II. 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

III. Dosing: Adult (and age >=12 years, weight >=35 kg)

  1. Take 400 mg orally twice daily

IV. 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

V. 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)

VI. 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

VII. Safety

  1. Unknown safety in pregnancy
  2. Unknown safety in Lactation

VIII. 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

X. References

  1. (2022) Med Lett Drugs Ther 64: 193-4

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Ontology: maribavir (C1508759)

Definition (NCI_NCI-GLOSS) A substance that blocks the ability of viruses to make new viruses and infect cells. It is being studied in the prevention of cytomegalovirus infection in cancer patients who have had a donor stem cell transplant. It is a type of antiviral agent.
Definition (NCI) An orally available benzimidazole riboside compound with activity against cytomegalovirus (CMV). Maribavir is a selective ATP competitor of viral UL97 kinase, which is involved in viral nuclear maturation events, such as viral DNA assembly and movement of viral capsids from the nucleus of infected cells. Maribavir has activity against strains of CMV that are resistant to standard anti-CMV agents.
Concepts Nucleic Acid, Nucleoside, or Nucleotide (T114) , Pharmacologic Substance (T121)
MSH C400401
SnomedCT 426042003, 426852000
LNC LP157325-4, MTHU045712
English benzimidavir, Benzimidavir, Maribavir (substance), Maribavir, Maribavir (product), Benzimidazol-2-amine, NTBC, maribavir, MARIBAVIR, 5,6-dichloro-2-isopropylamino-1-b-L-ribofuranosyl-1H-benzimidazole
Spanish maribavir (sustancia), maribavir, maribavir (producto)