Drug General Information (ID: DDIY81HFB2)
Drug Name			Probenecid		Drug Info		Valganciclovir		Drug Info
Drug Type		Small molecule				Small molecule
Therapeutic Class		Uricosuric Agents				Antiviral Agents
Structure

Mechanism of Probenecid-Valganciclovir Interaction (Severity Level: Moderate)
Competitive inhibition of renal tubular secretion Click to Show/Hide Mechanism Graph
Drug Name		Probenecid				Valganciclovir
Mechanism		Competitive inhibition of renal tubular secretion of ganciclovir				Ganciclovir
Key Mechanism Factor 1
		Factor Name		Renal tubular secretion
		Factor Description		Renal tubular secretion allows selective transfer of substances from the blood around the capillaries into the renal tubules via filtrate. Drug excretion may be reduced when two drugs compete for renal tubular secretion.
Mechanism Description		Decreased elimination of Valganciclovir caused by Probenecid mediated competitive inhibition of renal tubular secretion

Recommended Action
Management		Caution is advised if ganciclovir or its prodrug, valganciclovir, must be used concomitantly with probenecid. Close monitoring for toxicities associated with ganciclovir such as myelosuppression is recommended during concurrent therapy.

References
1	Product Information. Cytovene (ganciclovir). Genentech, South San Francisco, CA.
2	Product Information. Valcyte (valganciclovir) Roche Laboratories, Nutley, NJ.
3	Cimoch PJ, Lavelle J, Pollard R, et al. "Pharmacokinetics of oral ganciclovir alone and in combination with zidovudine, didanosine, and probenecid in HIV-infected subjects." J Acquire Immune Defic Hum Retrovirol 17 (1998): 227-34