Precautions and warnings

Be careful if the patient has kidney problems or blood cell issues, or has had bad blood reactions to medicines before. This drug should be given only to children when necessary, and birth control should be used during treatment and for at least 90 days afterwards. Make sure to inject into veins with good blood flow. Avoid getting the drug on your skin or in your eyes. Keep the patient well-hydrated during the infusion. Regularly check white blood cell and platelet counts during treatment. For those being treated for CMV retinitis, have an eye exam every 4 to 6 weeks.

Drug Interactions

Using this medication with zidovudine increases the risk of blood-related side effects. It can also raise the levels of didanosine in the blood. Taking it with probenecid or other drugs that affect how the kidneys filter substances may also increase its concentration in your body. Using IV ganciclovir together with oral mycophenolate mofetil can cause higher levels of both drugs, as they compete to be removed by the kidneys. If you take this medication with immunosuppressants (like azathioprine, ciclosporin, or corticosteroids), your bone marrow or immune system could be overly suppressed. Taking it with imipenem and cilastatin can cause seizures. Using it together with other drugs that affect fast-growing cells (like dapsone, pentamidine, pyrimethamine, flucytosine, cancer drugs, amphotericin B, co-trimoxazole, or other nucleoside analogues) may increase the risk of serious side effects.

Mode of actions

Ganciclovir is a man-made medicine similar to one of the building blocks of DNA, called guanine. It works against a virus called cytomegalovirus (CMV). Ganciclovir blocks the action of an enzyme (DNA polymerase) that the virus needs to make new DNA, which stops the virus from multiplying.

Dosage & Administration

Adult: IV Cytomegaloviral infections Induction: 5 mg/kg 12 hrly for 14-21 days. Maintenance: 5 mg/kg once daily for 7 days/wk or 6 mg/kg once daily for 5 days/wk.

Prevention of cytomegaloviral infections in immunocompromised patients Initial: 5 mg/kg 12 hrly for 7-14 days. Maintenance: 5 mg/kg once daily for 7 days/wk or 6 mg/kg once daily for 5 days/wk.

Renal impairment: For dialysis patients: 1.25 mg/kg for induction or 0.625 mg/kg for maintenance, to be given postdialysis on days when dialysis is performed.

CrCl (ml/min)
10-24 1.25 mg/kg 24 hrly for induction, then 0.625 mg/kg 24 hrly for maintenance.
25-49 2.5 mg/kg 24 hrly for induction, then 1.25 mg/kg 24 hrly for maintenance.
50-69 2.5 mg/kg 12 hrly for induction, then 2.5 mg/kg 24 hrly for maintenance.
>70 5 mg/kg 12 hrly for induction, then 5 mg/kg 24 hrly for maintenance.

Ophth: Cytomegaloviral retinitis As intravitreal implant which can last for 5-8 mth: Use as directed.

Eye Gel: Instill 1 drop in the affected eye 5 times per day (approximately every 3 hours while awake) until the corneal ulcer heals and then 1 drop 3 times per day for 7 days.

Pregnancy & Lactation

Although animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in pregnant women, but during pregnancy, this medicine can be used just when definitely required despite potential risks.

Mothers with a newborn baby who have used this drug during the last 3 months of pregnancy may seldom create symptoms including drowsiness, muscle stiffness or shakiness, feeding or breathing troubles, constant crying. If you notice any of these symptoms of your baby's particularly during their first month, tell the doctor immediately.

This medicine passes into breast milk. Talk to your doctor before breastfeeding.

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