Ganciclovir: Difference between revisions
(Replace manual dosing with dynamic SMW tables (Adult + Pediatric))
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==Adult Dosing==
==Adult Dosing==
*[[CMV]] prophylaxis, solid organ transplant
===Indications by Disease===
**IV route: 5mg/kg IV q12h x7-14 days, then 5mg/kg IV q24h or 6mg/kg IV 5x/wk
{{#ask: [[Has DrugName::Ganciclovir]] [[Has Population::Adult]]
**PO route: 1000mg PO tid, give with food
|?Treats disease=Disease
 
|?Has Dose=Dose
*[[CMV]] prophylaxis, HIV-assoc.
|?Has Context=Context
**IV route: 5mg/kg IV 5-7x/wk; Info: not 1st-line agent
|format=table
**PO route: 1000mg PO tid; Info: not 1st-line agent; give with food
|limit=50
 
|mainlabel=-
*[[CMV]] retinitis, immunocompromised patients
|headers=show
**Induction treatment: 5mg/kg IV q12h x14-21 days; Info: not 1st-line agent
|sort=Treats disease
**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==
==Pediatric Dosing==
''Off label use as pediatric medication''
===Indications by Disease===
 
{{#ask: [[Has DrugName::Ganciclovir]] [[Has Population::Pediatric]]
*[[CMV]] prophylaxis, solid organ transplant
|?Treats disease=Disease
**Induction: 5mg/kg IV q12h x7-14 days
|?Has Dose=Dose
**Maintenance: 5mg/kg IV q24h; Alt: 6mg/kg IV 5x/wk
|?Has Context=Context
 
|format=table
*[[CMV]] prophylaxis, HIV-assoc
|limit=50
**5mg/kg IV q24h
|mainlabel=-
 
|headers=show
*[[CMV]] infection
|sort=Treats disease
**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==
==Special Populations==

Revision as of 01:52, 20 March 2026

Administration

  • Type: Antiviral
  • Routes of Administration: IV, PO
  • Common Trade Names: Cytovene

Adult Dosing

Indications by Disease

DiseaseDoseContext
CMV colitis5mg/kg IV q12hrs x 21 daysUntil symptom resolution
CMV neurologic disease5mg/kg IV q12hrs x 21 days then 5mg/kg IV q24hrsCombined with Foscarnet
CMV pneumonia5mg/kg IV q12hrs x 3 weeksCMV pneumonia
Encephalitis5mg/kg IV every 12hrCMV

Pediatric Dosing

Indications by Disease

DiseaseDoseContext
Encephalitis5mg/kg IV q12hrsPediatric CMV

Special Populations

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

Common

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

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