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Является пролекарством ганцикловира. После приема внутрь быстро трансформируется в ганцикловир при участии эстераз кишечника и печени.\n\nГанцикловир является синтетическим аналогом гуанина. Внутри клетки ганцикловир последовательно метаболизируется в форму монофосфата при участии клеточной деоксигуанозинкиназы, затем в активный ганцикловир трифосфат. Действуя как субстрат и встраиваясь в ДНК, ганцикловир трифосфат конкурентно ингибирует синтез вирусной ДНК. Это приводит к подавлению синтеза ДНК за счет ингибирования элонгации цепи ДНК. Ганцикловир подавляет вирусную ДНК-полимеразу активнее, чем клеточную полимеразу.\n\nК валганцикловиру чувствительны цитомегаловирус человека, Herpes simplex типов 1 и 2, Varicella zoster, вирус Эпштейна-Барр и вирус гепатита B.\n\n##### ФАРМАКОКИНЕТИКА\n\nПосле приема внутрь быстро абсорбируется из ЖКТ, в стенке кишечника и в печени превращается в ганцикловир. Абсолютная биодоступность ганцикловира после его превращения из валганцикловира составляет приблизительно 60%. Связывание ганцикловира с белками плазмы составляет 1-2%.\n\nВыводится главным образом почками.\n\nПосле приема валганцикловира конечный T1/2 ганцикловира составляет около 4.2 ч.\n\n##### ПОКАЗАНИЯ К ПРИМЕНЕНИЮ\n\nЛечение цитомегаловирусного ретинита при СПИД.\n\nПрофилактика ЦМВ-инфекции после трансплантации органов у пациентов из группы риска.\n\n##### ПРОТИВОПОКАЗАНИЯ\n\nАбсолютное число нейтрофилов <500/мкл, число тромбоцитов <25000/мкл; уровень гемоглобина <80 г/л; КК<10 мл/мин; беременность, период грудного вскармливания; детский возраст до 12 лет; повышенная чувствительность к валганцикловиру, ганцикловиру. \n\nС _осторожностью_\n\nПочечная недостаточность, пациенты пожилого возраста (безопасность и эффективность не установлены).\n\nИз-за сходного химического строения валганцикловира, ацикловира и валацикловира возможны реакции перекрестной чувствительности к этим веществам.\n\n##### ПРИМЕНЕНИЕ ПРИ БЕРЕМЕННОСТИ И КОРМЛЕНИИ ГРУДЬЮ\n\nПротивопоказано применение при беременности и в период грудного вскармливания.\n\n##### ПРИМЕНЕНИЕ ДЕТЬМИ\n\nПротивопоказано применение у детей в возрасте до 12 лет. \n\n##### ПРИМЕНЕНИЯ ПРИ ХРОНИЧЕСКИХ ЗАБОЛЕВАНИЯХ\n\nПациентам с нарушениями функции почек, больным, находящимся на гемодиализе требуется коррекция режима дозирования. \n\nС осторожностью применять у пациентов пожилого возраста. \n\n##### СПОСОБ ПРИМЕНЕНИЯ И ДОЗЫ\n\nВнутрь по 450 мг 1-2 раза/сут в соответствии со схемой лечения.\n\nПациентам с нарушениями функции почек, больным, находящимся на гемодиализе, а также при угнетении костномозгового кроветворения требуется коррекция режима дозирования.\n\n##### ПОБОЧНОЕ ДЕЙСТВИЕ\n\n _Со стороны пищеварительной системы:_ диарея, тошнота, рвота, боли в животе, запор, боли в верхних отделах живота, диспепсия, вздутие живота, асцит, нарушение функции печени.\n\n_Со стороны системы кроветворения:_ нейтропения, анемия, тромбоцитопения, лейкопения; панцитопения, угнетение функции костного мозга, апластическая анемия; потенциально угрожающие жизни кровотечения, связанные с развитием тромбоцитопении.\n\n_Инфекционные осложнения:_ кандидоз слизистой оболочки полости рта, фарингит/назофарингит, синусит, инфекции верхних дыхательных путей, грипп, пневмония, бронхит, пневмоцистная пневмония, инфекции мочевыводящих путей.\n\n_Со стороны нервной системы:_ головная боль, бессонница, периферическая невропатия, парестезии, тремор, головокружение (кроме вертиго), депрессия, судороги, психотические расстройства, галлюцинации, спутанность сознания, ажитация.\n\n_Со стороны кожи и подкожно-жировой клетчатки:_ дерматит, ночная потливость, зуд, угри.\n\n_Со стороны дыхательной системы:_ кашель, одышка, продуктивный кашель, выделения из носа, плевральный выпот.\n\n_Со стороны органов чувств:_ отслойка сетчатки, нечеткое зрение.\n\n_Со стороны костно-мышечной системы:_ боли в спине, артралгия, судороги в мышцах, боли в конечностях.\n\n_Со стороны мочевыделительной системы:_ почечная недостаточность, дизурия, снижение КК.\n\nС _о стороны иммунной системы:_ реакция отторжения трансплантата.\n\n_Со стороны обмена веществ:_ анорексия, кахексия, снижение аппетита, дегидратация, снижение массы тела.