Ganciclovir
CYTOVENE
What it isViral-kinase-activated guanosine analog inhibiting viral DNA polymerase; cytomegalovirus disease.
Why it mattersIt is the IV standard for sight- or organ-threatening CMV, where oral prophylactic agents are insufficient.
What it changesMyelosuppression requires frequent counts; renal adjustment, fetal toxicity, fertility impairment, and handling precautions matter.
FDA-approved for
- CMV (1989)
FDA label
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| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| CMV retinitis maintenance (immunocompromised) | Normal renal function | 1000 mg TID | 1000 mg TID or 500 mg every 3 h (6x/day, waking hours) | |
| CMV disease prevention (advanced HIV) | Adults | 1000 mg TID | 1000 mg TID | |
| CMV disease prevention (transplant recipients) | Adults | 1000 mg TID | 1000 mg TID |
Renal Reduce dose per creatinine clearance (e.g., CrCl ≥70: 1000 mg TID or 500 mg q3h); lower for reduced CrCl
Hepatic Undefined
Recommended dose should not be exceeded
Instructions
- Take with food
- Capsules must not be used for induction treatment
Contraindications
- Hypersensitivity to ganciclovir or acyclovir
Cautions
- Granulocytopenia, anemia, thrombocytopenia
- Risk of more rapid CMV retinitis progression with oral capsules vs IV
- Potential carcinogenicity/teratogenicity/impaired spermatogenesis
Adverse reactions
- Neutropenia
- Anemia
- Thrombocytopenia
- GI intolerance
Pregnancy Category C; embryotoxic and teratogenic in animals; use only if benefit justifies fetal risk
Lactation Undefined
⚠ BOXED WARNINGS
- Hematologic toxicity
- Impairment of fertility
- Fetal toxicity
- Mutagenesis and carcinogenesis
Cost, est. cash$10–$500/month
Generic entry2003
Classes and tags
Clinical profile
Legacy pregnancy categoryUnknown / historical label unavailable
Defining liabilityAgent-specific renal, hepatic, hematologic, metabolic and drug-interaction toxicity.
Mechanism of action: Ganciclovir ballicule
