Ganciclovir

Brand names

• Cytovene
• Vitrasert

Usage

To treat or prevent infections caused by cytomegalovirus (CMV). CMV infection of the eyes occurs in patients with weakened immune systems and is prevalent among people with AIDS. A more widespread infection with CMV may occur in patients who have received organ or bone marrow transplants and who are being treated with medications (immunosuppressants) to prevent rejection.

How it works

Ganciclovir interferes with the activity of enzymes needed for the replication of viral DNA in cells, thus preventing the virus from multiplying.

Side effects

Serious

Unusual or persistent fevers, chills, unusual fatigue, sore throat, bruising, or bleeding (these may be signs of serious anemia or problems with the cells of your immune system); skin rash, tremor, eye pain, or sudden change in vision (blurring or partial loss of sight), pain at the injection site.

Common

No common side effects are associated with the use of ganciclovir.

Less common

Abdominal discomfort, decreased appetite, nausea, vomiting, sweating.

Possible interactions

Other medicaments:

Ganciclovir taken concurrently with:

• amphotericin B (Fungizone, Abelcet) may result in increased bone marrow suppression.
• cancer chemotherapy may result in additive bone marrow suppression.
• cotrimoxazole (Septra) may result in added bone marrow suppression problems.
• cyclosporine (Sandimmune) can result in increased kidney toxicity.
• dapsone is a benefit-to-risk decision, as additive bone marrow suppression may occur.
• flucytosine (Ancobon) can cause additive bone marrow toxicity.
• imipenem/cilastatin (Primaxin) can cause seizures.
• pentamidine may result in additive bone marrow suppression.
• tacrolimus (Prograf) can result in increased risk of kidney toxicity.
• zidovudine (AZT) will often cause a serious increase in bone marrow suppression.

The following medicament may increase the effects of ganciclovir:



• probenecid (Benemid)-by interfering with elimination by the kidney.

Herbal medicines or minerals:

Some patients use Echinacea to attempt to boost their immune systems. Unfortunately, use of Echinacea is not recommended in people with damaged immune systems. This herb may also actually weaken any immune system if it is used too often or for too long a time. Caution: St. John's wort may also cause extreme reactions to the sun. Additive photosensitivity may be possible.

Alcohol:

No restrictions; however, alcohol may blunt the immune system.

Marijuana smoking:

May increase somnolence.

Exposure to sun:

Caution is advised. Photosensitivity has been reported.

Discontinuation:

Talk with your doctor before stopping this medicine.

Special storage instructions:

Store the intravenous form at 39 degrees F (4 degrees C) and use within 12 hours after it has been reconstituted.