\n\n_Со стороны сердечно-сосудистой системы:_ артериальная гипотензия, артериальная гипертензия.\n\n_Со стороны лабораторных показателей:_ гиперкалиемия, гипокалиемия, гипомагниемия, гипергликемия, гипофосфатемия, гипокальциемия, гиперкреатининемия.\n\n_Послеоперационные осложнения:_ послеоперационные осложнения, боли в послеоперационном периоде, инфицирование послеоперационной раны, увеличение частоты необходимости дренирования, плохое заживление послеоперационной раны\n\n _Со стороны организма в целом:_ лихорадка, утомляемость, отеки нижних конечностей, боли, отеки, периферические отеки, слабость, реакции гиперчувствительности к валганцикловиру.\n\n##### ВЗАИМОДЕЙСТВИЕ С ДРУГИМИ ЛЕКАРСТВЕННЫМИ ПРЕПАРАТАМИ И ДРУГИЕ ВИДЫ ВЗАИМОДЕЙСТВИЯ\n\nВалганцикловир преобразуется в ганцикловир, поэтому взаимодействия, характерные для ганцикловира, могут ожидаться и при применении валганцикловира.\n\nПрименение валганцикловира одновременно с другими препаратами, оказывающими миелосупрессивный или нефротоксический эффект, может усиливать их токсическое действие.\n\n##### ОСОБЫЕ УКАЗАНИЯ\n\nИз-за сходного химического строения валганцикловира и ацикловира, валацикловира возможны реакции перекрестной чувствительности к этим препаратам. \n\nС осторожностью применять у пациентов пожилого возраста (безопасность и эффективность препарата не установлены).\n\nВ экспериментальных исследованиях на животных было выявлено мутагенное, тератогенное, асперматогенное и канцерогенное действие ганцикловира. Валганцикловир следует считать потенциальным тератогеном и канцерогеном для человека, применение которого может вызывать врожденные пороки развития и рак. Кроме того, вероятно, что валганцикловир может временно или необратимо подавлять сперматогенез.\n\nЛечение не следует начинать, если абсолютное число нейтрофилов меньше 500 клеток/мкл или число тромбоцитов меньше 25 000 клеток/мкл, а также если гемоглобин ниже 80 г/л. \n\nВ ходе лечения рекомендуется регулярно проводить контроль развернутой формулы крови и тромбоцитов. Пациентам с тяжелой лейкопенией, нейтропенией, анемией и/или тромбоцитопенией рекомендуется назначать гемопоэтические факторы роста и/или прерывать применение валганцикловира.\n\nСледует избегать одновременного применения валганцикловира и имипенема/циластатина в случаях, если потенциальные преимущества лечения не превышают возможный риск. \n\nПоскольку как зидовудин, так и ганцикловир могут вызывать нейтропению и анемию, у некоторых пациентов может отмечаться непереносимость при одновременном приеме валганцикловира и зидовудина в полных дозах. \n\nВ связи с возможным повышением плазменных концентраций диданозина в присутствии ганцикловира, следует тщательно контролировать состояние пациентов на предмет возникновения симптомов токсического действия диданозина. \n\n_Влияние на способность к управлению транспортными средствами и механизмами_\n\nПри лечении валганцикловиром и/или ганцикловиром возможно возникновение судорог, седативного эффекта, головокружения, атаксии и/или спутанности сознания, что может отрицательно повлиять на деятельность, требующую повышенной концентрации внимания, включая вождение автотранспорта и работу с машинами и механизмами. \n\n##### СРОК ГОДНОСТИ\n\n3 года\n\n##### УСЛОВИЯ ХРАНЕНИЯ\n\nПри температуре не выше 25 град.\n\n##### УСЛОВИЯ ОТПУСКА\n\nПо рецепту\n\n##### ПРОТИВОПОКАЗАНИЯ\n\nАбсолютное число нейтрофилов <500/мкл, число тромбоцитов <25000/мкл; уровень гемоглобина <80 г/л; КК<10 мл/мин; беременность, период грудного вскармливания; детский возраст до 12 лет; повышенная чувствительность к валганцикловиру, ганцикловиру. \n\nС _осторожностью_\n\nПочечная недостаточность, пациенты пожилого возраста (безопасность и эффективность не установлены).\n\nИз-за сходного химического строения валганцикловира, ацикловира и валацикловира возможны реакции перекрестной чувствительности к этим веществам.","overSized","imageComparisonOptions",[],"reviewsCounters",{},"redemptionStats",[],"saleEndsDateIso","cashback","showMultipleFractionsCounter","promoTitle","promoDescription","promoLegalDescription","lowestRecentPrice","productDisclaimers",[1102],{"_1103":1104,"_274":1105},"details","Цена действительна только при заказе онлайн. 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ВАЛГАНЦИКЛОВИР-ТЕВА ТАБ П/П/О 450МГ №60

ФАРМАКО-ТЕРАПЕВТИЧЕСКАЯ ГРУППА