Ganciclovir

C. diff Risk

None

Oral Bioavailability

NA

Approximate Cost

$$$$

Dosing

Adult

Induction
5 mg/kg IV q12h

Maintenance
5 mg/kg IV q24h

Hepatic

No hepatic dose adjustment

General Information

Common Usage

Treatment and prophylaxis of CMV disease in immunocompromised hosts

Drug Monitoring

Laboratory

  • BMP & CBC weekly

Clinical

  • Mental status changes/seizures

  • ┬áHematuria reported in cases of overdose

Adverse Effects

Common

  • ┬áHematologic toxicity (neutropenia > thrombocytopenia) - reversible

  • Carcinogenic/teratogenic

Rare

  • Anemia

  • Rash

  • CNS toxicity (headache, seizure, confusion)

  • GI intolerance

  • Hepatotoxicity

Major Interactions

Imipenem/cilastatin: increase risk of seizure when given with ganciclovir/valganciclovir;

Cyclosporine and Amphotericin B: enhanced nephrotoxic effects of cyclosporine and amphotericin B when co administered with ganciclovir/valganciclovir;

Mycophenolate: increased serum concentration of ganciclovir/valganciclovir when co-adminstered.

Additional Information

Teratogenic/carcinogenic - avoid direct skin and/or mucous membrane contact with gancoclovir solution

Pharmacology

Antimicrobial class: Antiviral - Synthetic Guanine Analog

Pregnancy category: C

Average serum half life: 4 hours

Biliary penetration: Moderate

CSF penetration: Moderate/High

Lung penetration: Moderate

Urine penetration: High