Nurses Compass
Drug Guide
Maribavir
Classification
Therapeutic: Antiviral
Pharmacological: Viral DNA polymerase inhibitor
FDA Approved Indications
- Treatment of cytomegalovirus (CMV) infection in adult and pediatric transplant patients at risk for CMV disease
Mechanism of Action
Maribavir inhibits the CMV viral kinase UL97, preventing viral replication and maturation.
Dosage and Administration
Adult: 400 mg orally twice daily
Pediatric: Dosing varies based on weight and condition, consultation with specialist recommended
Geriatric: No specific dose adjustment required but monitor for adverse effects
Renal Impairment: Adjust dose in severe renal impairment; consult specific guidelines
Hepatic Impairment: No specific dose adjustment; use with caution and monitor liver function
Pharmacokinetics
Absorption: Well absorbed orally
Distribution: Wide distribution, including tissues
Metabolism: Primarily hepatic, involving CYP enzymes
Excretion: Primarily fecal, minor renal excretion
Half Life: Approximately 6 hours
Contraindications
- Hypersensitivity to maribavir or excipients
Precautions
- Use with caution in patients with renal or hepatic impairment, monitor for adverse reactions, caution in pregnancy and lactation
Adverse Reactions - Common
- Altered taste (Common)
- Nausea (Common)
- Fatigue (Common)
Adverse Reactions - Serious
- Hematologic toxicities (neutropenia, anemia, thrombocytopenia) (Uncommon)
- Liver function abnormalities (Uncommon)
Drug-Drug Interactions
- CYP3A4 inhibitors or inducers may alter maribavir levels
Drug-Food Interactions
- No significant interactions reported
Drug-Herb Interactions
- Limited data; monitor for interactions with herbal supplements
Nursing Implications
Assessment: Monitor for signs of CMV infection, adverse effects, and hepatic/renal function
Diagnoses:
- Risk for infection
- Impaired liver function
Implementation: Administer with or without food, as prescribed; monitor laboratory values regularly
Evaluation: Assess for resolution of CMV infection, monitor for adverse effects, and adjust therapy accordingly
Patient/Family Teaching
- Take medication exactly as prescribed
- Report signs of adverse effects (e.g., unusual bleeding, severe fatigue)
- Maintain follow-up appointments for lab testing
- Inform healthcare provider of all medications and supplements
Special Considerations
Black Box Warnings:
- None currently designated
Genetic Factors: None specified
Lab Test Interference: May affect certain laboratory tests; consult lab guidelines
Overdose Management
Signs/Symptoms: Nausea, vomiting, diarrhea, dizziness, or other adverse effects
Treatment: Supportive care; no specific antidote; contact poison control or seek emergency care
Storage and Handling
Storage: Store at room temperature, away from moisture, heat, and light
Stability: Stable for specified period as per manufacturer instructions