Ganciclovir

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Definition
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Half-life
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3 h

Indication
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Life threatening infections with the cytomegalovirus, especially CMV retinitis in AIDS.

Limited indication
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Pregnancy, nursing, renal failure.

Dosage and method of use
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5 mg/kg bw/day i.v. over 3 weeks, followed by maintenance therapy with 6 mg/kg bw i.v. 5 days/week or 3 times/day 4 cps. at 250 mg p.o., if necessary alternating with foscarnet for 14 days.

Remember! The infusion must always be administered over one hour to keep NW low!

Undesirable effects
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Severe neutropenia (correction of neutropenia with granulocyte colony stimulating factor and dose reduction by 30-50%, discontinuation at < 500/μl), thrombopenia, fever, headache, allergic reactions, gastrointestinal complaints, hyperhidrosis.

Notice! Under therapy and up to 3 months after discontinuation of the preparation, men and women must practice effective contraception!

Interactions
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See Table 1.

Contraindication
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Neutropenia (< 500 cells/μl), thrombopenia (< 25,000 cells/μl), cytostatic therapy.

Preparations
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Cymeven

Tables
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Major interactions of ganciclovir

amphotericin B

Haematotoxicity ↑

Cephalosporins

cerebral seizures ↑

Cotrimoxazole

Haematotoxicity ↑

Dapson

Haematotoxicity ↑, cerebral Krampfanfälle↑

Didanosine

frequent pancreatitis, anaemia, blood formation disorders

Doxorubicin

Haematotoxicity ↑

Flucytosine

Haematotoxicity ↑

β lactam antibiotics

cerebral seizures ↑

Pentamidine i.v.

hematotoxicity ↑

Zidovudine

Haematotoxicity ↑

Cytostatics

Haematotoxicity ↑

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Last updated on: 29.10.2020