{"id":51193,"date":"2023-09-20T09:18:21","date_gmt":"2023-09-20T09:18:21","guid":{"rendered":"https:\/\/medsname.com\/valgan\/"},"modified":"2026-04-30T16:19:01","modified_gmt":"2026-04-30T16:19:01","slug":"valgan","status":"publish","type":"product","link":"https:\/\/medsbase.com\/cs\/product\/valgan\/","title":{"rendered":"Valgan"},"content":{"rendered":"<div class=\"medsbase-tldr-answer\" style=\"background:#fff8e1;border-left:4px solid #f5a623;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<h3 style=\"margin-top:0;\">Rychl\u00e1 odpov\u011b\u010f<\/h3>\n<p style=\"margin-bottom:0;\"><strong>Valgan<\/strong> \u2014 valganciklovir 450 mg (Cipla). Profarmakum gancikloviru \u2014 pou\u017e\u00edv\u00e1 se pro cytomegalovirus (CMV) retinitidu u HIV\/AIDS, profylaxi a l\u00e9\u010dbu CMV u p\u0159\u00edjemc\u016f transplantovan\u00fdch org\u00e1n\u016f a kostn\u00ed d\u0159en\u011b a pro vrozen\u00fd CMV. Lep\u0161\u00ed peror\u00e1ln\u00ed biologick\u00e1 dostupnost ne\u017e ganciklovir.<\/p>\n<\/div>\n<div class=\"medsbase-trust-strip\" style=\"background:#f7f7f7;border-left:4px solid #2c7cb0;padding:14px 18px;margin:18px 0;border-radius:4px;\">\n<p style=\"margin:0 0 6px 0;\"><strong>Co z\u00edsk\u00e1te s MedsBase:<\/strong><\/p>\n<ul style=\"margin:6px 0 0 22px;padding:0;list-style:disc;\">\n<li>v\u00fdrobce certifikovan\u00e9ho WHO-GMP<\/li>\n<li>Diskr\u00e9tn\u00ed balen\u00ed v oby\u010dejn\u00e9 ob\u00e1lce<\/li>\n<li>Dod\u00e1n\u00ed po cel\u00e9m sv\u011bt\u011b<\/li>\n<li>Hodnoceno v\u00edce ne\u017e 1 400 z\u00e1kazn\u00edky (<a href=\"https:\/\/medsbase.com\/cs\/reviews\/\">\u010d\u00edst recenze<\/a>)<\/li>\n<\/ul>\n<\/div>\n<p class=\"medsbase-reship-line\" style=\"background:#eef7ee;border-left:4px solid #4caf50;padding:10px 14px;margin:14px 0;border-radius:3px;\">\ud83d\udce6 <strong>Z\u00e1ruka op\u011btovn\u00e9ho zasl\u00e1n\u00ed:<\/strong> pokud va\u0161e objedn\u00e1vka nedoraz\u00ed do 20 pracovn\u00edch dn\u016f od odesl\u00e1n\u00ed, za\u0161leme ji znovu bez dal\u0161\u00edch n\u00e1klad\u016f. <a href=\"https:\/\/medsbase.com\/cs\/medsbase-re-shipment-assurance-policy\/\">P\u0159e\u010d\u00edst podm\u00ednky<\/a>.<\/p>\n<h3>Pro\u010d objedn\u00e1vat z MedsBase<\/h3>\n<p>Valgan je expedov\u00e1n od v\u00fdrobce certifikovan\u00e9ho WHO-GMP v neutr\u00e1ln\u00edm balen\u00ed, fakturov\u00e1n prost\u0159ednictv\u00edm regulovan\u00e9ho platebn\u00edho procesoru (v\u00fdpis z \u00fa\u010dtu uv\u00e1d\u00ed regulovan\u00e9ho zpracovatele platebn\u00edch karet \u2014 nikdy MedsBase nebo n\u00e1zev l\u00e9ku). Ka\u017ed\u00e1 objedn\u00e1vka je pokryta na\u0161\u00ed 20-pracovn\u00ed denn\u00ed z\u00e1rukou na p\u0159eposl\u00e1n\u00ed.