Letermovir
Letermovir is an antiviral medication used to prevent cytomegalovirus (CMV) infection in adult transplant recipients, including those undergoing hematopoietic stem cell or solid organ transplantation. It belongs to a class of CMV antivirals and works by targeting the CMV terminase complex, which is essential for viral replication. This medication is available in both oral and intravenous formulations for prophylaxis.
Letermovir is a CMV-targeting antiviral used to prevent cytomegalovirus infection in adult transplant patients.
Key facts at a glance
- ATC
- J05AX18
- RxNorm
- 1988648
- Generic
- Letermovir
- Class
- atc-j05
- Brands
- Prevymis
- Availability
- rx
- Lactation
- unknown
- Routes
- oral
- Forms
- injection, tablet
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 480mg once daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- weight-based: 480mg once daily (≥50kg) or 240mg once daily (<50kg)
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 480mg once daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
10 groupspregnancy
first trimesteravoid if possible
use only if potential benefits outweigh potential risks to the fetus
regular fetal monitoring and ultrasound examinations
Use with caution and monitor for adverse effects.
pregnancy
second trimesteravoid if possible
use only if potential benefits outweigh potential risks to the fetus
regular fetal monitoring and ultrasound examinations
Use with caution and monitor for adverse effects.
pregnancy
third trimesteravoid if possible
use only if potential benefits outweigh potential risks to the fetus
regular fetal monitoring and assessment of fetal growth
Use with caution and monitor for adverse effects.
lactation
not applicableno adjustment
discontinue breastfeeding or discontinue drug; decision should be made considering importance of drug to mother
monitor infant for adverse effects
geriatric
over 65 yearsno adjustment
no dose adjustment required based on population PK analysis
routine monitoring of renal function
pediatric_age
0 to 18 yearsnot recommended
not approved for use in patients under 18 years of age; safety and efficacy not established
not applicable
renal_impairment
mild to moderateno adjustment
no dose adjustment required for mild to moderate renal impairment
routine renal function monitoring
renal_impairment
severeno adjustment
no dose adjustment required; not significantly removed by dialysis
monitor renal function closely
Use with caution and monitor for adverse effects.
hepatic_impairment
mild to moderateno adjustment
no dose adjustment required for mild to moderate hepatic impairment
routine liver function monitoring
hepatic_impairment
severeuse with caution
not studied in severe hepatic impairment; use only if benefits outweigh risks
closely monitor liver function
Statistics and clinical data
Drug class
Drug class information for Letermovir
Common uses
Therapeutic indication for Letermovir
FDA approval year
FDA approval timeline for Letermovir (Prevymis)
Mechanism of action
Molecular mechanism of antiviral action
Prevention of cytomegalovirus (CMV) infection and disease in adult recipients of allogeneic hematopoietic stem cell transplants or solid organ transplants who are at risk for CMV reactivation.
Letermovir inhibits the CMV terminase complex (comprising pUL51, pUL56, and pUL89 proteins), which is required for viral DNA processing and packaging into infectious virions, thereby preventing viral replication.
Not indicated for treatment of existing CMV disease; use with caution in patients with renal or hepatic impairment; may cause gastrointestinal side effects; drug interactions possible with certain immunosuppressants and antiarrhythmics.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy