GANCICLOVIR (Systemic)
Some commonly used brand names are:
In the U.S.?
In Canada?
Another commonly used name is DHPG.
Category
Description
Ganciclovir (gan-SYE-kloe-vir) is an antiviral. Itis used to treat infections caused by viruses.
Ganciclovir is used to treat the symptoms of cytomegalovirus (CMV) infectionof the eyes in people whose immune system is not working fully. This includespatients with acquired immune deficiency syndrome (AIDS). Ganciclovir willnot cure this eye infection, but it may help to keep the symptoms from becomingworse. It is also used to help prevent CMV infection in patients who receiveorgan or bone marrow transplants, as well as in patients with advanced humanimmunodeficiency virus (HIV) infection. Ganciclovir may be used for otherserious CMV infections as determined by your doctor. However, it does notwork in treating certain viruses, such as the common cold or the flu.
This medicine may cause some serious side effects, including anemia andother blood problems. Before you begin treatment with ganciclovir, you andyour doctor should talk about the good this medicine will do as well as therisks of using it.
Ganciclovir is to be administered only by or under the supervision of yourdoctor. It is available in the following dosage forms:
Oral- Capsules (U.S. and Canada)
Parenteral- Injection (U.S. and Canada)
Before Receiving This Medicine
In deciding to use a medicine, the risks of taking the medicine must beweighed against the good it will do. This is a decision you and your doctorwill make. For ganciclovir, the following should be considered:
Allergies?Tell your doctor if you have ever had any unusual orallergic reaction to acyclovir or ganciclovir. Also tell your health careprofessional if you are allergic to any other substances, such as foods, preservatives,or dyes.
Pregnancy?Use of ganciclovir during pregnancy should be avoidedwhenever possible since ganciclovir has caused cancer and birth defects inanimal studies. The use of birth control is recommended during ganciclovirtherapy. Men should use a condom while receiving ganciclovir, and for at least90 days following treatment. Also, animal studies have shown that ganciclovircauses a decrease in fertility.
Breast-feeding?Breast-feeding should be stopped during treatmentwith this medicine because ganciclovir may cause serious unwanted effectsin nursing babies.
Children?Ganciclovir can cause serious side effects in anypatient. Therefore, it is especially important that you discuss with the child'sdoctor the good that this medicine may do as well as the risks of using it.
Older adults?Many medicines have not been studied specificallyin older people. Therefore, it may not be known whether they work exactlythe same way they do in younger adults or if they cause different side effectsor problems in older people. There is no specific information comparing useof ganciclovir in the elderly with use in other age groups.
Other medicines?Although certain medicines should not be usedtogether at all, in other cases two different medicines may be used togethereven if an interaction might occur. In these cases, your doctor may want tochange the dose, or other precautions may be necessary. When you are takingganciclovir, it is especially important that your health care professionalknow if you are taking any of the following:
- Amphotericin B by injection (e.g., Fungizone) or
- Antineoplastics (cancer medicine) or
- Antithyroid agents (medicine for overactive thyroid) or
- Azathioprine (e.g., Imuran) or
- Chloramphenicol (e.g., Chloromycetin) or
- Colchicine or
- Cyclophosphamide (e.g., Cytoxan) or
- Flucytosine (e.g., Ancobon) or
- Interferon (e.g., Intron A, Roferon-A) or
- Mercaptopurine (e.g., Purinethol) or
- Zidovudine (e.g., AZT, Retrovir)?Caution should be used ifthese medicines and ganciclovir are used together; receiving ganciclovir whileyou are using these medicines may make anemia and other blood problems worse
- Carmustine (e.g., BiCNU) or
- Cisplatin (e.g., Platinol) or
- Combination pain medicine containing acetaminophen and aspirin (e.g.,Excedrin) or other salicylates (with large amounts taken regularly) or
- Cyclosporine (e.g., Sandimmune) or
- Deferoxamine (e.g., Desferal) (with long-term use) or
- Gold salts (medicine for arthritis) or
- Inflammation or pain medicine, except narcotics, or
- Lithium (e.g., Lithane) or
- Other anti-infectives (e.g., amphotericin B) or
- Penicillamine (e.g., Cupramine) or
- Streptozocin (e.g., Zanosar) or
- Tiopronin (e.g., Thiola)?Use of these medicines may increasethe chance of side effects affecting the kidneys
- Methotrexate (e.g., Mexate) or
- Plicamycin (e.g., Mithracin)?These medicines may increase thechance of side effects affecting the blood and the kidneys
Other medical problems?The presence of other medicalproblems may affect the use of ganciclovir. Make sure you tell your doctorif you have any other medical problems, especially:
- Kidney disease?Ganciclovir may build up in the blood in patientswith kidney disease, increasing the chance of side effects
- Low platelet count or
- Low white blood cell count?Ganciclovir may make these blooddiseases worse
Proper Use of This Medicine
It is important that you take ganciclovir capsules with food.This is to make sure the medicine is fully absorbed into the body and willwork properly.
