Ganciclovir

C difficile risk
None
Oral Bioavailability
N/A
Cost
$30-60/d

Dosing

Defined criteria for use and/or important safety considerations. See below for more information.

  • Round to nearest 50 mg

  • Use adjusted body weight in obesity

5 mg/kg IV q12h

5 mg/kg IV q24h

CrCl ≥ 70 mL/minCrCl 50 - 69 mL/minCrCl 25 - 49 mL/minCrCl 10 - 24 mL/minCrCl < 10 mL/minNo renal adjustment required2.5 mg/kg IV q12h2.5 mg/kg IV q24h1.25 mg/kg IV q24h1.25 mg/kg IV 3 x /week

CrCl ≥ 70 mL/minCrCl 50 - 69 mL/minCrCl 25 - 49 mL/minCrCl 10 - 24 mL/minCrCl < 10 mL/minNo renal adjustment required2.5 mg/kg IV q24h1.25 mg/kg IV q24h0.625 mg/kg IV q24h0.625 mg/kg IV 3 x /week

CMV TreatmentCMV Prophylaxis/Maintenance1.25 mg/kg IV 3 x /week

  • Give dose after dialysis on HD days 0.625 mg/kg IV 3 x /week

  • Give dose after dialysis on HD days

CMV TreatmentCMV Prophylaxis/Maintenance1.25 mg/kg IV 3 x /week0.625 mg/kg IV 3 x /week

CMV TreatmentCMV Prophylaxis/Maintenance2.5 mg/kg IV q24h1.25 mg/kg IV q24h

General Information

CMV treatment and prophylaxis/maintenace

  • CBC for cytopenias

  • Creatinine

  • Cytopenias (usually responds to G-CSF)

  • Increased creatinine

  • Headache, insomnia, mental status changes

  • GI upset

  • Tremor

Mycophenolate can increase ganciclovir concentration

  • Valganciclovir is the prodrug of ganciclovir

  • Resistance can occur; if suspected, consult ID/Microbiology

Antimicrobial class: Antiviral. Nucleoside analogue.

Pregnancy category: C

Average serum half life: 3.5 hours

CSF penetration: Therapeutic

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