Livtencity

Cytomegalovirus (CMV) infection &/or disease that are refractory (w/ or w/o resistance) to ≥1 prior therapies, including ganciclovir, valganciclovir, cidofovir or foscarnet in adult patients who have undergone haematopoietic stem cell transplant (HSCT) or solid organ transplant (SOT).

400 mg bd resulting in a daily dose of 800 mg for 8 wk. Treatment duration may need to be individualised based on each patient's clinical characteristics.

May be taken with or without food: Can be taken as whole tab, crushed tab, or crushed tab through nasogastric or orogastric tube.

Hypersensitivity. Co-administration w/ ganciclovir or valganciclovir.

Virologic failure can occur during & after treatment. Monitor CMV DNA levels & investigate resistance mutations in patients who do not respond to treatment. Discontinue treatment if maribavir resistance mutations are detected. Not expected to be effective in treating CMV CNS infections. Risk of adverse reactions or reduced therapeutic effect due to medicinal product interactions. Co-administration is not recommended w/ strong CYP3A inducers rifampicin, rifabutin or St. John's wort. Increase dose to 1,200 mg bd if co-administration w/ other strong or moderate CYP3A inducers (eg, carbamazepine, efavirenz, phenobarb & phenytoin) cannot be avoided. Caution w/ concomitant use of immunosuppressants that are CYP3A/P-gp substrates w/ narrow therapeutic margins. Administration has not been studied in patients w/ ESRD, including patients on dialysis; patients w/ severe hepatic impairment (Child-Pugh class C). Not recommended during pregnancy & in women of childbearing potential not using contraception. Discontinue breast-feeding during treatment. Safety & efficacy in patients <18 yr have not been established.

Taste disturbance; diarrhoea, nausea, vomiting; fatigue. Headache; upper abdominal pain; decreased appetite; increased immunosuppressant drug level, decreased wt.

Increased plasma conc w/ CYP3A inhibitors. Decreased plasma conc w/ strong or moderate CYP3A inducers. Antagonised antiviral effect of ganciclovir & valganciclovir. Risk for lack of efficacy of sensitive CYP1A2 substrates w/ narrow therapeutic window (eg, tizanidine & theophylline). Increased plasma conc of CYP3A/P-gp substrates w/ narrow therapeutic margins (including tacrolimus, cyclosporine, sirolimus & everolimus); sensitive P-gp substrates (eg, digoxin, dabigatran); OAT3 substrates (eg, ciprofloxacin, imipenem, cilastatin). Increased exposure of sensitive BCRP substrates (eg, rosuvastatin).

Antivirals

J05AX10 - maribavir ; Belongs to the class of other antivirals. Used as a direct acting antiviral in the systemic treatment of viral infections.

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