Peringatan Keamanan

Data are limited regarding overdosage with maribavir. As there is no specific antidote for maribavir overdose, patients suspected of overdosage should be monitored closely for adverse reactions and treated symptomatically as clinically indicated.L39322 As maribavir is extensively protein-bound in plasma, dialysis is unlikely to be of benefit.L39322

Maribavir

DB06234

small molecule approved investigational

Deskripsi

Maribavir is an inhibitor of the cytomegalovirus (CMV; HHV5) pUL97 kinase which is used to treat CMV infections in patients post-transplantation.L39322 Most standard CMV therapies, such as ganciclovir or foscarnet, target CMV DNA polymerase - while generally effective, these medications tend to promote the development of CMV resistance to DNA polymerase-based therapies, and their use is often limited by toxicities like myelosuppression and renal injury.A242557 Maribavir is novel in that it instead targets the CMV pUL97 kinase, thereby providing an effective alternative treatment option in cases of resistant infections.

Maribavir was approved by the FDA in November 2021, under the name Livtencity (Takeda), for the treatment of resistant CMV infections in post-transplant patients.L39327 The drug was also approved by Health Canada in September 2022 L43262 and by European Commission in November 2022.L44411

Struktur Molekul 2D

Berat 376.23
Wujud solid

Peta Jejaring Molekuler
Legenda: Obat • Target • Gen • Enzim • (Panah → menunjukkan arah efek / relasi) • Transporter • Carrier

Profil Farmakokinetik

Waktu Paruh (Half-Life) In post-transplant patients, the mean half-life of elimination was 4.32 hours.[L39322]
Volume Distribusi The mean apparent steady-state volume of distribution for maribavir was 27.3 L.[L39322]
Klirens (Clearance) In post-transplant patients, the mean oral clearance of maribavir was 2.85 L/h.[L39322]

Absorpsi

Population pharmacokinetic modeling in patients receiving maribavir 400mg twice daily showed an AUC0-tau and Cmax of 128 µg.h/mL and 17.2 µg/mL, respectively.L39322 It has a median Tmax of one to three hours.L39322

Metabolisme

Maribavir is extensively metabolized following oral administration, primarily by CYP3A4 and, to a lesser extent, by CYP1A2.L39322 Its major circulating metabolite is VP 44469, an inactive N-dealkylated metabolite.L39322

Rute Eliminasi

Maribavir is eliminated primarily via hepatic metabolism.L39322 Following the oral administration of radiolabeled maribavir, 61% of the dose was excreted in the urine (<2% as unchanged drug) and 14% was excreted in the feces (5.7% as unchanged drug).L39322

Interaksi Makanan

2 Data
  • 1. Avoid St. John's Wort. Co-administration with St. John's wort decreases serum levels of maribavir and may decrease its therapeutic efficacy.
  • 2. Take with or without food. The co-administration of food with maribavir does not significantly affect its disposition.

