Ganciclovir

Ganciclovir is a synthetic nucleoside analogue of guanine closely related to aciclovir.

Indications

Treatment & suppression of life threatening or slight threatening cytomegalovirus infections in immuno compromised patients, including those with AIDS and those with iatrogenic immunosuppression associated with organ transplantation or chemo therapy of neoplastic disease.

Dosage

Adult: For immunocompromised and advanced HIV patients: 1g tid with food.

Contra-Indications

Hypersensitivity absolute neutrophil count below 500 cells/mm3; platelet count below 25,000/ mm3 ; pregnancy and lactation. Not to be administered as a bolus injection.

Special Precautions

Renal impairment; preexisting cytopaenias or history of cytopaenic reactions to drugs;child; contraceptive precautions to be followed during and at least 90 days thereafter; care in administering only into veins with good blood flow. Avoid contact with the skin and eyes.

Side Effects

Haematolgical disturbances; marrow depression; GI disturbances; fever, rash and abnormal liver function tests; irritation and phloebitis at injection site. Less frequent: CV, CNS. metabolic, musculoskeletal, respiratory, urogenital, ocular effects, cutaneous symptoms and increased serum-creatinine and BUN concentration. Potential risk of testicular effects and female fertility.

Drug Interactions

Renal clearance reduced by probenecid; imipenem-cilastatin(generalised seizures); zidovudine;didanosine; additive toxic effects with myelosuppressants;oral mycophenolate mofetil.