Drug Interaction Report

Ganciclovir Injection and Maribavir: Interaction Details

A pharmacist-reviewed analysis of the Ganciclovir Injection and Maribavir interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Maribavir

Livtencity
+

Ganciclovir Injection

Cytovene® I.V.® Zirgan
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Dr. Brian Staiger, PharmD, BCPS
Updated Aug 8, 2026
Editorial policy · Data sources
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
How we grade severity & evidence

Severity levels

  • Contraindicated: These should generally not be used together.
  • Major: Potentially serious — often needs a change or close monitoring.
  • Moderate: Can be significant — usually manageable with monitoring.
  • Minor: Usually limited clinical impact.

Evidence grades

  • Established: Well documented — supported by controlled studies or strong clinical data.
  • Probable: Good supporting evidence, though not definitively proven.
  • Suspected: Some evidence suggests this interaction, but it is not well established.
  • Possible: Limited or conflicting evidence; the interaction may occur.
  • Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.

Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.

Of 16 documented Ganciclovir Injection interactions, 13 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Reduced ganciclovir or valGANciclovir exposure and reduced efficacy of ganciclovir or valGANciclovir

Interaction Deep Dive

Coadministration of maribavir with ganciclovir or valGANciclovir (prodrug of ganciclovir) is not recommended, as maribavir may antagonize the antiviral activity of ganciclovir or valGANciclovir by inhibiting human CMV pUL97 kinase, which is required for activation/phosphorylation of ganciclovir or valGANciclovir. Virologic failure due to resistance can occur during and after treatment with maribavir. Virologic relapse during the post-treatment period usually occurred within 4-8 weeks after treatment discontinuation. Some maribavir pUL97 resistance-associated substitutions confer cross-resistance to ganciclovir or valGANciclovir. Monitor CMV DNA levels and check for maribavir resistance if the patient is not responding to treatment or relapses1.

Why it happens (mechanism)

Inhibition of human CMV pUL97 kinase of ganciclovir or valGANciclovir

Literature reports

1 report — tap to read

a) When maribavir was tested in combination with other antiviral compounds, antagonism of the antiviral activity was seen in combination with ganciclovir or valGANciclovir. The pUL97 kinase activity inhibited by maribavir is necessary to activate ganciclovir or valGANciclovir 1.

Common questions

Can I take Ganciclovir Injection and Maribavir together?

Reduced ganciclovir or valGANciclovir exposure and reduced efficacy of ganciclovir or valGANciclovir Always confirm with your pharmacist or prescriber before making any change.

How serious is the Ganciclovir Injection and Maribavir interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Ganciclovir Injection or Maribavir need adjusting while I take them together?
  • What symptoms should prompt me to call you or my prescriber right away?
  • Does the timing of my doses matter for this combination?
  • Is there a safer alternative to one of these medications for me?

References (1)

  1. Product Information: LIVTENCITY® oral tablets, maribavir oral tablets. Takeda Pharmaceuticals America Inc (per FDA), Cambridge, MA, 2025. DailyMed
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Maribavir

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All Maribavir interactions (28)
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Ganciclovir Injection

Keep reading about Ganciclovir Injection

All Ganciclovir Injection interactions (16) Ganciclovir Injection drug information
Also serious with: Azathioprine Bupropion Clomipramine Emtricitabine
Beyond drug–drug

These medications also interact with supplements

Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:

Maribavir + Activated Charcoal Grapefruit St. John's Wort Acacia Rigidula Adrafinil African Wild Potato American Elder Astaxanthin + 135 more

major · moderate · minor — check everything you take with our drug–supplement interaction checker.

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.