Interaksi Obat

319 Data
Rubella virus vaccine The therapeutic efficacy of Rubella virus vaccine can be decreased when used in combination with Maribavir.
Bacillus calmette-guerin substrain tice live antigen The therapeutic efficacy of Bacillus calmette-guerin substrain tice live antigen can be decreased when used in combination with Maribavir.
Bacillus calmette-guerin substrain connaught live antigen The therapeutic efficacy of Bacillus calmette-guerin substrain connaught live antigen can be decreased when used in combination with Maribavir.
Yellow fever vaccine The therapeutic efficacy of Yellow fever vaccine can be decreased when used in combination with Maribavir.
Anthrax vaccine The therapeutic efficacy of Anthrax vaccine can be decreased when used in combination with Maribavir.
Typhoid Vaccine Live The therapeutic efficacy of Typhoid Vaccine Live can be decreased when used in combination with Maribavir.
BCG vaccine The therapeutic efficacy of BCG vaccine can be decreased when used in combination with Maribavir.
Human adenovirus e serotype 4 strain cl-68578 antigen The therapeutic efficacy of Human adenovirus e serotype 4 strain cl-68578 antigen can be decreased when used in combination with Maribavir.
Vibrio cholerae CVD 103-HgR strain live antigen The therapeutic efficacy of Vibrio cholerae CVD 103-HgR strain live antigen can be decreased when used in combination with Maribavir.
Adenovirus type 7 vaccine live The therapeutic efficacy of Adenovirus type 7 vaccine live can be decreased when used in combination with Maribavir.
Varicella zoster vaccine (live/attenuated) The therapeutic efficacy of Varicella zoster vaccine (live/attenuated) can be decreased when used in combination with Maribavir.
Bacillus calmette-guerin substrain russian BCG-I live antigen The therapeutic efficacy of Bacillus calmette-guerin substrain russian BCG-I live antigen can be decreased when used in combination with Maribavir.
Ganciclovir The therapeutic efficacy of Ganciclovir can be decreased when used in combination with Maribavir.
Valganciclovir The therapeutic efficacy of Valganciclovir can be decreased when used in combination with Maribavir.
Phenytoin The serum concentration of Maribavir can be decreased when it is combined with Phenytoin.
Pentobarbital The serum concentration of Maribavir can be decreased when it is combined with Pentobarbital.
Carbamazepine The serum concentration of Maribavir can be decreased when it is combined with Carbamazepine.
Mitotane The serum concentration of Maribavir can be decreased when it is combined with Mitotane.
Primidone The serum concentration of Maribavir can be decreased when it is combined with Primidone.
Rimexolone The serum concentration of Maribavir can be decreased when it is combined with Rimexolone.
Rifampin The serum concentration of Maribavir can be decreased when it is combined with Rifampicin.
Phenobarbital The serum concentration of Maribavir can be decreased when it is combined with Phenobarbital.
Rifapentine The serum concentration of Maribavir can be decreased when it is combined with Rifapentine.
Dexamethasone The serum concentration of Maribavir can be decreased when it is combined with Dexamethasone.
Fosphenytoin The serum concentration of Maribavir can be decreased when it is combined with Fosphenytoin.
St. John's Wort The serum concentration of Maribavir can be decreased when it is combined with St. John's Wort.
Midostaurin The serum concentration of Maribavir can be decreased when it is combined with Midostaurin.
Enzalutamide The serum concentration of Maribavir can be decreased when it is combined with Enzalutamide.
Lumacaftor The serum concentration of Maribavir can be decreased when it is combined with Lumacaftor.
Apalutamide The serum concentration of Maribavir can be decreased when it is combined with Apalutamide.
Digoxin The serum concentration of Digoxin can be increased when it is combined with Maribavir.
Rifabutin The serum concentration of Maribavir can be decreased when it is combined with Rifabutin.
Rosuvastatin The serum concentration of Rosuvastatin can be increased when it is combined with Maribavir.
Cyclosporine The serum concentration of Cyclosporine can be increased when it is combined with Maribavir.
Everolimus The serum concentration of Everolimus can be increased when it is combined with Maribavir.
Sirolimus The serum concentration of Sirolimus can be increased when it is combined with Maribavir.
Tacrolimus The serum concentration of Tacrolimus can be increased when it is combined with Maribavir.
Afatinib The serum concentration of Afatinib can be increased when it is combined with Maribavir.
Bosutinib The serum concentration of Bosutinib can be increased when it is combined with Maribavir.
Brentuximab vedotin The serum concentration of Brentuximab vedotin can be increased when it is combined with Maribavir.
Colchicine The serum concentration of Colchicine can be increased when it is combined with Maribavir.
Edoxaban The serum concentration of Edoxaban can be increased when it is combined with Maribavir.
Ledipasvir The serum concentration of Ledipasvir can be increased when it is combined with Maribavir.
Naloxegol The serum concentration of Naloxegol can be increased when it is combined with Maribavir.
Pazopanib The serum concentration of Pazopanib can be increased when it is combined with Maribavir.
Prucalopride The serum concentration of Prucalopride can be increased when it is combined with Maribavir.
Ranolazine The serum concentration of Ranolazine can be increased when it is combined with Maribavir.
Silodosin The excretion of Silodosin can be decreased when combined with Maribavir.
Topotecan The serum concentration of Topotecan can be increased when it is combined with Maribavir.
Rifaximin The serum concentration of Rifaximin can be increased when it is combined with Maribavir.
Vincristine The excretion of Vincristine can be decreased when combined with Maribavir.
Doxorubicin The serum concentration of Doxorubicin can be increased when it is combined with Maribavir.
Fluvoxamine The metabolism of Maribavir can be decreased when combined with Fluvoxamine.
Fluconazole The metabolism of Maribavir can be decreased when combined with Fluconazole.
Erythromycin The serum concentration of Maribavir can be increased when it is combined with Erythromycin.
Ziprasidone The metabolism of Maribavir can be decreased when combined with Ziprasidone.
Isradipine The metabolism of Maribavir can be decreased when combined with Isradipine.
Diltiazem The metabolism of Maribavir can be decreased when combined with Diltiazem.
Clozapine The metabolism of Maribavir can be decreased when combined with Clozapine.
Haloperidol The serum concentration of Haloperidol can be increased when it is combined with Maribavir.
Ciprofloxacin The metabolism of Maribavir can be decreased when combined with Ciprofloxacin.
Voriconazole The metabolism of Maribavir can be decreased when combined with Voriconazole.
Nicardipine The metabolism of Maribavir can be decreased when combined with Nicardipine.
Verapamil The metabolism of Maribavir can be decreased when combined with Verapamil.
Aprepitant The metabolism of Maribavir can be decreased when combined with Aprepitant.
Isoniazid The metabolism of Maribavir can be decreased when combined with Isoniazid.
Primaquine The metabolism of Maribavir can be decreased when combined with Primaquine.
Miconazole The metabolism of Maribavir can be decreased when combined with Miconazole.
Danazol The metabolism of Maribavir can be decreased when combined with Danazol.
Fusidic acid The metabolism of Maribavir can be decreased when combined with Fusidic acid.
Zimelidine The metabolism of Maribavir can be decreased when combined with Zimelidine.
Dronedarone The metabolism of Maribavir can be decreased when combined with Dronedarone.
Milnacipran The metabolism of Maribavir can be decreased when combined with Milnacipran.
Simeprevir The metabolism of Maribavir can be decreased when combined with Simeprevir.
Isavuconazonium The metabolism of Maribavir can be decreased when combined with Isavuconazonium.
Desvenlafaxine The metabolism of Maribavir can be decreased when combined with Desvenlafaxine.
Nilvadipine The metabolism of Maribavir can be decreased when combined with Nilvadipine.
Seproxetine The metabolism of Maribavir can be decreased when combined with Seproxetine.
Crizotinib The serum concentration of Crizotinib can be increased when it is combined with Maribavir.
Linagliptin The metabolism of Maribavir can be decreased when combined with Linagliptin.
Indalpine The metabolism of Maribavir can be decreased when combined with Indalpine.
Netupitant The metabolism of Maribavir can be decreased when combined with Netupitant.
Barnidipine The metabolism of Maribavir can be decreased when combined with Barnidipine.
Benidipine The metabolism of Maribavir can be decreased when combined with Benidipine.
Venetoclax The serum concentration of Venetoclax can be increased when it is combined with Maribavir.
Isavuconazole The metabolism of Maribavir can be decreased when combined with Isavuconazole.
Fosnetupitant The metabolism of Maribavir can be decreased when combined with Fosnetupitant.
Berotralstat The serum concentration of Berotralstat can be increased when it is combined with Maribavir.
Nelfinavir The metabolism of Maribavir can be decreased when combined with Nelfinavir.
Indinavir The metabolism of Maribavir can be decreased when combined with Indinavir.
Terfenadine The metabolism of Maribavir can be decreased when combined with Terfenadine.
Ritonavir The serum concentration of Maribavir can be increased when it is combined with Ritonavir.
Efavirenz The metabolism of Maribavir can be decreased when combined with Efavirenz.
Ergotamine The metabolism of Maribavir can be decreased when combined with Ergotamine.
Amprenavir The metabolism of Maribavir can be decreased when combined with Amprenavir.
Delavirdine The metabolism of Maribavir can be decreased when combined with Delavirdine.
Methimazole The metabolism of Maribavir can be decreased when combined with Methimazole.
Loperamide The excretion of Loperamide can be decreased when combined with Maribavir.
Conivaptan The metabolism of Maribavir can be decreased when combined with Conivaptan.
Tipranavir The metabolism of Maribavir can be decreased when combined with Tipranavir.