<\/p>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>FDA \u010dern\u00e9 v\u00fdstra\u017en\u00e9 r\u00e1me\u010dky<\/strong><br \/>Valganciklovir nese v\u00edce \u010dern\u00fdch v\u00fdstra\u017en\u00fdch r\u00e1me\u010dk\u016f: \u00fatlum kostn\u00ed d\u0159en\u011b (granulocytopenie, an\u00e9mie, trombocytopenie), karcinogenita a teratogenita u zv\u00ed\u0159at a po\u0161kozen\u00ed plodnosti u mu\u017e\u016f\/\u017een. Pou\u017e\u00edvejte pouze p\u0159i jasn\u00e9 indikaci. T\u011bhotn\u00e9 nebo potenci\u00e1ln\u011b t\u011bhotn\u00e9 \u017eeny mus\u00ed pou\u017e\u00edvat \u00fa\u010dinnou antikoncepci b\u011bhem l\u00e9\u010dby A alespo\u0148 1 m\u011bs\u00edc po n\u00ed.<\/div>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:14px 0;border-radius:3px;\"><strong>Povinn\u00e9 monitorov\u00e1n\u00ed<\/strong><br \/>T\u00fddenn\u00ed vy\u0161et\u0159en\u00ed krevn\u00edho obrazu b\u011bhem induk\u010dn\u00ed terapie a prvn\u00edho m\u011bs\u00edce udr\u017eovac\u00ed l\u00e9\u010dby, pot\u00e9 ka\u017ed\u00e9 2-4 t\u00fddny. P\u0159eru\u0161te l\u00e9\u010dbu, pokud neutrofily &lt;500\/\u03bcL, trombocyty &lt;25 000\/\u03bcL nebo hemoglobin prudce poklesne. Monitorujte ren\u00e1ln\u00ed funkci (\u00faprava d\u00e1vky podle ClCr). Monitorujte zrakovou funkci b\u011bhem l\u00e9\u010dby CMV retinitidy.<\/div>\n<h2>D\u00e1vkov\u00e1n\u00ed<\/h2>\n<table style=\"width:100%;border-collapse:collapse;margin:12px 0;\">\n<tr style=\"background:#2c7cb0;color:#fff;\">\n<th style=\"padding:8px;border:1px solid #ddd;\">Indikace<\/th>\n<th style=\"padding:8px;border:1px solid #ddd;\">D\u00e1vka<\/th>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Indukce CMV retinitidy (HIV)<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">900 mg 2\u00d7 denn\u011b po dobu 21 dn\u016f s j\u00eddlem<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">Udr\u017eovac\u00ed l\u00e9\u010dba CMV retinitidy<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">900 mg 1\u00d7 denn\u011b s j\u00eddlem<\/td>\n<\/tr>\n<tr>\n<td style=\"padding:8px;border:1px solid #ddd;\">Prevence CMV (po transplantaci)<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">900 mg 1\u00d7 denn\u011b po dobu 100\u2013200 dn\u016f po transplantaci<\/td>\n<\/tr>\n<tr style=\"background:#f9f9f9;\">\n<td style=\"padding:8px;border:1px solid #ddd;\">Kongenit\u00e1ln\u00ed CMV (pediatrie)<\/td>\n<td style=\"padding:8px;border:1px solid #ddd;\">16 mg\/kg 2\u00d7 denn\u011b po dobu 6 m\u011bs\u00edc\u016f \u2014 pod odborn\u00fdm dohledem<\/td>\n<\/tr>\n<\/table>\n<p>U\u017e\u00edvat s j\u00eddlem. \u00daprava d\u00e1vky p\u0159i ren\u00e1ln\u00ed insuficienci (CrCl &lt;60 ml\/min). Tablety je nutn\u00e9 polykat cel\u00e9 \u2014 manipulace s rozl\u00e1man\u00fdmi tabletami p\u0159edstavuje teratogenn\u00ed riziko.<\/p>\n<h2 id=\"faqs\">\u010casto kladen\u00e9 dotazy<\/h2>\n<h3>Kdy je indikov\u00e1n valganciklovir?<\/h3>\n<p>CMV retinitida u HIV\/AIDS (p\u0159ev\u00e1\u017en\u011b historick\u00e9 s modern\u00ed ART), prevence a l\u00e9\u010dba CMV po transplantaci solidn\u00edch org\u00e1n\u016f a kostn\u00ed d\u0159en\u011b, kongenit\u00e1ln\u00ed CMV u symptomatick\u00fdch novorozenc\u016f. Konzultujte s odborn\u00edkem na infek\u010dn\u00ed choroby nebo transplanta\u010dn\u00edm specialistou.<\/p>\n<h3>Jak to funguje?