letermovir

Drug-drug:

May ↑ pimozide levels, which may ↑ risk of torsades de pointes; concurrent use contraindicated.
May ↑ ergotamine and dihydroergotamine levels, which may ↑ risk of ergotism; concurrent use contraindicated.
May significantly ↑ pitavastatin and simvastatin levels when concurrently administered with cyclosporine, which may ↑ risk of myopathy and rhabdomyolysis; concurrent use contraindicated.
May ↑ amiodarone levels and risk of toxicity; closely monitor amiodarone concentrations.
May ↓ warfarin levels and ↑ the risk for a thromboembolic event; closely monitor INR.
May ↓ phenytoin levels; concurrent use not recommended.
May ↑ glyburide, repaglinide, and pioglitazone levels; closely monitor blood glucose levels; when used concurrently with cyclosporine, avoid use with repaglinide.
May ↓ voriconazole levels and effectiveness.
Bosentan, carbamazepine, efavirenz, etravirine, modafinil, nafcillin, nevirapine, phenobarbital, phenytoin, rifabutin, rifampin, and thioridazine may ↓ levels and effectiveness; concurrent use not recommended.
May ↑ atorvastatin levels and the risk of toxicity; do not exceed atorvastatin dose of 20 mg/day; when used concurrently with cyclosporine, avoid use with atorvastatin.
May ↑ pitavastatin and simvastatin levels and the risk of toxicity; concurrent use not recommended.
May ↑ fluvastatin, lovastatin, pravastatin, and rosuvastatin levels and the risk of toxicity; consider ↓ statin dose; when used concurrently with cyclosporine, avoid use with lovastatin.
Concurrent use with cyclosporine↑ both cyclosporine and letermovir levels; ↓ letermovir dose and closely monitor whole blood concentrations of cyclosporine.
May ↑ sirolimus and tacrolimus levels and the risk of toxicity; closely monitor whole blood concentrations of sirolimus and tacrolimus.
May ↓ omeprazole and pantoprazole levels and effectiveness.

Drug-Natural Products:

St. John's wort may ↓ levels and effectiveness; concurrent use not recommended.

IV therapy should only be used when patients are unable to take oral therapy.

Hematopoietic Stem Cell Transplant

IV PO (Adults and Children ≥12 yr and ≥30 kg): 480 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: 240 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
PO (Children ≥12 yr and 15–<30 kg): Tablets or oral pellets: 240 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: Oral pellets: 120 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
PO (Children ≥12 yr and 7.5–<15 kg): Oral pellets: 120 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: Oral pellets: 60 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
PO (Children ≥12 yr and 6–<7.5 kg): Oral pellets: 80 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: Oral pellets: 40 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
PO (Children 6 mo–<12 yr and ≥30 kg): Tablets or oral pellets: 480 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: Tablets or oral pellets: 240 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
PO (Children 6 mo–<12 yr and 15–<30 kg): Tablets or oral pellets: 240 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: Oral pellets: 120 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
PO (Children 6 mo–<12 yr and 7.5–<15 kg): Oral pellets: 120 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: Oral pellets: 60 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
PO (Children 6 mo–<12 yr and 6–<7.5 kg): Oral pellets: 80 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: Oral pellets: 40 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
IV (Children ≥12 yr and 15–<30 kg): 120 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: 120 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
IV (Children ≥12 yr and 7.5–<15 kg): 60 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: 60 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
IV (Children ≥12 yr and 6–<7.5 kg): 40 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: 40 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
IV (Children 6 mo–<12 yr and ≥30 kg): 480 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: 240 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
IV (Children 6 mo–<12 yr and 15–<30 kg): 120 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: 120 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
IV (Children 6 mo–<12 yr and 7.5–<15 kg): 60 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: 60 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.
IV (Children 6 mo–<12 yr and 6–<7.5 kg): 40 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease. Concurrent use with cyclosporine: 40 mg once daily started between Day 0 and Day 28 post-transplantation and continued through Day 100 post-transplantation. May be continued through Day 200 post-transplantation if the patient is at risk for late CMV infection and disease.

Kidney Transplant

IV PO (Adults and Children ≥12 yr and ≥40 kg): 480 mg once daily started between Day 0 and Day 7 post-transplantation and continued through Day 200 post-transplantation. Concurrent use with cyclosporine: 240 mg once daily started between Day 0 and Day 7 post-transplantation and continued through Day 200 post-transplantation.

ROUTE	ONSET	PEAK	DURATION
IV	rapid	end of infusion	unknown
PO	unknown	0.75–2.25 hr	unknown

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Interactions ⬆ ⬇

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Route/Dosage ⬆ ⬇

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Classifications ⬆ ⬇

Pharmacokinetics ⬆ ⬇

Time/Action Profile ⬆ ⬇

Patient/Family Teaching ⬆ ⬇

Pronunciation ⬆