To get the best results, ganciclovir must be givenfor the full time of treatment. Also, this medicine works best whenthere is a constant amount in the blood. To help keep the amount constant,ganciclovir must be given on a regular schedule.
Dosing?The dose of ganciclovir will be different fordifferent patients. Follow your doctor's orders or thedirections on the label. The following information includes only theaverage doses of ganciclovir. If your dose is different,do not change it unless your doctor tells you to do so.
- For oral dosage form (capsules):
- For treatment of CMV retinitis after you have received ganciclovirinjection for at least fourteen to twenty-one days:
- Adults and teenagers?1000 milligrams (mg) three times a daywith food; or 500 mg six times a day, every three hours with food, duringwaking hours.
- Children?Use and dose must be determined by your doctor.
- For prevention of CMV disease in transplant patients and patientswith advanced HIV infection:
- Adults and teenagers?1000 mg three times a day with food.
- Children?Use and dose must be determined by your doctor.
- For injection dosage form:
- For treatment of CMV retinitis:
- Adults and teenagers?Dose is based on body weight and mustbe determined by your doctor. At first, 5 mg per kilogram (2.3 mg per pound)of body weight is injected into a vein every twelve hours for fourteen totwenty-one days. Then, 5 mg per kilogram (2.3 mg per pound) of body weightis injected into a vein once a day for seven days of the week; or 6 mg perkilogram (2.7 mg per pound) of body weight is injected into a vein once aday for five days of the week.
- Children?Use and dose must be determined by your doctor.
- For prevention of CMV in transplant patients:
- Adults and teenagers?Dose is based on body weight and mustbe determined by your doctor. At first, 5 mg per kilogram (2.3 mg per pound)of body weight is injected into a vein every twelve hours for seven to fourteendays. Then the dose is reduced to 5 mg per kilogram (2.3 mg per pound) ofbody weight once a day for seven days of the week; or 6 mg per kilogram (2.7mg per pound) of body weight is injected into a vein once a day for five daysof the week.
- Children?Use and dose must be determined by your doctor.
Precautions After Receiving This Medicine
Ganciclovir can lower the number of white blood cells in your blood, increasingthe chance of getting an infection. It can also lower the number of platelets,which are necessary for proper blood clotting. If this occurs, there are certainprecautions you can take to reduce the risk of infection or bleeding:
- Check with your doctor immediately ifyou think you are getting an infection or if you get a fever or chills.
- Check with your doctor immediately ifyou notice any unusual bleeding or bruising; black, tarry stools; blood inurine or stools; or pinpoint red spots on your skin.
- Be careful when using a regular toothbrush, dental floss, or toothpick.Your medical doctor, dentist, or nurse may recommend other ways to clean yourteeth and gums. Check with your medical doctor before having any dental workdone.
- Be careful not to cut yourself when you are using sharp objects suchas a safety razor or fingernail or toenail cutters.
The use of birth control is recommended for both menand women. Women should use effective birth control methods while receivingthis medicine. Men should use a condom during treatment with this medicineand for at least 90 days after treatment has been completed.
It is very important that your doctor check you atregular visits for any blood problems that may be caused by this medicine.
If you have CMV retinitis: It is also very importantthat your ophthalmologist (eye doctor) check your eyes at regular visitssince it is still possible that you may have some loss of eyesight duringganciclovir treatment.
Side Effects of This Medicine
Along with its needed effects, a medicine may cause some unwanted effects.Although not all of these side effects may occur, if they do occur they mayneed medical attention.
Medicines like ganciclovir can sometimes cause serious side effects suchas blood problems; these are described below. Discuss these possible effectswith your doctor.
Check with your doctor immediately if any ofthe following side effects occur:
Other sideeffects may occur that usually do not need medical attention. These side effectsmay go away during treatment as your body adjusts to the medicine. However,check with your doctor if any of the following side effects continue or arebothersome:
Other side effects not listed above may also occur insome patients. If you notice any other effects, check with your doctor.
Revised: 04/04/2001
