An oral antiviral for cytomegalovirus (CMV) after transplant
Maribavir
An oral antiviral used to treat cytomegalovirus (CMV) infection in people who have had a transplant, when other CMV medicines have not worked.
What is Maribavir?
Maribavir is a specialist antiviral taken by mouth to treat cytomegalovirus (CMV) infection in people who have had a transplant, usually when other CMV medicines have not worked or are not suitable, often because the virus has become resistant. It works in a different way from the older CMV medicines, which is why it can help when they have failed. The most common side effects are taste disturbance, often a strange or metallic taste, and stomach upset. An important safety point is that it should not be combined with certain other CMV medicines such as ganciclovir and valganciclovir, which it can work against, and it interacts with several other medicines.
Education and reference only. This is a plain-language guide to Maribavir — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Maribavir is an antiviral medicine used to treat cytomegalovirus (CMV) infection or disease in adults who have had a transplant. CMV is a common virus that usually causes no problems in healthy people but can become serious in people whose immune system is weakened, such as after an organ or stem-cell transplant. Maribavir is taken by mouth and is mainly used when standard CMV treatments have not worked or cannot be tolerated, including when the virus has become resistant to them. It is prescribed and supervised by a specialist transplant or infection team.
How it works
Maribavir blocks an enzyme that CMV needs to copy itself and to package its genetic material, so the virus cannot multiply effectively. Because it targets the virus in a different way from the older CMV medicines, it can still work against virus that has become resistant to them. By bringing the amount of virus down, it helps control the infection and reduce the harm it can cause in someone with a weakened immune system. It is taken by mouth, usually for a defined course, with the specialist team watching the virus levels to judge how well it is working.
Company & origin
Originated / developed by: Specialist manufacturer.
A specialist antiviral medicine used in the UK to treat cytomegalovirus (CMV) infection after a transplant when other treatments have not worked or cannot be used.
Practical use
How to take Maribavir
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- Take it by mouth as prescribed, swallowing the tablets as your specialist team advises.
- Take it for the full course you are given, even if you feel better, so the infection is properly controlled.
- Do not take it together with certain other CMV medicines such as ganciclovir or valganciclovir, as it can work against them.
- Give your team a full list of your other medicines, as maribavir interacts with several, including some transplant medicines.
- Tell your team about a strange taste, which is common, and report ongoing stomach upset or anything that worries you.
Weighing it up
Advantages & disadvantages of Maribavir
Advantages
- An oral treatment for CMV after transplant, which can be taken at home rather than into a vein.
- Works in a different way from older CMV medicines, so it can help when they have failed or the virus is resistant.
- Generally avoids some of the bone-marrow and kidney side effects seen with some other CMV treatments.
Disadvantages
- Commonly causes taste disturbance and stomach upset.
- Must not be combined with certain other CMV medicines such as ganciclovir and valganciclovir.
- Interacts with several other medicines, and the virus can sometimes become resistant to it.
Practical use
Good to know
The most noticeable side effect is taste disturbance, often a strange, bitter or metallic taste, which is common but usually settles after treatment ends; stomach upset such as nausea is also common and taking it with or without food as advised can help. The single most important safety point is that maribavir must not be taken together with certain other CMV medicines, particularly ganciclovir and valganciclovir, because it can work against them and reduce their effect, so the team will not combine them. Maribavir also interacts with a number of other medicines, including some immunosuppressants used after transplant, and it can change their levels, so it is important to give a full list of everything you take. The team checks the virus levels during treatment, because the virus can sometimes become resistant to maribavir as well, and they will adjust treatment if needed.
Who should not take it / use with caution
- People who have had a serious allergic reaction to maribavir should not take it.
- It should not be combined with certain other CMV medicines such as ganciclovir and valganciclovir.
- It is used with care, and with attention to interactions, in people taking other transplant medicines, under specialist supervision.
Monitoring
- Checking the amount of CMV virus in the blood to see how well treatment is working.
- Watching for the virus becoming resistant, which can prompt a change of treatment.
- Monitoring levels of certain transplant medicines that maribavir can affect.
Side effects
- Taste disturbance, often a strange, bitter or metallic taste, which usually settles after treatment.
- Nausea, diarrhoea, vomiting or other stomach upset.
- Tiredness, and in some people changes in blood tests used to monitor treatment.
Key interactions
- It must not be combined with certain other CMV medicines, particularly ganciclovir and valganciclovir, as it can work against them.
- It can change the levels of some transplant immunosuppressants, so these may need closer monitoring.
- It interacts with several other medicines, so a full and up-to-date medicines list is important.
Available as: Tablets taken by mouth.
Answers
Maribavir: frequently asked questions
What is maribavir used for?
It is used to treat cytomegalovirus (CMV) infection in people who have had a transplant, usually when other CMV medicines have not worked or cannot be used, including when the virus is resistant.
Why does it give me a strange taste?
Taste disturbance, often a bitter or metallic taste, is a common side effect of maribavir that usually settles once the course of treatment has finished.
Can I take it with my other CMV medicine?
No. Maribavir should not be combined with certain other CMV medicines such as ganciclovir and valganciclovir, because it can work against them and reduce their effect.
Why does my team need my full medicines list?
Maribavir interacts with several other medicines, including some used after transplant, and can change their levels, so a complete list helps keep treatment safe.
How is it taken?
It is taken by mouth as tablets for a defined course, under the supervision of your specialist transplant or infection team, who check how well it is working.
Authoritative sources
- BNF
- NICE CKS
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