What is Maribavir: Uses, Dosage, Side Effects and More

Maribavir is a specialized antiviral medication designed to treat cytomegalovirus (CMV) infections that don't respond to standard treatments. If you're dealing with a stubborn CMV infection that hasn't improved with other medications, maribavir might be the solution your doctor recommends.

This medication represents a newer approach to fighting CMV, particularly when the virus has developed resistance to traditional antiviral drugs. Understanding how maribavir works and what to expect can help you feel more confident about your treatment journey.

What is Maribavir?

Maribavir is an oral antiviral medication that belongs to a unique class of drugs called benzimidazole nucleoside analogues. Unlike other CMV treatments, it works by targeting a specific protein that the virus needs to multiply and spread throughout your body.

The medication comes in tablet form and is taken by mouth, making it more convenient than some other CMV treatments that require intravenous administration. It's specifically designed for adults and adolescents who weigh at least 35 kilograms (about 77 pounds).

What makes maribavir special is its ability to work against CMV strains that have become resistant to other antiviral medications. This gives doctors another powerful tool when standard treatments aren't effective.

What is Maribavir Used For?

Maribavir is primarily used to treat cytomegalovirus infections in people who have received organ transplants or stem cell transplants. CMV can be particularly dangerous for these patients because their immune systems are suppressed to prevent organ rejection.

The medication is specifically prescribed when CMV infections are resistant to or refractory to standard antiviral treatments like ganciclovir, valganciclovir, foscarnet, or cidofovir. This resistance can develop when the virus mutates or when previous treatments haven't completely eliminated the infection.

Your doctor might recommend maribavir if you've been struggling with persistent CMV symptoms despite trying other medications. These symptoms can include fever, fatigue, muscle aches, and in severe cases, damage to organs like the lungs, liver, or digestive tract.

How Does Maribavir Work?

Maribavir works by blocking a specific enzyme called UL97 kinase that CMV needs to reproduce itself. Think of this enzyme as a key that the virus uses to unlock its ability to multiply inside your cells.

When maribavir blocks this enzyme, it prevents the virus from making copies of itself and spreading to other cells in your body. This mechanism is different from other CMV medications, which is why it can be effective even when other treatments have failed.

The medication is considered moderately strong and specifically targeted. While it's potent against CMV, it's designed to have less impact on your healthy cells compared to some broader-spectrum antiviral drugs.

How Should I Take Maribavir?

Take maribavir exactly as your doctor prescribes, typically twice daily with food. Taking it with meals helps your body absorb the medication better and can reduce the chance of stomach upset.

You can take maribavir with any type of food - there's no need to follow a special diet. However, avoid taking it on an empty stomach as this can decrease how well your body absorbs the medication and may increase side effects.

Swallow the tablets whole with a full glass of water. Don't crush, chew, or split the tablets, as this can affect how the medication is released in your body. If you have trouble swallowing pills, talk to your doctor about alternative options.

Try to take your doses at the same times each day to maintain steady levels of the medication in your system. Setting phone reminders can help you stay on track with your dosing schedule.

How Long Should I Take Maribavir For?

The duration of maribavir treatment varies depending on how your body responds to the medication and how quickly your CMV infection clears. Most people take it for several weeks to months, but some may need longer treatment.

Your doctor will monitor your progress through regular blood tests that measure the amount of CMV in your system. These tests help determine whether the medication is working and when it might be safe to stop treatment.

Don't stop taking maribavir on your own, even if you're feeling better. CMV infections can return if treatment is stopped too early, and the virus might become even more resistant to treatment. Always follow your doctor's guidance about when to discontinue the medication.

What Are the Side Effects of Maribavir?

Like all medications, maribavir can cause side effects, though not everyone experiences them. Most side effects are manageable and tend to improve as your body adjusts to the medication.

Here are the most common side effects you might experience:

• Nausea and vomiting
• Diarrhea
• Fatigue or tiredness
• Headache
• Changes in taste (metallic taste or loss of taste)
• Decreased appetite
• Swelling in hands, feet, or legs

These common side effects usually don't require stopping the medication, but let your doctor know if they become bothersome or interfere with your daily activities.

Some people may experience more serious side effects that require immediate medical attention. While these are less common, it's important to be aware of them:

• Severe allergic reactions with rash, difficulty breathing, or swelling of face and throat
• Signs of liver problems like yellowing of skin or eyes, dark urine, or severe stomach pain
• Unusual bleeding or bruising
• Severe or persistent diarrhea that leads to dehydration
• Signs of kidney problems like changes in urination or swelling

Contact your healthcare provider immediately if you experience any of these serious side effects. They can help determine whether you need to adjust your dose or try a different treatment approach.

Who Should Not Take Maribavir?

Maribavir isn't suitable for everyone, and certain health conditions or circumstances may make it unsafe for you to take this medication. Your doctor will carefully review your medical history before prescribing it.

You should not take maribavir if you're allergic to the medication or any of its ingredients. Signs of an allergic reaction can include rash, itching, swelling, or difficulty breathing.

People with severe kidney disease may need dose adjustments or might not be able to take maribavir safely. Your doctor will check your kidney function before starting treatment and monitor it regularly while you're taking the medication.

If you have liver problems, your doctor will need to weigh the benefits and risks carefully. Maribavir can affect liver function, so regular monitoring is essential if you have existing liver conditions.

Pregnancy and breastfeeding require special consideration. While there's limited data on maribavir's safety during pregnancy, your doctor will only prescribe it if the benefits clearly outweigh the potential risks to you and your baby.

Maribavir Brand Names

Maribavir is available under the brand name Livtencity in the United States. This is currently the only brand name under which the medication is marketed.

The medication was developed by Takeda Pharmaceuticals and received FDA approval in 2021. Since it's a relatively new medication, generic versions are not yet available.

When picking up your prescription, make sure the pharmacy gives you Livtencity specifically, as there are no generic alternatives currently on the market.

Maribavir Alternatives

If maribavir isn't suitable for you or doesn't work effectively, several alternative treatments are available for CMV infections. Your doctor will choose the best option based on your specific situation and the characteristics of your infection.

Traditional CMV treatments include ganciclovir and valganciclovir, which are often tried first. These medications work differently than maribavir and may be effective even if you've had resistance issues with other drugs.

For more resistant infections, foscarnet and cidofovir are other options, though these typically require intravenous administration and more intensive monitoring. These medications can be more challenging to tolerate but may be necessary in certain situations.

Newer treatments like letermovir might also be considered, particularly for prevention of CMV infection in high-risk patients. Your doctor will discuss which alternatives might work best for your specific circumstances.

Is Maribavir Better Than Ganciclovir?

Maribavir and ganciclovir work differently against CMV, so comparing them isn't straightforward. Each medication has its own strengths and is used in different situations.

Ganciclovir is typically the first-line treatment for CMV infections and has been used successfully for many years. It's well-studied and effective for most CMV infections, especially when caught early.

Maribavir's main advantage is its effectiveness against CMV strains that have become resistant to ganciclovir and similar medications. It also offers the convenience of oral administration, while ganciclovir often requires intravenous treatment.

However, maribavir is generally reserved for cases where ganciclovir and related medications haven't worked or aren't suitable. Your doctor will consider factors like your infection's resistance pattern, your overall health, and previous treatment responses when choosing between these options.