Ganciclovir interactions

Food & lifestyle

• high-fat foods

  Moderate

  Absorption

  Food delays but enhances the oral absorption and bioavailability of ganciclovir capsules, possibly due to prolongation of gastrointestinal transit time.

  What to do: To ensure maximal oral absorption, oral ganciclovir should be administered with or immediately after a meal.

  3 sources

  1. "Product Information. Cytovene (ganciclovir)." Genentech (2002):
  2. Lavelle J, Follansbee S, Trapnell CB, Buhles WC, Griffy KG, Jung D, Dorr A, Conner J "Effect of food on the relative bioavailability of oral ganciclovir." J Clin Pharmacol 36 (1996): 238-41
  3. Jung D, Griffy K, Dorr A "Effect of food on high-dose oral ganciclovir disposition in HIV-positive subjects." J Clin Pharmacol 39 (1999): 161-5

Conditions

Conditions in which Ganciclovir needs care, as documented in this source.

• Bone Marrow Failure Disorders

  Major

  The use of ganciclovir is commonly associated with bone marrow toxicity. Neutropenia, anemia and thrombocytopenia have been reported. Therapy with ganciclovir should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Routine blood counts are recommended, and dosing adjusted or discontinued accordingly. Ganciclovir should not be used in patients with an absolute neutrophil count < 500/mcL or a platelet count < 25,000/mcL. Some neutropenic patients requiring ganciclovir may be candidates for granulocyte colony stimulating factor.

  4 sources

  1. Faulds D, Heel RC "Ganciclovir: a review of its antiviral activity, pharmacokinetic properties and therapeutic efficacy in cytomegalovirus infections." Drugs 39 (1990): 597-638
  2. SOCA Reseach Group, et al. "Mortality in patients with the acquired immunodeficiency syndrome treated with either foscarnet or ganciclovir for cytomegalovirus retinitis." N Engl J Med 326 (1992): 213-20
  3. Sulecki M, Rosenfeld CS, Przepiorka D, et al. "Treatment of ganciclovir-induced neutropenia with recombinant human GM-CSF." Am J Med 90 (1991): 401-2
  4. "Product Information. Cytovene (ganciclovir)." Genentech (2002):

• Kidney Diseases

  Major

  Ganciclovir is primarily eliminated by the kidney. Patients with renal impairment may be at greater risk for toxicity from ganciclovir due to decreased drug clearance. Therapy with ganciclovir should be administered cautiously in these patients at reduced dosages. Serum creatinine values should be monitored frequently, and the dosing further adjusted or discontinued accordingly.

  3 sources

  1. Sommadossi JP, Bevan R, Ling T, et al. "Clinical pharmacokinetics of ganciclovir in patients with normal and impaired renal function." Rev Infect Dis 10 (1988): s507-14
  2. Lake KD, Fletcher CV, Love KR, et al. "Ganciclovir pharmacokinetics during renal impairment." Antimicrob Agents Chemother 32 (1988): 1899-900
  3. "Product Information. Cytovene (ganciclovir)." Genentech (2002):

• Diseases requiring hemodialysis

  Moderate

  Ganciclovir is substantially removed by hemodialysis. Plasma levels of ganciclovir have been shown to reduce by 50% following hemodialysis. Ganciclovir should be administered on non-dialysis days or following dialysis sessions.

  2 sources

  1. "Product Information. Cytovene (ganciclovir)." Genentech (2002):
  2. Swan SK, Munar MY, Wigger MA, Bennett WM "Pharmacokinetics of ganciclovir in a patient undergoing hemodialysis." Am J Kidney Dis 17 (1991): 69-72