Table 6.

Valganciclovir drug interactions²²

Valganciclovir interactions with	Drug interactions	Comments
Zidovudine	Myelosuppression	This calls for reduction in valganciclovir dosage or substitution with a different antiretroviral drug.
Didanosine	Paradoxical decline in the CD4 cell counts, despite persistent suppression of viral load	The probable explanation is the inhibition of purine nucleoside phosphorylase by ganciclovir and its prodrug valganciclovir.
Mycophenolate mofetil22	Myelosuppression	Granulocytopenia reversed with granulocyte-colony stimulating factor
Probenecid22	Reduces renal clearance and increases plasma concentration	Close monitoring advised
Imipenem/cilastatin	Induces convulsions	No human studies done
Stavudine/zalcitabine/trimethoprim22	No untoward effects reported
Nephrotoxic drugs such as aminoglycosides, cisplatin, tacrolimus and amphotericin B12	Increased nephrotoxicity	Avoidance or cautious administration is advised