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Ganciclovir Brand Names
Cytovene | Vitrasert | Zirgan
What is Ganciclovir
Ganciclovir is a synthetic, purine nucleoside analog used for the treatment and prevention of cytomegalovirus (CMV) infections. An ophthalmic gel is used for the treatment of herpetic keratitis
In addition, ganciclovir has been shown to be active against other viruses, including herpes simplex, varicella zoster, and human herpesvirus 6 and 8.
Hematologic toxicity is common with systemic ganciclovir administration; dosage adjustments for neutropenia or thrombocytopenia may be required.
he FDA originally approved intravenous ganciclovir in June 1989. Ganciclovir ophthalmic gel (Virgan) was given an orphan drug designation for acute herpetic keratitis in April 2007 and was granted full approval (Zirgan) in September of 2009.
Ganciclovir oral capsules and intraocular implant were withdrawn from the US market in 2013.
Indications
- acute retinal necrosis (ARN)
- B virus (cercopithecine herpesvirus)
- congenital cytomegalovirus (CMV) disease
- cytomegalovirus (CMV)
- cytomegalovirus (CMV) disease prophylaxis
- cytomegalovirus (CMV) pneumonitis
- cytomegalovirus (CMV) retinitis
- cytomegalovirus (CMV) retinitis prophylaxis
- cytomegalovirus (CMV)-associated gastrointestinal disease
- encephalitis
- Epstein-Barr virus
- herpes simplex keratitis (dendritic keratitis)
- herpes simplex virus infection
- herpes simplex virus type 1
- herpes simplex virus type 2
- human herpesvirus 6 (HHV-6)
- human herpesvirus 6 (HHV-6) infection
- human herpesvirus 8 (HHV-8)
- human herpesvirus 8 (HHV-8) infection
- multicentric Castleman disease
- neonatal herpes simplex virus infection
- progressive outer retinal necrosis (PORN)
- varicella (chickenpox) infection
- varicella-zoster virus
Side Effects
- abdominal pain
- agranulocytosis
- alopecia
- anaphylactoid reactions
- anemia
- anorexia
- anosmia
- anxiety
- aphasia
- arrhythmia exacerbation
- arthralgia
- back pain
- bleeding
- blurred vision
- bone marrow suppression
- bronchospasm
- candidiasis
- cardiac arrest
- cataracts
- chest pain (unspecified)
- chills
- cholelithiasis
- cholestasis
- clastogenesis
- confusion
- conjunctival hyperemia
- conjunctivitis
- constipation
- cough
- cranial nerve palsies
- depression
- diaphoresis
- diarrhea
- dizziness
- drowsiness
- dysesthesia
- dysgeusia
- dyspepsia
- dysphagia
- dyspnea
- edema
- elevated hepatic enzymes
- eructation
- exfoliative dermatitis
- fatigue
- fever
- flatulence
- GI perforation
- hallucinations
- headache
- hearing loss
- hematuria
- hemolytic anemia
- hemolytic-uremic syndrome
- hepatic failure
- hepatitis
- hypercalcemia
- hypertension
- hypertriglyceridemia
- hypoesthesia
- hyponatremia
- hypotension
- increased intracranial pressure
- increased urinary frequency
- infection
- infertility
- influenza
- injection site reaction
- insomnia
- irritability
- keratitis
- leukopenia
- macular edema
- malaise
- memory impairment
- metabolic acidosis
- muscle cramps
- myalgia
- myasthenia
- nausea
- neutropenia
- new primary malignancy
- ocular irritation
- ocular pain
- otalgia
- pancreatitis
- pancytopenia
- paresthesias
- peripheral neuropathy
- peripheral vasodilation
- phlebitis
- pruritus
