Ganciclovir Sodium (DHPG)



Ganciclovir Sodium (DHPG)





(gan sye’ kloe vir)

Cytovene, Vitrasert, Zirgan

PREGNANCY CATEGORY C


Drug class

Antiviral


Therapeutic Actions

Antiviral activity; inhibits viral DNA replication in cytomegalovirus (CMV).


Indications



  • IV and implant: Treatment of CMV retinitis in immunocompromised patients, including patients with AIDS


  • IV: Prevention of CMV disease in transplant recipients at risk for CMV disease


  • Ophthalmic: Treatment of acute herpetic keratitis


  • Unlabeled use: Treatment of other CMV infections in immunocompromised patients



Contraindications and Cautions



  • Contraindicated with hypersensitivity to ganciclovir or acyclovir, lactation.


  • Use cautiously with cytopenia, history of cytopenic reactions, impaired renal function, pregnancy.


Available Forms

Powder for injection—500 mg/vial; ocular implant—4.5 mg; ophthalmic gel—0.15%


Dosages

Adults



  • CMV retinitis: Initial dose, 5 mg/kg given IV at a constant rate over 1 hr, every 12 hr for 14–21 days. For maintenance, 5 mg/kg given by IV infusion over 1 hr once daily, 7 days/wk or 6 mg/kg once daily, 5 days/wk. Implant surgically placed in affected eye every 5–8 mo.


  • Prevention of CMV disease in transplant recipients: 5 mg/kg IV over 1 hr every 12 hr for 7–14 days; then 5 mg/kg/day IV once
    daily for 7 days/wk, or 6 mg/kg/day IV once daily for 5 days/wk. Duration depends on duration and degree of immunosuppression.

Patients 2 yr and older

Ophthalmic gel: 1 drop in affected eye(s) five times daily (approximately every 3 hr while awake) until ulcer heals. Maintenance dose, 1 drop three times daily for 7 days.

Pediatric patients

Safety and efficacy not established. Use only if benefit outweighs potential carcinogenesis and reproductive toxicity.

Patients with renal impairment































Initial IV dose CrCl (mL/min) Dose IV (mg/kg) Dosing Intervals
70 or more 5 12 hr
50–69 2.5 12 hr
25–49 2.5 24 hr
10–24 1.25 24 hr
<10 1.25 Three times/wk following hemodialysis































Maintenance CrCl (mL/min) Dose IV (mg/kg) Dosing Intervals
70 or more 5 24 hr
50–69 2.5 24 hr
25–49 1.25 24 hr
10–24 0.625 24 hr
<10 0.625 Three times/wk following hemodialysis

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Jul 21, 2016 | Posted by in NURSING | Comments Off on Ganciclovir Sodium (DHPG)

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