Ganciclovir

C difficile risk
None
Oral Bioavailability
N/A

Dosing

CrCl ≥70CrCl 50-69- Induction: 5 mg/kg IV q12h

  • Maintenance: 5 mg/kg IV q24h- Induction: 2.5 mg/kg IV q12h

  • Maintenance: 2.5 mg/kg IV q24h

CrCl 30-49CrCl 10-29CrCl <10- Induction: 2.5 mg/kg IV q24h

  • Maintenance: 1.25 mg/kg IV q24h- Induction: 1.25 mg/kg IV q24h

  • Maintenance: 0.625 mg/kg IV q24h- Induction: 1.25 mg/kg IV 3 times weekly

  • Maintenance: 0.625 mg/kg IV 3 times weekly

  • Induction: 1.25 mg/kg IV 3 times weekly following dialysis, if receiving dialysis three times weekly

  • Maintenance: 0.625 mg/kg IV 3 times weekly following dialysis, if receiving dialysis three times weekly

General Information

CMV treatment and prophylaxis/maintenace

Monitor CBC for cytopenias and creatinine

  • Cytopenias (usually responds to G-CSF)

  • Hyperhidrosis

  • GI upset

  • Diarrhea

  • Increased creatinine

Mycophenolate can increase ganciclovir concentration

  • Valganciclovir is the prodrug of ganciclovir

  • Resistance can occur; if suspected, consult ID

Antimicrobial class: Antiviral. Nucleoside analogue.

Pregnancy category: C
(US Black Box warning: Based on animal data and limited human data, ganciclovir has the potential to cause birth defects and may cause temporary or permanent inhibition of spermatogenesis in males and suppression of fertility in females.)

Average serum half life: 3.5 hours

CSF penetration: Therapeutic