Ganciclovir

The dose of ganciclovir is based on body weight. Ganciclovir is given as an intravenous (IV) infusion (injected slowly into the vein over a period of one hour). It is done in a hospital or clinic setting under the supervision of a health care professional. The dose will be determined by your doctor according to individual needs.

For treatment of CMV retinitis, the recommended starting dose of ganciclovir is 5 mg per kilogram of body weight, given every 12 hours for 14 to 21 days. After 2 to 3 weeks of treatment, ganciclovir may be given once daily as long as the disease does not progress.

For prevention of CMV disease in transplant recipients, the recommended starting dose of ganciclovir is 5 mg per kilogram of body weight, given every 12 hours for 7 to 14 days. After this time, ganciclovir may be given once daily. The length of treatment is determined by the doctor and depends on how long immunosuppressant medications are required.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important this medication be given exactly as recommended by your doctor. If you miss an appointment to receive ganciclovir, contact your doctor as soon as possible to reschedule your appointment.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Each 10 mL clear, glass vial of sterile powder contains ganciclovir sodium equivalent to 500 mg of ganciclovir. Nonmedicinal ingredient: sodium 46 mg (2 mEq).

Do not use Ganciclovir if you:

• are allergic to ganciclovir or any ingredients of Ganciclovir
• are allergic to valganciclovir, acyclovir, or Valacyclovir

There may be an interaction between ganciclovir and any of the following:

• abacavir
• adefovir
• didanosine
• emtricitabine
• entecavir
• imipenem
• lamivudine
• mycophenolate
• probenecid
• tenofovir
• Trimethoprim

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with Ganciclovir. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the Nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Before you begin using a medication, be sure to inform your doctor of any medical conditions or Allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use Ganciclovir.

Bleeding: Ganciclovir can cause a decrease in the number of platelets that are produced in the body. Platelets are responsible for forming clots. If you experience unusual bruising or bleeding, bleeding gums, unusual nosebleeds, stools that look like coffee grounds or blood in urine, contact your doctor as soon as possible.

Blood disorders: If you have any blood disorders (e.g., anemia, thrombocytopenia), discuss with your doctor how Ganciclovir may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Ganciclovir, and whether any special monitoring is needed.

Cancer: Although it has not been clearly demonstrated in humans, there is the possibility that ganciclovir might cause certain types of cancer. If you have concerns, discuss this with your doctor.

Drowsiness/reduced alertness: Ganciclovir may reduce alertness by causing drowsiness, dizziness, or confusion. Some people have had seizures while using Ganciclovir. Avoid hazardous activities such as driving or operating machinery until you know whether the medication affects your ability to perform such tasks.

Fertility: Ganciclovir may decrease fertility in both males and females, and these effects may persist after the medication has been stopped and may be permanent.

Kidney function: The kidneys remove ganciclovir from the body. People who have decreased kidney function may experience higher than expected levels of ganciclovir in the blood and therefore an increased level of side effects.

If you have reduced kidney function or Kidney Disease, discuss with your doctor how Ganciclovir may affect your medical condition, how your medical condition may affect the dosing and effectiveness of Ganciclovir, and whether any special monitoring is needed.

Red blood cells: Ganciclovir may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired, pale skin, decreased blood pressure or pounding heartbeat, contact your doctor as soon as possible.

Reduced white blood cells: Ganciclovir can cause low levels of white blood cells. This usually happens within 1 to 2 weeks of starting treatment. Your doctor should order regular blood tests to monitor for changes in the numbers of blood cells during treatment. If you experience symptoms of an infection (e.g., fever, sore throat) contact your doctor immediately.

Pregnancy: Ganciclovir should not be used during pregnancy because it can be harmful to the developing child. Women who are taking Ganciclovir should use an effective method of birth control (e.g., birth control pill, condoms) while they are taking Ganciclovir. Men who are taking Ganciclovir should use a barrier method of birth control (e.g., a condom) while they are using Ganciclovir, and for at least 90 days after stopping the medication.

Breast-feeding: It is not known if ganciclovir passes into breast milk. Due to the severity of side effects with ganciclovir and the risk of harm to the baby, women should not breast feed while they are using this medication.
Children: The safety and effectiveness of using this medication have not been established for children less than 12 years of age.

Seniors: The safety of using ganciclovir has not been established for seniors. Seniors are generally at an increased risk of side effects. Your doctor should closely monitor the effects of Ganciclovir when it is being given to a senior.