Absorption: 59.4% absorbed following oral administration, rapidly converted to ganciclovir.
Distribution: Unknown.
Metabolism/Excretion: Rapidly converted to ganciclovir; ganciclovir is mostly excreted by the kidneys.
Half-life: 4.1 hr (intracellular half-life of ganciclovir phosphate is 18 hr).
GI: abdominal pain, diarrhea, nausea, vomiting.
GU: ↓fertility, renal impairment.
Hemat: NEUTROPENIA, THROMBOCYTOPENIA, anemia, aplastic anemia, bone marrow depression, pancytopenia.
Neuro: ataxia, paresthesia, peripheral neuropathy , SEIZURES, headache, insomnia, agitation, confusion, dizziness, hallucinations, psychosis, sedation.
Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), INFECTION, fever.
Treatment of CMV Disease
- PO (Adults): Induction — 900 mg twice daily for 21 days; Maintenance treatment or patients with inactive CMV retinitis — 900 mg once daily.
Renal Impairment
- CCr 40–59 mL/min (Adults): Induction — 450 mg twice daily for 21 days; Maintenance treatment or patients with inactive CMV retinitis — 450 mg once daily.
Renal Impairment
- CCr 25–39 mL/min (Adults): Induction — 450 mg once daily for 21 days; Maintenance treatment or patients with inactive CMV retinitis — 450 mg every 2 days.
Renal Impairment
- CCr 10–24 mL/min (Adults): Induction — 450 mg every 2 days for 21 days; Maintenance treatment or patients with inactive CMV retinitis — 450 mg twice weekly.
Prevention of CMV Disease in Transplant Patients
- PO (Adults): Kidney/pancreas, or heart transplant — 900 mg once daily, starting 10 days prior to transplant and continued for 100 days after; Kidney transplant — 900 mg once daily, starting 10 days prior to transplant and continued for 200 days after.
Renal Impairment
- PO (Adults): CCr 40–59 mL/min — 450 mg once daily; CCr 25–39 mL/min — 450 mg every 2 days; CCr 12–24 mL/min — 450 mg twice weekly.
- PO (Children 4 mo-16 yr): Kidney transplant — Dose is based on body surface area (BSA) and CCr. Dose = 7 × BSA × CCr (see prescribing information for equations used for BSA and CCr); all calculated doses should be rounded to nearest 25 mg (max = 900 mg) and administered as oral solution; should be started 10 days prior to transplant and continued for 200 days after.
- PO (Children 4 mo-16 yr): Heart transplant — Dose is based on BSA and CCr. Dose = 7 × BSA × CCr (see prescribing information for equations used for BSA and CCr); all calculated doses should be rounded to nearest 25 mg (max = 900 mg) and administered as oral solution; should be started 10 days prior to transplant and continued for 100 days after.
Renal Impairment
- PO (Adults): CCr 40–59 mL/min — 450 mg once daily; CCr 25–39 mL/min — 450 mg every 2 days; CCr 12–24 mL/min — 450 mg twice weekly.
Therapeutic Classification: antivirals
(ganciclovir blood levels)
