GANCICLOVIR

Indications & Dose:

Life-threatening or sight-threatening cytomegalovirus infections in immunocompromised patients only; prevention of cytomegalovirus disease during immunosuppressive therapy following organ transplantation; local treatment of CMV retinitis. 

• BY  INJECTION :

Adults & Children:

Above 3 months age: By IV infusion, initially (induction) 5 mg/ kg every 12 hours for 14-21 days for treatment or for 7-14 days for prevention; maintenance (for patients at risk of relapse of retinitis) 6 mg/kg daily on 5 days per week or 5 mg/ kg daily until adequate recovery of immunity; if retinitis progresses initial induction treatment may be repeated.

• BY MOUTH
  

CMV disease: 1000mg 3 times daily or 500 mg 6 times daily. 

Contraindications:

Pregnancy. Ensure effective contraception during treatment and barrier contraception for men during and for at least 90 days after treatment. Breast-feeding; hypersensitivity to ganciclovir or aciclovir, abnormally low haemoglobin, neutrophil, or platelet counts. 

Side Effects:

Cautions:

Precautions:

Close monitoring of full blood count; history of cytopenia; low platelet count; potential carcinogen and teratogen; renal impairment; radiotherapy; ensure adequate hydration during intravenous administration; Vesicant-infuse into vein with adequate flow preferably using plastic cannula; children (possible risk of long-term carcinogenic or reproductive toxicity-not for neonatal or congenital cytomegalovirus disease).

Interaction:

Myelosuppresants, zidovudine, dida-nosine, imipenem, probenecid. 

Warnings:

Adverse Effects:

Diarrhoea, nausea, vomiting, dyspepsia, abdominal pain, constipation, flatulence, dysphagia, hepatic dysfunction; dyspnoea, chest pain, cough; headache, insomnia, convulsions, dizziness, neuropathy, depression, anxiety, confusion, abnormal thinking, fatigue, weight loss, anorexia; infection, fever, night sweats; anaemia, leucopenia, thrombocytopenia, pancytopenia, renal impairment; myalgia, arthralgia; macular oedema, retinal detachment, vitreous floaters, eye pain; ear pain, taste disturbance; dermatitis, pruritus; injection-site reactions; less commonly mouth ulcers, pancreatitis, arrhythmias, hypotension, anaphylactic reactions, psychosis, tremor, male infertility, haematuria, disturbances in hearing and vision, and alopecia. 

Lactations:

PREGNANCY C (Risk cannot be ruled out), LACTATION v (Contraindicated or not recommended). 

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

Patient And Carer Advice: