Adult Dosing
CMV prophylaxis
Treatment of CMV retinitis in immunocompromised patients
- 1000 mg PO tid; alt: 500 mg PO q3 hr while awake (6 doses/day) with food
Pediatric Dosing
- Safety and effectiveness in pediatrics have not been established
Renal Dose Adjustment (Based on CrCl)
- 50-69 mL/min: 1500 mg/day PO div daily-tid
- 25-49 mL/min: 1000 mg/day PO div daily-bid
- 10-24 mL/min: 500 mg PO daily
- <10 mL/min: 500 mg 3 times/wk; administer dose after following hemodialysis
Hepatic Dose Adjustment
- Hepatic impairment: Dose adjustments not defined
See Supplemental Patient Information
- Avoid administration of this drug if the absolute neutrophil count is <500 cells/µL or the platelet count is <25,000 cells/µL. Granulocytopenia, anemia and thrombocytopenia may occur in patients having therapy with this drug. Granulocytopenia usually occurs during the first 7-14 days of therapy but may occur at any time during treatment. Following discontinuation of this drug it may recover within 3-7 days. Colony-stimulating factors may increase neutrophil and WBC counts in patients receiving treatment for CMV retinitis
- At the recommended doses ganciclovir is associated with temporary or permanent inhibition of spermatogenesis
- This drug possesses potential for mutagenicity and teratogenicity. Advise women of childbearing potential to use effective contraception during treatment. Advise men to practice barrier contraception during and for at least 90 days following treatment with this drug
- Higher doses are associated with increasing toxicity. Provide adequate hydration during administration of this drug
- Take utmost care to infuse solutions containing this drug only into veins with adequate blood flow to permit rapid dilution and distribution
- Dose modification is essential on impairment of renal function
Cautions: Use cautiously in
- Renal impairment
- Myelosuppression
- History of cytopenic reactions to other drugs, chemicals or irradiation
Supplemental Patient Information
- Inform patients that granulocytopenia (neutropenia), anemia and thrombocytopenia may occur requiring dose modifications including discontinuation
Pregnancy Category:C
Breastfeeding: Unknown whether ganciclovir is excreted in human milk. Manufacturer advises mothers to discontinue nursing if they are receiving this drug.
