Uses

Ganciclovir is indicated for the treatment of cytomegalovirus (CMV) retinitis in immunocompromised adults, including those with AIDS. It is also used for the prevention of CMV disease in adult transplant recipients who are at risk.

Do not use if

Contraindicated in patients with a history of clinically significant hypersensitivity reactions, including anaphylaxis, to ganciclovir, valganciclovir, or any component of the formulation.

Side effects

Serious adverse effects include granulocytopenia, anemia, thrombocytopenia, and pancytopenia. Renal impairment may also occur. Mutagenic and carcinogenic potential has been noted in preclinical studies.

Warnings

Hematologic toxicity including granulocytopenia and thrombocytopenia requires close monitoring. Ganciclovir is associated with impairment of fertility and fetal toxicity; it should not be used during pregnancy unless benefits outweigh risks. Mutagenic and carcinogenic potential necessitates caution.

How it works

Ganciclovir is a deoxynucleoside analogue that inhibits CMV DNA polymerase. After phosphorylation, it competitively inhibits viral DNA synthesis and is incorporated into viral DNA, causing chain termination. Intravenous administration provides predictable pharmacokinetics with measurable peak plasma concentrations.

Storage

Store intact vials at controlled room temperature 20–25°C (68–77°F). Reconstituted solution may be stored in the vial at 25°C (77°F) for no longer than 12 hours; do not refrigerate or freeze reconstituted solution.