Pharm

Maribavir

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Maribavir, Livtencity

  • See Also
  1. Letermovir
  2. Ganciclovir
  3. Cidofovir
  4. Foscarnet
  5. Valganciclovir
  6. Cytomegalovirus
  • Indications
  1. Resistant Cytomegalovirus Infection in Adults (and age >=12 years, weight >=35 kg)
    1. Post-Solid Organ Transplant
    2. Post Hematopoietic Stem Cell Transplant cancer patients
  • Dosing
  • Adult (and age >=12 years, weight >=35 kg)
  1. Take 400 mg orally twice daily
  • Mechanism
  1. Benzimidazole riboside with activity against Cytomegalovirus
  2. Selective ATP competitive inhibitor for viral UL97 Kinase
    1. Blocks viral DNA assembly and viral capsid transmission into cells
  • Pharmacokinetics
  1. Good oral Bioavailability
  2. Half-Life: 4.3 hours
  3. Peak Activity after ingestion: 1 to 3 hours
  4. Renal Excretion
  5. Hepatic metabolism
    1. Primarily CYP3A4 substrate (with some metabolism by CYP1A2)
  • Adverse Effects
  1. Common
    1. Dysgeusia
    2. Nausea and Vomiting
    3. Diarrhea
    4. Fatigue
  2. Serious
    1. Nephrotoxicity (8.5%)
      1. Contrast with >21% for Foscarnet
    2. Neutropenia (9.4%)
      1. Contrast with >33% for Ganciclovir
  • Safety
  1. Unknown safety in pregnancy
  2. Unknown safety in Lactation
  • Drug Interactions
  1. Strong CYP3A4 Inducers (esp. Anticonvulsants) may decrease Maribavir levels
    1. Carbamazepine
      1. Increase Maribavir dose to 800 mg twice daily
    2. Phenytoin or Phenobarbital
      1. Increase Maribavir dose to 1200 mg twice daily
  2. Maribavir is a weak CYP3A4 and P-gp Inhibitor and may increase levels of drugs (monitor levels)
    1. Tacrolimus
    2. Cyclosporine
  • Resources
  1. Maribavir (DailyMed)
    1. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c94fc2c5-e840-4f18-b7d8-d5eacb26d3a0
  • References
  1. (2022) Med Lett Drugs Ther 64: 193-4