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Letermovir - Indications, Dosage, Side Effects and Precautions

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Information about Letermovir

Generic Name : Letermovir
Up-to-date prescription details regarding Letermovir are provided here.

Pronunciation : le-TERM-oh-vir

Learn the correct pronunciation of the Letermovir, understand it's uses, recommended dosages, its indications, how to take, when to take, when not to take, side effects, special precautions, warnings and its and its storage instructions.
You will also find a list of the medication's International and Indian brand or trade names, as well as its pricing information. For verification of the information presented on this page or for additional clarifications, it's advisable to consult your doctor.


Therapeutic Classification : Antivirals

Trade Names/Brand Names of Letermovir

India :


Prevymis

Overview of Letermovir

• Letermovir is an antiviral agent which is used for the prevention of cytomegalovirus (CMV) disease.

Why is Letermovir Prescribed? (Indications)

Letermovir is an antiviral CMV DNA terminase complex inhibitor which is prescribed for prevention of the development of cytomegalovirus (CMV) infection in adult patients who underwent stem cell transplant or who test positive for the CMV antigens but do not suffer from the disease.

When should Letermovir not be taken? (Contraindications)

Letermovir should not be used in patients taking drugs such as-

• Ergot alkaloids ( ergotamine, dihydroergotamine, ergonovine, methylergonovine)
Pimozide
• Simvastatin and pitavastatin

Levtermovir increases the concentrations of these drugs, which in turn can cause serious adverse effects.

Letermovir is not recommended in the following conditions-

• Allergy to letermovir Children under 18 years of age
• Severe liver disease

What is the dosage of Letermovir?

The recommended adult dose of letermovir is 480mg once a day.
• Letermovir should be initiated between day 0 and day 28 either before or after engraftment should be continued until day 100 post-transplantation.
• Letermovir injection should be used only in patients who cannot take tablets and patients should be switched to tablets as soon as possible.
• Dosage adjustments are usually not required while switching from injection to oral therapy or tablets.
• When administered along with cyclosporine, the dose of letermovir should be reduced to 240 mg once daily.

How should Letermovir be taken?

• Letermovir is available in tablet form as well as in injection form.
• Tablets of letermovir should be taken by mouth without regard to meals while the injection should be given intravenously or into the vein.
• Swallow the tablets as a whole with sufficient quantity of water and care should be taken that they should not be crushed or split or opened.
• Letermovir injection should be added to an intravenous bag of 0.9% sodium chloride or 5% dextrose and should be given slowly by a separate intravenous cannula taking at least 1 hour to complete the infusion.

What are the warnings and precautions for Letermovir?

• Take letermovir for the exact period as prescribed.

What are the side effects of Letermovir?

Common: Nausea, vomiting, stomach pain, loose stools, headache, cough, tiredness, swelling of arms or feet
Cardiovascular: Atrial fibrillation, increased heartbeat
Others: Fatigue, breathing difficulty, skin rashes, itching, other allergic reactions

What are the other precautions for Letermovir?

• Do not shake the injection vial. Dilute the injection only before administration.
• Discard the injection in case of any discoloration or presence of particulate matter.

What are the Drug Interactions of Letermovir?

• Letermovir can interact with several drugs when taken together and frequent monitoring for adverse effects or when possible, the serum drug concentration measurement is required to avoid serious side effects.

Letermovir increases the blood concentration of following drugs

• Amiodarone
• Atorvastatin, fluvastatin, lovastatin, pravastatin, rosuvastatin
• Antidiabetic drugs (e.g. Glyburide, repaglinide, rosiglitazone)
• Sirolimus or tacrolimus
• Cyclosporine
• Alfentanil or fentanyl
• Midazolam
• Quinidine

Letermovir should not be used with the following drugs since it increases their blood levels and they in turn can cause serious adverse effects:

• Ergot alkaloids ( ergotamine, dihydroergotamine, ergonovine, methylergonovine)
• Pimozide
• Simvastatin and pitavastatin

Letermovir decreases the concentration of following drugs

• Warfarin
• Phenytoin
Voriconazole
• Omeprazole and pantoprazole

The co-administration of rifampin and letermovir is not recommended since rifampin can decrease letermovir blood levels.
Patients on treatment with both the drugs letermovir and cyclosporine should not take lovastatin.

What are the storage conditions for Letermovir?

• Store letermovir tablets and injections in their original package at a room temperature between 20°C and 25°C.
• The diluted injection can be stored at a room temperature for 24 hours or in a refrigerator at 2°C to 8°C for a period of 48 hours.
• If the diluted solution is kept for more than the above period, the infusion has to be discarded.
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