Ganciclovir: Difference between revisions
(Ganciclovir peds dosing) |
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==Adult Dosing== | ==Adult Dosing== | ||
*CMV prophylaxis, solid organ transplant | *[[CMV]] prophylaxis, solid organ transplant | ||
**IV route: 5 mg/kg IV q12h x7-14 days, then 5 mg/kg IV q24h or 6 mg/kg IV 5x/wk | **IV route: 5 mg/kg IV q12h x7-14 days, then 5 mg/kg IV q24h or 6 mg/kg IV 5x/wk | ||
**PO route: 1000 mg PO tid, give w/ food | **PO route: 1000 mg PO tid, give w/ food | ||
*CMV prophylaxis, HIV-assoc. | *[[CMV]] prophylaxis, HIV-assoc. | ||
**IV route: 5 mg/kg IV 5-7x/wk; Info: not 1st-line agent | **IV route: 5 mg/kg IV 5-7x/wk; Info: not 1st-line agent | ||
**PO route: 1000 mg PO tid; Info: not 1st-line agent; give w/ food | **PO route: 1000 mg PO tid; Info: not 1st-line agent; give w/ food | ||
*CMV retinitis, immunocompromised pts | *[[CMV]] retinitis, immunocompromised pts | ||
**Induction tx: 5 mg/kg IV q12h x14-21 days; Info: not 1st-line agent | **Induction tx: 5 mg/kg IV q12h x14-21 days; Info: not 1st-line agent | ||
**Maintenance tx, IV route: 5 mg/kg IV 5-7x/wk; Alt: 6 mg/kg IV 5x/wk; Info: not 1st-line agent | **Maintenance tx, IV route: 5 mg/kg IV 5-7x/wk; Alt: 6 mg/kg IV 5x/wk; Info: not 1st-line agent | ||
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*Off label use as pediatric medication | *Off label use as pediatric medication | ||
*CMV prophylaxis, solid organ transplant | *[[CMV]] prophylaxis, solid organ transplant | ||
**Induction: 5 mg/kg IV q12h x7-14 days | **Induction: 5 mg/kg IV q12h x7-14 days | ||
**Maintenance: 5 mg/kg IV q24h; Alt: 6 mg/kg IV 5x/wk | **Maintenance: 5 mg/kg IV q24h; Alt: 6 mg/kg IV 5x/wk | ||
*CMV prophylaxis, HIV-assoc: 5 mg/kg IV q24h | *[[CMV]] prophylaxis, HIV-assoc: 5 mg/kg IV q24h | ||
*CMV infection | *[[CMV]] infection | ||
**Induction: 5 mg/kg IV q12h x14-21 days; Info: may incr. dose to 7.5 mg/kg IV q12h | **Induction: 5 mg/kg IV q12h x14-21 days; Info: may incr. dose to 7.5 mg/kg IV q12h | ||
**Maintenance: 5 mg/kg IV q24h; Alt: 6 mg/kg IV 5x/wk | **Maintenance: 5 mg/kg IV q24h; Alt: 6 mg/kg IV 5x/wk | ||
*CMV infection, congenital (<1 mo): 6 mg/kg IV q12h x6wk | *[[CMV]] infection, congenital (<1 mo): 6 mg/kg IV q12h x6wk | ||
==Special Populations== | ==Special Populations== | ||
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==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*thrombocytopenia | *[[thrombocytopenia]] | ||
*neutropenia | *[[neutropenia]] | ||
*pancytopenia | *pancytopenia | ||
*sepsis | *[[sepsis]] | ||
*nephrotoxicity | *nephrotoxicity | ||
*seizures | *[[seizures]] | ||
*retinal detachment | *retinal detachment | ||
*HTN | *[[HTN]] | ||
*pancreatitis | *[[pancreatitis]] | ||
===Common=== | ===Common=== | ||
*diarrhea | *[[diarrhea]] | ||
*fever | *[[fever]] | ||
*leukopenia | *[[leukopenia]] | ||
*anorexia | *[[anorexia]] | ||
*vomiting | *[[vomiting]] | ||
==Pharmacology== | ==Pharmacology== | ||
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<references/> | <references/> | ||
[[Epocrates, UpToDate]] | [[Epocrates, UpToDate]] | ||
[[Category:Drugs]] | |||
Revision as of 12:04, 7 February 2016
Administration
- Type: Antiviral
- Routes of Administration: IV, PO
- Common Trade Names: Cytovene
Adult Dosing
- CMV prophylaxis, solid organ transplant
- IV route: 5 mg/kg IV q12h x7-14 days, then 5 mg/kg IV q24h or 6 mg/kg IV 5x/wk
- PO route: 1000 mg PO tid, give w/ food
- CMV prophylaxis, HIV-assoc.
- IV route: 5 mg/kg IV 5-7x/wk; Info: not 1st-line agent
- PO route: 1000 mg PO tid; Info: not 1st-line agent; give w/ food
- CMV retinitis, immunocompromised pts
- Induction tx: 5 mg/kg IV q12h x14-21 days; Info: not 1st-line agent
- Maintenance tx, IV route: 5 mg/kg IV 5-7x/wk; Alt: 6 mg/kg IV 5x/wk; Info: not 1st-line agent
- Maintenance tx, PO route: 1000 mg PO tid; Alt: 500 mg PO q3h while awake (6 doses/day); Info: not 1st-line agent; give w/ food
Pediatric Dosing
- Off label use as pediatric medication
- CMV prophylaxis, solid organ transplant
- Induction: 5 mg/kg IV q12h x7-14 days
- Maintenance: 5 mg/kg IV q24h; Alt: 6 mg/kg IV 5x/wk
- CMV prophylaxis, HIV-assoc: 5 mg/kg IV q24h
- CMV infection
- Induction: 5 mg/kg IV q12h x14-21 days; Info: may incr. dose to 7.5 mg/kg IV q12h
- Maintenance: 5 mg/kg IV q24h; Alt: 6 mg/kg IV 5x/wk
- CMV infection, congenital (<1 mo): 6 mg/kg IV q12h x6wk
Special Populations
Renal Dosing
- IV route, induction tx: CrCl 50-69: 2.5 mg/kg q12h; CrCl 25-49: 2.5 mg/kg q24h; CrCl 10-24: 1.25 mg/kg q24h; CrCl <10: 1.25 mg/kg 3x/wk; HD: give dose after dialysis, no supplement
- IV route, maintenance tx: CrCl 50-69: 2.5 mg/kg q24h; CrCl 25-49: 1.25 mg/kg q24h; CrCl 10-24: 0.625 mg/kg q24h; CrCl <10: 0.625 mg/kg 3x/wk; HD: give dose after dialysis, no supplement
- PO route: CrCl 50-69: 1500 mg/day divided qd-tid; CrCl 25-49: 1000 mg/day divided qd-bid; CrCl 10-24: 500 mg qd; CrCl <10: 500 mg 3x/wk; HD: give dose after dialysis, no supplement
Contraindications
- Allergy to class/drug
- hypersens. to acyclovir
- ANC <500
- Plt <25,000
Adverse Reactions
Serious
- thrombocytopenia
- neutropenia
- pancytopenia
- sepsis
- nephrotoxicity
- seizures
- retinal detachment
- HTN
- pancreatitis
Common
Pharmacology
- Half-life: 3hr
- Metabolism: CYP450
- Excretion: Urine
Mechanism of Action
Inhibits DNA polymerase and incorporates into viral DNA