Ganciclovir
General Information
Special restricted formulary antimicrobial: For details see OUH netFormulary
IV ganciclovir requires manufacture by a specialist aseptic service unit. Contact the ward pharmacist as soon as the decision to treat with ganciclovir is made.
Renal and hepatic impairment
Renal impairment
In oncology/ haematology settings use the regimen in the table below:
|
eGFR (mL/min/1.73m2) |
Induction dose (up to the first 14-21 days of treatment) |
Maintenance dose (after induction therapy) |
|
over 70 |
5mg/kg every 12 hours |
5mg/kg every 24 hours |
|
50-69 |
2.5mg/kg every 12 hours |
2.5mg/kg every 24 hours |
|
25-49 |
2.5mg/kg every 24 hours |
1.25mg/kg every 24 hours |
|
10-24 |
1.25mg/kg every 24 hours |
0.625mg/kg every 24 hours |
|
less than 10 or HD/CAPD |
1.25mg/kg every 24 hours three times a week after haemodialysis |
0.625mg/kg three times a week (For HD /CAPD- give after haemodialysis) |
In renal/ transplant/ infectious diseases settings use the regimen in the table below:
|
eGFR (mL/min/1.73m2) |
Treatment dose |
|
over 50 |
5mg/kg every 12 hours |
|
25-50 |
2.5mg/kg every 12 hours |
|
10-24 |
2.5mg/kg every 24 hours |
|
less than 10 or HD/CAPD |
1.25mg/kg every 24 hours It is removed by haemodialysis- so give after haemodialysis on haemodialysis days |
When dose adjusting, round +/- to the nearest 10mg.
Hepatic impairment
No information available for use in hepatic impairment.
Pregnancy and breastfeeding
Discuss with pharmacy.
Additional information
- Cytotoxic precautions required for administration.
- Risk of myelosuppression – monitor FBC before and during treatment. See local protocols for further advice.
References
- Renal Drug Database. Ganciclovir. Accessed via renaldrugdatabse.com 17/12/18; last updated 21/12/17
- BNF online accessed via www.medicinescomplete.com 17/12/18; last updated 31/5/18