Background
- Cytosine nucleotide analogue that inhibits DNA polymerase in human herpesviruses
- Indications: Adenovirus, CMV after solid organ transplantation, Cytomegalovirus, Herpes simplex virus
Spectrum of Activity
- Active against essentially all DNA viruses, including polyomaviruses (BK virus, JC virus), human papillomavirus, adenovirus, all of the human herpesviruses, poxviruses (including monkeypox virus and variola virus)
- Not active against hepatitis B virus or RNA viruses
Pharmacokinetics and Pharmacodynamics
- Unlike ganciclovir, it does not need phosphorylation by UL97
Dosing
- Should be given with probenecid 2 g IV prior to each dose
Safety
- Major adverse effect is irreversible renal tubular necrosis, which may be prevented by probenecid