Target Protein

Serine/threonine protein kinase UL97 UL97

Referensi & Sumber

Synthesis reference: Glover BN, Huang LF, Lancaster RW, Long ST, Rizzolio MC, Schmitt EA, Sickles BR. (2010). Crystalline forms of an antiviral benzimidazole compound (US Patent No. US7714123B2).
Artikel (PubMed)
  • PMID: 34462268
    Sun K, Welty D: Elucidation of Metabolic and Disposition Pathways for Maribavir in Nonhuman Primates through Mass Balance and Semi-Physiologically Based Modeling Approaches. Drug Metab Dispos. 2021 Nov;49(11):1025-1037. doi: 10.1124/dmd.121.000493. Epub 2021 Aug 30.
  • PMID: 18316526
    Goldwater DR, Dougherty C, Schumacher M, Villano SA: Effect of ketoconazole on the pharmacokinetics of maribavir in healthy adults. Antimicrob Agents Chemother. 2008 May;52(5):1794-8. doi: 10.1128/AAC.00951-07. Epub 2008 Mar 3.
  • PMID: 12121907
    Koszalka GW, Johnson NW, Good SS, Boyd L, Chamberlain SC, Townsend LB, Drach JC, Biron KK: Preclinical and toxicology studies of 1263W94, a potent and selective inhibitor of human cytomegalovirus replication. Antimicrob Agents Chemother. 2002 Aug;46(8):2373-80. doi: 10.1128/AAC.46.8.2373-2380.2002.
  • PMID: 31981100
    Hakki M: Moving Past Ganciclovir and Foscarnet: Advances in CMV Therapy. Curr Hematol Malig Rep. 2020 Apr;15(2):90-102. doi: 10.1007/s11899-020-00557-6.

Contoh Produk & Brand

Produk: 5 • International brands: 2
Produk
  • Livtencity
    Tablet, coated • 200 mg/1 • Oral • US • Approved
  • Livtencity
    Tablet • 200 mg • Oral • Canada • Approved
  • Livtencity
    Tablet, film coated • 200 mg • Oral • EU • Approved
  • Livtencity
    Tablet, film coated • 200 mg • Oral • EU • Approved
  • Livtencity
    Tablet, film coated • 200 mg • Oral • EU • Approved
International Brands
  • Camvia — ViroPharma Inc.
  • Livtencity — Takeda Pharmaceuticals America, Inc.

Sekuens Gen/Protein (FASTA)

Sekuens dimuat saat dibutuhkan agar halaman tetap ringan.
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