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Clinical context remains essential
Independent clinical review is pending. Confirm indication, exact formulation/route, population, renal measure and units, kidney-function stability, dialysis prescription, interacting drugs, monitoring and source revision. An RX mirror and its original label are not independent corroboration. Missing disagreement notes do not certify agreement.
Adult 450 mg tablet source. No pediatric solution or institutional HD regimen is inferred.
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Jarrell et al.: valganciclovir prophylaxis during CVVHD (primary abstract)
Product / population
Single-center prospective pharmacokinetic study of ten adult solid-organ transplant recipients in ICU on CVVHD; abstract only.
Renal method
Continuous veno-venous hemodialysis; not intermittent dialysis.
Source revision
Clinical Infectious Diseases, 2021; published online 2020. PMID 32379860.
Retrieved
2026-09-07
Local review status
Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.
Documented differences and cautions on this drug
All record notes are retained here, including notes about sources not selected in this review.
Adult tablet label versus UCSF intermittent-HD practice
The VALCYTE label provides no adult tablet dose for hemodialysis and says those tablets should not be used. UCSF lists institutional oral treatment and prophylaxis schedules in intermittent HD. This is a real label-versus-institution difference, not two independently agreeing labels.
What to reconcile: Confirm CMV indication, transplant context, formulation, dialysis schedule, cytopenias and infectious-disease input. The institutional regimen is not labeled approval; IV ganciclovir is preferred by UCSF for initiation in unstable renal function or dialysis.
Continuous-HD prophylaxis: institutional interval versus small PK study
UCSF lists prophylaxis every 48 hours during continuous HD. The Jarrell primary abstract studied daily enteral dosing in ten ICU transplant recipients on CVVHD and found that most reached a proposed trough target. These sources differ, but the study is not a comparative clinical-outcomes trial.
What to reconcile: Reconcile the actual dialysis modality and clearance, absorption, CMV risk, counts and monitoring. Full-text flow-rate details were not reviewed; no universal CRRT dose is derived or automatically preferred.
Jarrell et al. / primary study indexed by PubMed · Single-center prospective pharmacokinetic study of ten adult solid-organ transplant recipients in ICU on CVVHD; abstract only.
Pharmacokinetic observation only. A drug-exposure observation is not itself a dose recommendation.
Selected source text imported locally; independent clinical review pending. Not a complete prescribing monograph.
Renal dosing, restrictions and evidence limits
Participants received 450 mg enterally every 24 hours for prophylaxis. Eight of ten achieved the proposed ganciclovir trough target of at least 0.60 microgram/mL; no neutropenia was documented, while significant thrombocytopenia occurred in six. The authors suggest daily dosing may be needed to achieve the desired exposure. This small pharmacokinetic study did not establish comparative clinical efficacy, universal safety or a prescription for every CRRT setting. Its daily schedule differs from UCSF's displayed continuous-HD prophylaxis interval; reconcile modality, clearance and monitoring with specialists.
RDM40-professional-valganciclovir-22f9e63629-C1 · Source locator: Primary-publication abstract: Methods, Results and Conclusions
Source-specific limits
Full text not re-reviewed; no exact dialysate or effluent-rate assumptions are invented.
This reference does not select a regimen. Complete the indication, measured/estimated renal function and trend, dialysis setting, source rationale, monitoring and reassessment plan in your institution's approved documentation system. Confirm the complete current source before adopting its regimen.
GlobalRPh v6.6 | RDM66-DIRECT-PHP-20260911 | Local library date 2026-09-11. Selected-card identity does not imply clinical verification.