- pulmonary fibrosis
- rash
- renal failure (unspecified)
- retinal detachment
- rhabdomyolysis
- seizures
- SIADH
- spermatogenesis inhibition
- Stevens-Johnson syndrome
- stomatitis
- stroke
- teratogenesis
- testicular atrophy
- thrombocytopenia
- tinnitus
- torsade de pointes
- tremor
- urinary retention
- urticaria
- vasculitis
- ventricular tachycardia
- visual impairment
- vomiting
- weight loss
- xerophthalmia
- xerosis
- xerostomia
Monitoring Parameters
- CBC with differential
- LFTs
- ophthalmologic exam
- pregnancy testing
- serum creatinine/BUN
Contraindications
- accidental exposure
- acyclovir hypersensitivity
- anemia
- antimicrobial resistance
- bone marrow suppression
- breast-feeding
- chemotherapy
- children
- contact lenses
- contraception requirements
- dehydration
- famciclovir hypersensitivity
- ganciclovir hypersensitivity
- geriatric
- infants
- infertility
- intramuscular administration
- leukopenia
- male-mediated teratogenicity
- neonates
- neoplastic disease
- neutropenia
- ocular exposure
- penciclovir hypersensitivity
- pregnancy
- pregnancy testing
- radiation therapy
- renal failure
- renal impairment
- reproductive risk
- subcutaneous administration
- thrombocytopenia
- valacyclovir hypersensitivity
- valganciclovir hypersensitivity
Interactions
- Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
- Aldesleukin, IL-2
- Aminoglycosides
- Amlodipine; Celecoxib
- Amphotericin B
- Amphotericin B cholesteryl sulfate complex (ABCD)
- Amphotericin B lipid complex (ABLC)
- Amphotericin B liposomal (LAmB)
- Aprotinin
- Bacitracin
- Bictegravir; Emtricitabine; Tenofovir Alafenamide
- Capreomycin
- Celecoxib
- Cidofovir
- Cisplatin
- Clofarabine
- Colchicine; Probenecid
- Colistimethate, Colistin, Polymyxin E
- Cyclosporine
- Dapsone
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dichlorphenamide
- Diclofenac
- Diclofenac; Misoprostol
- Didanosine, ddI
- Diflunisal
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Doravirine; Lamivudine; Tenofovir disoproxil fumarate
- Doxorubicin
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Emtricitabine; Tenofovir alafenamide
- Emtricitabine; Tenofovir disoproxil fumarate
- Entecavir
- Esomeprazole; Naproxen
- Etodolac
- Famotidine; Ibuprofen
- Fenoprofen
- Flucytosine
- Flurbiprofen
- Gallium
- Gallium Ga 68 Dotatate
- Hyaluronidase, Recombinant; Immune Globulin
- Hydrocodone; Ibuprofen
- Hydroxyurea
- Ibuprofen
- Ibuprofen; Oxycodone
- Ibuprofen; Pseudoephedrine
- Imipenem; Cilastatin
- Imipenem; Cilastatin; Relebactam
- Immune Globulin IV, IVIG, IGIV
- Indomethacin
- Inotersen
- Ketoprofen
- Ketorolac
- Lamivudine, 3TC; Zidovudine, ZDV
- Lamivudine; Tenofovir Disoproxil Fumarate
- Lansoprazole; Naproxen
- Mannitol
- Meclofenamate Sodium
- Mefenamic Acid
- Meloxicam
- Mycophenolate
- Nabumetone
- Naproxen
- Naproxen; Pseudoephedrine
- Naproxen; Sumatriptan
- Nitisinone
- Nonsteroidal antiinflammatory drugs
- Oxaprozin
- Pentamidine
- Piroxicam
- Polymyxin B
- Polymyxins
- Probenecid
- Rofecoxib
- Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
- Sulindac
- Tacrolimus
- Talimogene Laherparepvec
- Telavancin
- Telbivudine
- Tenofovir Alafenamide
- Tenofovir, PMPA
- Tolmetin
- Trimethoprim
- Valdecoxib
- Vancomycin
- Vinca alkaloids
- Zidovudine, ZDV