Ganciclovir: Difference between revisions
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==Administration== | ==Administration== | ||
*Type: Antiviral | *Type: [[Antiviral]] | ||
*Routes of Administration: IV, PO | *Routes of Administration: IV, PO | ||
*Common Trade Names: Cytovene | *Common Trade Names: Cytovene | ||
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==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: C | ||
*[[Lactation risk categories|Lactation risk]]: | *[[Lactation risk categories|Lactation risk]]: Infant risk cannot be ruled out | ||
===Renal Dosing=== | ===Renal Dosing=== | ||
*IV route, induction treatment: CrCl 50-69: 2.5mg/kg q12h; CrCl 25-49: 2.5mg/kg q24h; CrCl 10-24: 1.25mg/kg q24h; CrCl <10: 1.25mg/kg 3x/wk; HD: give dose after dialysis, no supplement | *IV route, induction treatment: CrCl 50-69: 2.5mg/kg q12h; CrCl 25-49: 2.5mg/kg q24h; CrCl 10-24: 1.25mg/kg q24h; CrCl <10: 1.25mg/kg 3x/wk; HD: give dose after dialysis, no supplement | ||
*IV route, maintenance treatment: CrCl 50-69: 2.5mg/kg q24h; CrCl 25-49: 1.25mg/kg q24h; CrCl 10-24: 0.625mg/kg q24h; CrCl <10: 0.625mg/kg 3x/wk; HD: give dose after dialysis, no supplement | *IV route, maintenance treatment: CrCl 50-69: 2.5mg/kg q24h; CrCl 25-49: 1.25mg/kg q24h; CrCl 10-24: 0.625mg/kg q24h; CrCl <10: 0.625mg/kg 3x/wk; HD: give dose after dialysis, no supplement | ||
*PO route: CrCl 50-69: 1500mg/day divided | *PO route: CrCl 50-69: 1500mg/day divided QD-tid; CrCl 25-49: 1000mg/day divided QD-bid; CrCl 10-24: 500mg QD; CrCl <10: 500mg 3x/wk; HD: give dose after dialysis, no supplement | ||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
* ANC < 500 | |||
*ANC <500 | * Platelets < 25,000 | ||
* | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
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*[[fever]] | *[[fever]] | ||
*[[leukopenia]] | *[[leukopenia]] | ||
* | *anorexia | ||
*[[vomiting]] | *[[vomiting]] | ||
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[[Category:Pharmacology]] | [[Category:Pharmacology]] | ||
[[Category:ID]] | |||
Latest revision as of 20:06, 22 September 2019
Administration
- Type: Antiviral
- Routes of Administration: IV, PO
- Common Trade Names: Cytovene
Adult Dosing
- CMV prophylaxis, solid organ transplant
- IV route: 5mg/kg IV q12h x7-14 days, then 5mg/kg IV q24h or 6mg/kg IV 5x/wk
- PO route: 1000mg PO tid, give with food
- CMV prophylaxis, HIV-assoc.
- IV route: 5mg/kg IV 5-7x/wk; Info: not 1st-line agent
- PO route: 1000mg PO tid; Info: not 1st-line agent; give with food
- CMV retinitis, immunocompromised patients
- Induction treatment: 5mg/kg IV q12h x14-21 days; Info: not 1st-line agent
- Maintenance treatment, IV route: 5mg/kg IV 5-7x/wk; Alt: 6mg/kg IV 5x/wk; Info: not 1st-line agent
- Maintenance treatment, PO route: 1000mg PO tid; Alt: 500mg PO q3h while awake (6 doses/day); Info: not 1st-line agent; give with food
Pediatric Dosing
Off label use as pediatric medication
- CMV prophylaxis, solid organ transplant
- Induction: 5mg/kg IV q12h x7-14 days
- Maintenance: 5mg/kg IV q24h; Alt: 6mg/kg IV 5x/wk
- CMV prophylaxis, HIV-assoc
- 5mg/kg IV q24h
- CMV infection
- Induction: 5mg/kg IV q12h x14-21 days; Info: may increase dose to 7.5mg/kg IV q12h
- Maintenance: 5mg/kg IV q24h; Alt: 6mg/kg IV 5x/wk
- CMV infection, congenital (<1 mo)
- 6mg/kg IV q12h x6wk
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk cannot be ruled out
Renal Dosing
- IV route, induction treatment: CrCl 50-69: 2.5mg/kg q12h; CrCl 25-49: 2.5mg/kg q24h; CrCl 10-24: 1.25mg/kg q24h; CrCl <10: 1.25mg/kg 3x/wk; HD: give dose after dialysis, no supplement
- IV route, maintenance treatment: CrCl 50-69: 2.5mg/kg q24h; CrCl 25-49: 1.25mg/kg q24h; CrCl 10-24: 0.625mg/kg q24h; CrCl <10: 0.625mg/kg 3x/wk; HD: give dose after dialysis, no supplement
- PO route: CrCl 50-69: 1500mg/day divided QD-tid; CrCl 25-49: 1000mg/day divided QD-bid; CrCl 10-24: 500mg QD; CrCl <10: 500mg 3x/wk; HD: give dose after dialysis, no supplement
Contraindications
- Allergy to class/drug
- ANC < 500
- Platelets < 25,000
Adverse Reactions
Serious
- thrombocytopenia
- neutropenia
- pancytopenia
- sepsis
- nephrotoxicity
- seizures
- retinal detachment
- hypertension
- pancreatitis
Common
- diarrhea
- fever
- leukopenia
- anorexia
- vomiting
Pharmacology
- Half-life: 3hr
- Metabolism: CYP450
- Excretion: Urine
Mechanism of Action
Inhibits DNA polymerase and incorporates into viral DNA
Comments
See Also
References
Epocrates, UpToDate