Generic Name: ganciclovir (gan-SYE-kloe-veer)

Brand Names: Cytovene®

Classification: Antiviral Drug

Issue Date: 1992

Ganciclovir is an antiviral drug. It slows the growth and spread of the cytomegalovirus. Ganciclovir is used to treat and prevent infections caused by cytomegalovirus. This infection usually occurs in patients who have suppressed immune systems such as patients with AIDS and organ transplant patients.

If you are injecting ganciclovir at home, your healthcare provider will give you detailed instructions on how and where to inject the medication. If you do not understand these directions, do not attempt to inject the medication. Contact your healthcare provider for further instructions.

Serious side effects affecting the blood have been reported with the use of ganciclovir. Decreased levels of blood cells (white blood cells, red blood cells, and platelets) have occurred. Your doctor may monitor your blood with blood tests.

Ganciclovir has caused birth defects in animals, and it is generally not recommended for use during pregnancy. Women should use an effective form of birth control during treatment with ganciclovir. Also, men should use a form of barrier contraception (e.g., condom) during and for at least 90 days following treatment with ganciclovir. Take all of the ganciclovir that has been prescribed, even if you begin to feel better. Your symptoms may start to improve before the infection is completely treated. Take oral ganciclovir with food to increase its absorption by the body.

Take ganciclovir exactly as directed by your doctor. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take each oral dose with a full glass of water. Take each oral dose with food to increase the absorption of the drug in your body. Your healthcare provider will administer injectable ganciclovir as an intravenous (into a vein) infusion.

If you are injecting ganciclovir at home, your healthcare provider will give you detailed instructions on how and where to inject the medication. If you do not understand these directions, do not attempt to inject the medication. Contact your healthcare provider for further instructions.

Do not use any ganciclovir that is discolored, has particles in it, or looks different from your previous doses. Throw away any unused ganciclovir after the amount of time determined by your pharmacist or doctor.

Take all of the ganciclovir that has been prescribed for you even if you begin to feel better. Your symptoms may start to improve before the infection is completely treated. Your doctor may want you to have blood tests, eye exams, or other evaluations during treatment with ganciclovir to monitor progress and side effects.

Store oral ganciclovir at room temperature away from moisture and heat. Dispose of used needles and syringes in a puncture resistant container out of the reach of children.

Your healthcare provider will store injectable ganciclovir as directed by the manufacturer or give you detailed storage instructions if you are storing the medication at home.

Before taking ganciclovir, tell your doctor if you have:

• had an allergic reaction to ganciclovir or acyclovir (Zovirax®)
• kidney disease
• blood problems or low blood counts

You may not be able to take ganciclovir, or you may need a dosage adjustment or special monitoring during treatment if you have any of the conditions listed above.

Ganciclovir is not known whether ganciclovir will be harmful to an unborn baby. Ganciclovir has caused birth defects in animals, and it is generally not recommended for use during pregnancy. Women should use an effective form of birth control during treatment with ganciclovir. Also, men should use a form of barrier contraception (e.g., condom) during and for at least 90 days following treatment with ganciclovir. It is not known whether ganciclovir passes into breast milk. Generally, breast-feeding should be avoided during treatment with ganciclovir. Do not take ganciclovir without first talking to your doctor if you are breast-feeding a baby.

If a dose of oral ganciclovir is missed, take the missed dose as soon as you remember. If it is almost time for the next dose, skip that dose and take only your next regularly scheduled dose. Do not take a double dose of this medication.

Contact your healthcare provider if you miss a dose of injectable ganciclovir.

Side Effects

Get emergency medical help if you have any of these signs of an allergic reaction:

• skin rash or hives
• difficulty breathing
• swelling of your face, lips, tongue, or throat

Serious side effects affecting the blood have been reported with the use of ganciclovir. Decreased levels of blood cells (white blood cells, red blood cells, and platelets) have occurred. Your doctor may monitor your blood with blood tests.

Stop taking ganciclovir and seek emergency medical attention if you experience any of the following serious side effects:

• an allergic reaction:
• difficulty breathing
• closing of the throat
• swelling of the lips, tongue, or face
• hives
• paleness and fatigue that may be signs of anemia (a low level of red blood cells)
• unusual bleeding or bruising
• fever or signs of infection
• numbness or tingling in a part of your body

Other, less serious side effects may be more likely to occur. Continue to take ganciclovir and talk to your doctor if you experience:

• nausea, vomiting, diarrhea, or decreased appetite
• increased sweating
• itching
• decreased sperm production or infertility

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

Before taking ganciclovir, tell your doctor if you are taking any of the following drugs:

• zidovudine (Retrovir®, AZT®)
• didanosine (Videx®)
• probenecid (Benemid®)
• imipenem-cilastatin (Primaxin®)

You may not be able to take ganciclovir, or you may require a dosage adjustment or special monitoring if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with ganciclovir. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor.