By Nipa Pharmaceuticals Ltd.
Unit Price: 280
Last Updated: 2019-11-05 09:25:23
Cytomegaloviral infections, Prophylaxis of cytomegaloviral infections in immunocompromised patients, Herpes simplex keratitis, CMV (cytomegalovirus) retinitis, Prophylaxis of cytomegaloviral infections in immunocompromised patients
Ganciclovir is an acyclic nucleoside analogue of 2’-deoxyguanosine that has antiviral effect against human cytomegalovirus and other human herpes viruses. It is phosphorylated to a substrate which competitively inhibits the binding of deoxyguanosine triphosphate to DNA polymerase resulting in inhibition of viral DNA synthesis.
Ophthalmic-Herpes simplex keratitis:
Intravenous-Prophylaxis of cytomegaloviral infections in immunocompromised patients:
Most common adverse reactions reported in patients are blurred vision, eye irritation, punctate keratitis and conjunctival hyperemia.
Patients should not wear contact lenses if they have signs or symptoms of herpetic keratitis or during the course of therapy with Ganciclovir. Patients should be advised not to allow the dropper tip to touch any surface, as this may contaminate the gel.
Increased risk of haematologic toxicity with zidovudine. May increase serum levels of didanosine. Increased serum concentration with probenecid and other drugs that inhibit renal tubular secretion and resorption. Use of IV ganciclovir with oral mycophenolate mofetil may result in increased plasma concentrations of both drugs due to competition for renal tubular secretion. Concomitant use with immunosuppressive agents (e.g. azathioprine, ciclosporin, corticosteroids) may result in excessive suppression of bone marrow or the immune system. Generalised seizure may occur when taken with imipenem and cilastatin. Concurrent use with drugs that inhibit replication of rapidly dividing cells (e.g. dapsone, pentamidine, pyrimethamine, flucytosine, cytotoxic antineoplastic agents, amphotericin B, co-trimoxazole, other nucleoside analogues) may result in additive toxicity.
Use in pregnancy: Pregnancy category C. There are no adequate and well-controlled studies in pregnant women. Ganciclovir should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
Use in lactation: It is not known whether topical ophthalmic Ganciclovir administration could result in sufficient systemic absorption to produce detectable quantities in breast milk. Caution should be exercised when Ganciclovir is administered to nursing mothers.
Symptoms: Haematological toxicity (e.g. pancytopenia, bone marrow depression, medullary aplasia, leucopenia, neutropenia, granulocytopenia); hepatotoxicity (e.g. hepatitis, liver function disorder); renal toxicity (e.g. worsening of haematuria in patient with renal impairment, acute renal failure, elevated creatinine); GI toxicity (e.g. abdominal pain, diarrhoea, vomiting); neurotoxicity (e.g. generalised tremor, convulsion).
Management: Symptomatic and supportive treatment. Haemodialysis and hydration may be useful in enhancing elimination of drug. For neutropenia, treatment with haematopoietic growth factors may be considered.
Hypersensitivity to ganciclovir or valganciclovir and other antivirals (e.g. aciclovir, valaciclovir).
Store between 20-25°C.
Use in children: Safety and efficacy in pediatric patients below the age of 2 years have not been established.
Use in elderly patients: No overall differences in safety or effectiveness have been observed between elderly and younger patients.