[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [Anti-herpesvirus agents](https://durgical.com/en/pharmacology/classes/anti-herpesvirus-agents/) › Valganciclovir

[Pharmacology](https://durgical.com/en/pharmacology/) · [Anti-herpesvirus agents](https://durgical.com/en/pharmacology/classes/anti-herpesvirus-agents/)

# Valganciclovir

The oral prodrug of ganciclovir. It prevents and treats cytomegalovirus (CMV) disease and can lower all blood cell counts.

Updated 2026-11-01

- Class: [Anti-herpesvirus agents](https://durgical.com/en/pharmacology/classes/anti-herpesvirus-agents/)
- Enzyme: CMV DNA polymerase (through ganciclovir, activated by UL97)
- ATC code: J05AB14
- WHO Model List of Essential Medicines

✂**CMV DNA polymerase (through ganciclovir, activated by UL97)**Valganciclovir

ⓘ The figure shows ganciclovir, the active form of valganciclovir, in herpes simplex virus 1 thymidine kinase; in CMV the activating kinase is UL97.

**Target in 3D:** CMV DNA polymerase (through ganciclovir, activated by UL97). PDB structure 1KI2 (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/1KI2) · Drag to rotate · pinch to zoom

## Mechanism of action

Valganciclovir is the L-valyl ester of ganciclovir. It is well absorbed and rapidly converted into ganciclovir, which is then phosphorylated by the CMV kinase UL97 and cellular kinases. Ganciclovir triphosphate inhibits the viral DNA polymerase and stops viral DNA synthesis.

- Absorbed and converted to ganciclovir
- CMV kinase UL97 adds the first phosphate
- Ganciclovir triphosphate inhibits the viral DNA polymerase
- CMV replication slows

## Pharmacokinetics

**Absorption**
Well absorbed by mouth, better with food; it replaces intravenous ganciclovir in many patients

**Metabolism**
Rapidly hydrolysed to ganciclovir

**Elimination**
As ganciclovir, by the kidneys

## Indications

- CMV retinitis in people with AIDS [Cytomegalovirus infection →](https://durgical.com/en/conditions/cytomegalovirus-infection/)
- Prevention of CMV disease after heart, kidney or kidney-pancreas transplantation in patients at risk [Cytomegalovirus infection →](https://durgical.com/en/conditions/cytomegalovirus-infection/)

## Adverse effects

### Common

- Diarrhoea, nausea, vomiting and abdominal pain
- Headache
- Muscle or joint pain
- Mouth ulcers

### Serious (rare, important)

- Severe leukopenia, neutropenia, anaemia and thrombocytopenia
- Reduced kidney function
- Tremor and seizures
- Fetal harm and reduced fertility; carcinogenic in animals

## Contraindications

- Hypersensitivity to valganciclovir or ganciclovir

## Key interactions

**Mycophenolate, zidovudine and other myelosuppressive drugs**
Additive bone marrow suppression

**Nephrotoxic drugs**
Higher risk of kidney injury and higher ganciclovir levels

## What is monitored

- Complete blood count and platelets regularly
- Serum creatinine
- Regular eye examinations in CMV retinitis

## Administration and safety

- Oral, with food
- Tablets are swallowed whole: never split, crushed or chewed
- Broken tablets must not touch skin, eyes or mucous membranes; wash with soap and water if they do
- Look-alike/sound-alike risk with valaciclovir, a much less toxic drug

## Nursing care

- Check the blood count before starting and as ordered
- Teach to report fever, sore throat, bleeding or unusual tiredness
- Handle tablets without crushing them
- Teach contraception: women during and for 30 days after; men, condoms during and for 90 days after
- Advise against breastfeeding during treatment

## Pregnancy and breastfeeding

Avoided in pregnancy because of the risk of fetal harm; a pregnancy test is done before starting.

## Memory aid

VALganciclovir ≠ VALaciclovir: one «g» more means CMV and blood counts.

## Test yourself

Think of the answer, then tap the question to see it.

## What is valganciclovir converted into?

Ganciclovir.

## Why must valganciclovir tablets not be crushed?

Ganciclovir is considered potentially carcinogenic and teratogenic; broken tablets must not contact skin or mucosa.

## Which transplant patients receive valganciclovir to prevent CMV disease?

Heart, kidney and kidney-pancreas recipients at risk of CMV.

[Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/valganciclovir/)

## Related drugs

- [Ganciclovir](https://durgical.com/en/pharmacology/ganciclovir/)
- [Valaciclovir](https://durgical.com/en/pharmacology/valaciclovir/)

## Related conditions

- [Cytomegalovirus infection](https://durgical.com/en/conditions/cytomegalovirus-infection/)

[← Back to the class: Anti-herpesvirus agents](https://durgical.com/en/pharmacology/classes/anti-herpesvirus-agents/)

Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given.

Sources: [Valganciclovir: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a605021.html) (MedlinePlus (U.S. National Library of Medicine), 2026); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=J05AB14) (WHO Collaborating Centre for Drug Statistics Methodology, 2026); [eEML - Electronic Essential Medicines List](https://list.essentialmeds.org/) (World Health Organization, 2025); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 62 (McGraw Hill, 2023).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/pharmacology/valganciclovir/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/valganciclovir/