<\/h3>\n<p>Profarmakum gancikloviru, kter\u00e9 je intracelul\u00e1rn\u011b p\u0159em\u011b\u0148ov\u00e1no na aktivn\u00ed formu virov\u00fdmi kin\u00e1zami (preferen\u010dn\u011b v bu\u0148k\u00e1ch infikovan\u00fdch CMV). Aktivn\u00ed forma je za\u010dlen\u011bna do virov\u00e9 DNA jako termin\u00e1tor \u0159et\u011bzce.<\/p>\n<h3>Pro\u010d je nutn\u00e9 monitorov\u00e1n\u00ed?<\/h3>\n<p>\u00datlum kostn\u00ed d\u0159en\u011b je d\u00e1vkov\u011b limituj\u00edc\u00ed toxicita. U 25\u201340 % pacient\u016f se rozvine v\u00fdznamn\u00e1 neutropenie nebo an\u00e9mie. B\u011bhem induk\u010dn\u00ed f\u00e1ze je povinn\u00fd t\u00fddenn\u00ed kontroln\u00ed krevn\u00ed obraz. G-CSF (filgrastim) se n\u011bkdy pou\u017e\u00edv\u00e1 ke zvl\u00e1dnut\u00ed neutropenie bez p\u0159eru\u0161en\u00ed terapie.<\/p>\n<h3>T\u011bhotenstv\u00ed?<\/h3>\n<p>Siln\u011b kontraindikov\u00e1no kv\u016fli teratogenit\u011b. \u017deny mus\u00ed pou\u017e\u00edvat \u00fa\u010dinnou antikoncepci b\u011bhem l\u00e9\u010dby a alespo\u0148 1 m\u011bs\u00edc po n\u00ed, mu\u017ei 90 dn\u00ed po l\u00e9\u010db\u011b. P\u0159ed zah\u00e1jen\u00edm l\u00e9\u010dby je nutn\u00fd t\u011bhotensk\u00fd test u osob s reproduk\u010dn\u00edm potenci\u00e1lem.<\/p>\n<h3>Interakce l\u00e9k\u016f?<\/h3>\n<p>Hlavn\u00ed interakce: zidovudin (aditivn\u00ed \u00fatlum kostn\u00ed d\u0159en\u011b), trimethoprim-sulfa, mykofenol\u00e1t (v kontextu transplantace), didanosin (zv\u00fd\u0161en\u00e9 hladiny). Probenecid sni\u017euje clearance. V\u017edy sd\u011blte v\u0161echny u\u017e\u00edvan\u00e9 l\u00e9ky v\u010detn\u011b imunosupresiv po transplantaci.<\/p>\n<h3>Funkce ledvin?<\/h3>\n<p>Vylu\u010dov\u00e1no ledvinami \u2013 upravte d\u00e1vku podle clearance kreatininu. CrCl &lt;10 ml\/min: vyvarujte se pod\u00e1n\u00ed; pacienti na hemodial\u00fdze vy\u017eaduj\u00ed d\u00e1vkovac\u00ed sch\u00e9ma po dial\u00fdze.<\/p>\n<h3>Vedlej\u0161\u00ed \u00fa\u010dinky?<\/h3>\n<p>\u00datlum kostn\u00ed d\u0159en\u011b (nej\u010dast\u011bj\u0161\u00ed), GI pot\u00ed\u017ee (nevolnost, zvracen\u00ed, pr\u016fjem), bolest hlavy, nespavost, hore\u010dka, odchl\u00edpen\u00ed s\u00edtnice u CMV retinitidy (souvisej\u00edc\u00ed s onemocn\u011bn\u00edm, nikoli s l\u00e9kem).<\/p>\n<h3>Skladov\u00e1n\u00ed?<\/h3>\n<p>P\u0159i teplot\u011b do 30 \u00b0C v p\u016fvodn\u00edm obalu. Rozdrcen\u00e9\/po\u0161kozen\u00e9 tablety jsou teratogenn\u00ed \u2013 manipulujte v rukavic\u00edch; t\u011bhotn\u00e9 \u010dlenky dom\u00e1cnosti by s nimi nem\u011bly manipulovat.<\/p>\n<h3>Co kdy\u017e vynech\u00e1m d\u00e1vku?<\/h3>\n<p>U\u017eijte, kdy\u017e si vzpomenete, pokud nen\u00ed t\u00e9m\u011b\u0159 \u010das na dal\u0161\u00ed d\u00e1vku. Neduplikujte d\u00e1vky. Proberte probl\u00e9my s adherenc\u00ed s va\u0161\u00edm transplanta\u010dn\u00edm nebo HIV t\u00fdmem \u2013 alternativn\u00ed anti-CMV l\u00e1tky (foscarnet, cidofovir) existuj\u00ed, pokud peror\u00e1ln\u00ed terapie sel\u017ee.<\/p>\n<h3>Rezistence?