiting 3 6

Adverse events not included in Table 4 and Table 5, which either occurred at a frequency of ≥ 5% in clinical studies with solid organ transplant patients, or were selected serious adverse events reported in studies with patients with CMV retinitis or in studies with solid organ transplant patients with a frequency of < 5% are listed below.

Allergic reactions: valganciclovir hypersensitivity

Bleeding complications: potentially life-threatening bleeding associated with thrombocytopenia

Central and peripheral nervous system: paresthesia, dizziness (excluding vertigo), convulsion

Gastrointestinal disorders: abdominal pain, constipation, dyspepsia, abdominal distention, ascites

General disorders and administration site disorders: fatigue, pain, edema, peripheral edema, weakness

Hemic system: anemia, neutropenia, thrombocytopenia, pancytopenia, bone marrow depression, aplastic anemia

Hepatobiliary disorders: abnormal hepatic function

Infections and infestations: pharyngitis/nasopharyngitis, upper respiratory tract infection, urinary tract infection, local and systemic infections and sepsis, postoperative wound infection

Injury, poisoning, and procedural complications: postoperative complications, postoperative pain, increased wound drainage, wound dehiscence

Metabolism and nutrition disorders: hyperkalemia, hypokalemia, hypomagnesemia, hyperglycemia, appetite decreased, dehydration, hypophosphatemia, hypocalcemia

Musculoskeletal and connective tissue disorders: back pain, arthralgia, muscle cramps, limb pain

Psychiatric disorders: depression, psychosis, hallucinations, confusion, agitation

Renal and urinary disorders: renal impairment, dysuria, decreased creatinine clearance

Respiratory, thoracic and mediastinal disorders: cough, dyspnea, rhinorrhea, pleural effusion

Skin and subcutaneous tissue disorders: dermatitis, pruritus, acne

Vascular disorders: hypotension

Laboratory abnormalities reported with Valcyte tablets in two studies in solid organ transplant patients are listed in Table 6 and Table 7.

Table 6 : Laboratory Abnormalities Reported in a Study of Selected Solid Organ Transplant Patients*

Laboratory Abnormalities Valcyte Tablets
Ganciclovir Capsules
Neutropenia: ANC/μL
   < 500 5 3
  500 - < 750 3 2
  750 - < 1000 5 2
Anemia: Hemoglobin g/dL
   < 6.5 1 2
  6.5 - < 8.0 5 7
  8.0 - < 9.5 31 25
Thrombocytopenia: Platelets/μL
   < 25000 0 2
  25000 - < 50000 1 3
  50000 - < 100000 18 21
Serum Creatinine: mg/dL
   > 2.5 14 21
   > 1.5 - 2.5 45 47
*Laboratory abnormalities are those reported by investigators.

Table 7 : Laboratory Abnormalities Reported in a Study of Kidney Transplant Patients*

Laboratory Abnormalities Valcyte Tablets Day 100 Post-transplant
Valcyte Tablets Day 200 Post-transplant
Neutropenia: ANC/μL
   < 500 9 10
  500 - < 750 6 6
  750 - < 1000 7 5
Anemia: Hemoglobin g/dL
   < 6.5 0 1
  6.5 - < 8.0 5 1
  8.0 - < 9.5 17 15
Thromb ocytop enia: Platelets/μL
   < 25000 0 0
  25000 - < 50000 1 0
  50000 - < 100000 7 3
Serum Creatinine: mg/dL
   > 2.5 17 14
   > 1.5 - 2.5 50 48
*Laboratory abnormalities are those reported by investigators.

Clinical Trial Experience in Pediatric Patients

Valcyte for oral solution and tablets have been studied in 109 pediatric solid organ transplant patients who were at risk for developing CMV disease (aged 4 months to 16 years) and in 24 neonates with symptomatic congenital CMV disease (aged 8 to 34 days), with duration of ganciclovir exposure ranging from 2 to 100 days. The overall safety profile was similar in pediatric patients as compared to adult patients. However, the rates of certain adverse events and laboratory abnormalities, such as upper respiratory tract infection, pyrexia, nasopharyngitis, anemia, and neutropenia, were reported more frequently in pediatric patients than in adults [see Use in Specific Populations, Clinical Studies].

Postmarketing Experience

In general, the adverse events reported during the postmarketing use of Valcyte were similar to those identified during the clinical trials and to those reported during the postmarketing use of ganciclovir. Please also refer to the intravenous ganciclovir product information and ganciclovir capsule product information for more information on postmarketing adverse events associated with ganciclovir.

Read the entire FDA prescribing information for Valcyte (Valganciclovir Hcl) »


Valcyte - User Reviews

Valcyte User Reviews

Now you can gain knowledge and insight about a drug treatment with Patient Discussions.

Here is a collection of user reviews for the medication Valcyte sorted by most helpful. Patient Discussions FAQs

Report Problems to the Food and Drug Administration


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