An oral and intravenous agent for the prophylaxis of cytomegalovirus infection in CMV-positive patients who have received an allogeneic hematopoietic stem cell transplant.

It is a potent non-nucleoside CMV inhibitor.

It targets the CMV DNA terminase complex, which is required for viral DNA processing and the assembly of infectious virions.

Has demonstrated activity against CMV strains that are resistant to DNA polymerase inhibitors such as ganglicor and cidofovir.

In a phase III clinical trial patients receiving letermovir were significantly less likely than patients receiving placebo to have clinically significant CMV infection, discontinue treatment at 24 weeks: 38% vs 61%.

Potential adverse events include tachycardia, other cardiac events, nausea, vomiting, diarrhea, peripheral edema, cough, headache. fatigue, and abdominal pain.

Nausea most frequent cause of discontinuation of drug.

Contraindications are coadministration with pimozide or ergot alkaloids and in patients taking pitvastastinor simivastatin with cyclosporine.

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