<\/h3>\n<p>P\u0159i dlouhodob\u00e9 expozici se m\u016f\u017ee vyvinout rezistence CMV \u2013 mutace UL97 a UL54 zp\u016fsobuj\u00ed rezistenci na ganciklovir. Maravirok\/foscarnet\/cidofovir jsou mo\u017enosti pro rezistentn\u00ed onemocn\u011bn\u00ed, v\u0161echny maj\u00ed sv\u00e9 vlastn\u00ed toxicity.<\/p>\n<p><!-- medsbase-related-alts-v1 --><\/p>\n<h2>Dal\u0161\u00ed antivirotika<\/h2>\n<ul>\n<li><a href=\"https:\/\/medsbase.com\/cs\/zimivir\/\">Zimivir<\/a> \u2013 valaciklovir pro HSV<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/natclovir\/\">Natclovir<\/a> \u2014 valacyklovir \u2014 zna\u010dka Natco<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/centrex\/\">Centrex<\/a> \u2013 valaciklovir 500\/1000 mg<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/x-vir\/\">X-Vir<\/a> \u2014 entecavir pro HBV<\/li>\n<li><a href=\"https:\/\/medsbase.com\/cs\/lamivir-hbv\/\">Lamivir HBV<\/a> \u2014 lamivudin pro HBV<\/li>\n<\/ul>\n<div style=\"background:#fff3f3;border-left:4px solid #d9534f;padding:12px 16px;margin:18px 0;border-radius:3px;font-size:.95em;\"><strong>Zdravotn\u00ed upozorn\u011bn\u00ed:<\/strong> Tato str\u00e1nka slou\u017e\u00ed pouze pro informaci a nenahrazuje l\u00e9ka\u0159skou p\u00e9\u010di kvalifikovan\u00e9ho odborn\u00edka. Proberte jak\u00e9koli nov\u00e9 l\u00e9ky se sv\u00fdm l\u00e9ka\u0159em nebo l\u00e9k\u00e1rn\u00edkem.<\/div>","protected":false},"excerpt":{"rendered":"<p>Valgan (Valganciklovir 450 mg) \u2014 Cipla ganciklovirov\u00fd profarmakum pro CMV retinitidu u HIV\/AIDS a pro prevenci\/ l\u00e9\u010dbu CMV u p\u0159\u00edjemc\u016f transplantovan\u00fdch org\u00e1n\u016f a kostn\u00ed d\u0159en\u011b.<\/p>","protected":false},"featured_media":51194,"comment_status":"open","ping_status":"open","template":"","meta":[],"product_brand":[],"product_cat":[3141,3223,3304],"product_tag":[],"class_list":{"0":"post-51193","1":"product","2":"type-product","3":"status-publish","4":"has-post-thumbnail","6":"product_cat-category-overview","7":"product_cat-chronic-conditions","8":"product_cat-hiv-medication","10":"first","11":"outofstock","12":"shipping-taxable","13":"purchasable","14":"product-type-variable","15":"has-default-attributes"},"acf":[],"_links":{"self":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product\/51193","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product"}],"about":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/types\/product"}],"replies":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/comments?post=51193"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media\/51194"}],"wp:attachment":[{"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/media?parent=51193"}],"wp:term":[{"taxonomy":"product_brand","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_brand?post=51193"},{"taxonomy":"product_cat","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_cat?post=51193"},{"taxonomy":"product_tag","embeddable":true,"href":"https:\/\/medsbase.com\/cs\/wp-json\/wp\/v2\/product_tag?post=51193"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}