II. Indications
- Resistant Cytomegalovirus Infection in Adults (and age >=12 years, weight >=35 kg)
- Post-Solid Organ Transplant
- Post Hematopoietic Stem Cell Transplant cancer patients
III. Dosing: Adult (and age >=12 years, weight >=35 kg)
- Take 400 mg orally twice daily
IV. Mechanism
- Benzimidazole riboside with activity against Cytomegalovirus
- Selective ATP competitive inhibitor for viral UL97 Kinase
- Blocks viral DNA assembly and viral capsid transmission into cells
V. Pharmacokinetics
- Good oral Bioavailability
- Half-Life: 4.3 hours
- Peak Activity after ingestion: 1 to 3 hours
- Renal Excretion
- Hepatic metabolism
VI. Adverse Effects
- Common
- Serious
- Nephrotoxicity (8.5%)
- Contrast with >21% for Foscarnet
- Neutropenia (9.4%)
- Contrast with >33% for Ganciclovir
- Nephrotoxicity (8.5%)
VII. Safety
- Unknown safety in pregnancy
- Unknown safety in Lactation
VIII. Drug Interactions
- Strong CYP3A4 Inducers (esp. Anticonvulsants) may decrease Maribavir levels
- Carbamazepine
- Increase Maribavir dose to 800 mg twice daily
- Phenytoin or Phenobarbital
- Increase Maribavir dose to 1200 mg twice daily
- Carbamazepine
- Maribavir is a weak CYP3A4 and P-gp Inhibitor and may increase levels of drugs (monitor levels)
IX. Resources
X. References
- (2022) Med Lett Drugs Ther 64: 193-4