Drug General Information (ID: DDIXZSYAB2)
Drug Name			Zidovudine		Drug Info		Valganciclovir		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Anti-Hiv Agents				Antiviral Agents
Structure

Mechanism of Zidovudine-Valganciclovir Interaction (Severity Level: Major)
Additive myelosuppressive effects Click to Show/Hide Mechanism Graph
Drug Name		Zidovudine				Valganciclovir
Mechanism		Myelosuppressive effects				Myelosuppressive effects
Key Mechanism Factor 1
		Factor Name		Myelosuppressive effects
		Factor Description		Myelosuppression, also known as bone marrow suppression, is a decrease in bone marrow activity that leads to a decrease in the production of blood cells. Some blood cell disorders include: erythrocytopenia (anemia), leukopenia (neutropenia), and thrombocytopenia (thrombocytopenia).
Mechanism Description		Additive myelosuppressive effects by the combination of Zidovudine and Valganciclovir

Recommended Action
Management		It is best to avoid the use of zidovudine with ganciclovir or its prodrug, valganciclovir, whenever possible. If simultaneous therapy is deemed necessary, reduced dosages of one (usually zidovudine) or both drugs may be required. Close clinical and laboratory monitoring for the development of severe hematologic adverse effects is recommended. alternatively, a less myelotoxic agent such as foscarnet may be considered in lieu of ganciclovir to treat cytomegalovirus infections in immunocompromised patients receiving zidovudine.

References
1	Burger DM, Meenhorst PL, Koks CH, Beijnen JH "Drug interactions with zidovudine." AIDS 7 (1993): 445-60. [PMID: 8507410]
2	Cerner Multum, Inc. "Australian Product Information.".
3	Canadian Pharmacists Association "e-CPS."