Therapeutic Classification: antivirals
Absorption: 59.4% absorbed following oral administration, rapidly converted to ganciclovir.
Distribution: Widely distributed to tissues, including CSF.
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).
(ganciclovir plasma concentrations)
| ROUTE | ONSET | PEAK | DURATION |
|---|
| PO | rapid | 2 hr | 12–24 hr |
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.
- 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.
