Ganciclovir

Should be taken with food.

Hypersensitivity to ganciclovir or valganciclovir and other antivirals (e.g. aciclovir, valaciclovir).

Patient w/ pre-existing cytopenias or a history of cytopenic reactions to other drugs, chemicals or radiation therapy. Renal impairment. Pregnancy and lactation. Patient Counselling This drug may cause convulsion, sedation, ataxia and/or confusion, if affected, do not drive or operate machinery. Monitoring Parameters Monitor haematological function (CBC w/ differential and platelet count), serum creatinine.

Haematologic effects (e.g. neutropenia, thrombocytopenia, anaemia, eosinophilia); headache, seizure, coma, confusion, thought disorders, dysphoria, agitation, hallucinations, abnormal dreams/nightmares, nervousness/anxiety, delirium, dizziness, dysaesthesia, asthenia, intention tremor, abnormal reflexes, ataxia, paraesthesia, psychosis, somnolence, obtundation; elevated serum aminotransferase and alkaline phosphatase levels; nausea, vomiting, diarrhoea, anorexia, GI haemorrhage, abdominal pain; increased serum creatinine and BUN levels, haematuria; inflammation, phlebitis and/or pain at inj site; burning or brief tingling sensations, superficial punctate keratitis, visual disturbance (ophth); fever, rash, oedema, myalgia, chills, malaise, cardiac arrhythmia, MI, cardiac arrest, HTN, hypotension, hypoglycaemia, dyspnoea, alopecia, urticaria, pruritus, hyponatraemia, deafness, syndrome of inappropriate secretion of antidiuretic hormone (SIADH).

Increased risk of haematologic toxicity w/ zidovudine. May increase serum levels of didanosine. Increased serum concentration w/ probenecid and other drugs that inhibit renal tubular secretion and resorption. Use of IV ganciclovir w/ oral mycophenolate mofetil may result in increased plasma concentrations of both drugs due to competition for renal tubular secretion. Concomitant use w/ immunosuppressive agents (e.g. azathioprine, ciclosporin, corticosteroids) may result in excessive suppression of bone marrow or the immune system. Generalised seizure may occur when taken w/ imipenem and cilastatin. Concurrent use w/ drugs that inhibit replication of rapidly dividing cells (e.g. dapsone, pentamidine, pyrimethamine, flucytosine, cytotoxic antineoplastic agents, amphotericin B, co-trimoxazole, other nucleoside analogues) may result in additive toxicity.

Antivirals

J05AB06 - ganciclovir ; Belongs to the class of nucleosides and nucleotides excluding reverse transcriptase inhibitors. Used in the systemic treatment of viral infections.
S01AD09 - ganciclovir ; Belongs to the class of antiinfectives, antivirals. Used in the treatment of eye infections.