Diferencia entre revisiones de «Ganciclovir»
(Replace manual dosing with dynamic SMW tables (Adult + Pediatric)) |
(Restore original dosing content alongside dynamic SMW tables) |
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| Línea 5: | Línea 5: | ||
==Adult Dosing== | ==Adult Dosing== | ||
*[[CMV]] prophylaxis, solid organ transplant | |||
**IV route: 5mg/kg IV q12h x7-14 days, then 5mg/kg IV q24h or 6mg/kg IV 5x/wk | |||
**PO route: 1000mg PO tid, give with food | |||
*[[CMV]] prophylaxis, HIV-assoc. | |||
**IV route: 5mg/kg IV 5-7x/wk; Info: not 1st-line agent | |||
**PO route: 1000mg PO tid; Info: not 1st-line agent; give with food | |||
*[[CMV]] retinitis, immunocompromised patients | |||
**Induction treatment: 5mg/kg IV q12h x14-21 days; Info: not 1st-line agent | |||
**Maintenance treatment, IV route: 5mg/kg IV 5-7x/wk; Alt: 6mg/kg IV 5x/wk; Info: not 1st-line agent | |||
**Maintenance treatment, PO route: 1000mg PO tid; Alt: 500mg PO q3h while awake (6 doses/day); Info: not 1st-line agent; give with food | |||
===Indications by Disease=== | ===Indications by Disease=== | ||
{{#ask: [[Has DrugName::Ganciclovir]] [[Has Population::Adult]] | {{#ask: [[Has DrugName::Ganciclovir]] [[Has Population::Adult]] | ||
|?Treats disease=Disease | |?Treats disease=Disease | ||
|?Has Dose=Dose | |?Has Dose=Dose | ||
|?Has Context=Context | |?Has Context=Context | ||
|format=table | |format=table | ||
|limit=50 | |limit=50 | ||
|mainlabel=- | |mainlabel=- | ||
|headers=show | |headers=show | ||
|sort=Treats disease | |sort=Treats disease | ||
}} | }} | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
''Off label use as pediatric medication'' | |||
*[[CMV]] prophylaxis, solid organ transplant | |||
**Induction: 5mg/kg IV q12h x7-14 days | |||
**Maintenance: 5mg/kg IV q24h; Alt: 6mg/kg IV 5x/wk | |||
*[[CMV]] prophylaxis, HIV-assoc | |||
**5mg/kg IV q24h | |||
*[[CMV]] infection | |||
**Induction: 5mg/kg IV q12h x14-21 days; Info: may increase dose to 7.5mg/kg IV q12h | |||
**Maintenance: 5mg/kg IV q24h; Alt: 6mg/kg IV 5x/wk | |||
*[[CMV]] infection, congenital (<1 mo) | |||
**6mg/kg IV q12h x6wk | |||
===Indications by Disease=== | ===Indications by Disease=== | ||
{{#ask: [[Has DrugName::Ganciclovir]] [[Has Population::Pediatric]] | {{#ask: [[Has DrugName::Ganciclovir]] [[Has Population::Pediatric]] | ||
|?Treats disease=Disease | |?Treats disease=Disease | ||
|?Has Dose=Dose | |?Has Dose=Dose | ||
|?Has Context=Context | |?Has Context=Context | ||
|format=table | |format=table | ||
|limit=50 | |limit=50 | ||
|mainlabel=- | |mainlabel=- | ||
|headers=show | |headers=show | ||
|sort=Treats disease | |sort=Treats disease | ||
}} | }} | ||
Revisión actual - 02:37 20 mar 2026
Administration
- Type: Antiviral
- Routes of Administration: IV, PO
- Common Trade Names: Cytovene
Adult Dosing
- CMV prophylaxis, solid organ transplant
- IV route: 5mg/kg IV q12h x7-14 days, then 5mg/kg IV q24h or 6mg/kg IV 5x/wk
- PO route: 1000mg PO tid, give with food
- CMV prophylaxis, HIV-assoc.
- IV route: 5mg/kg IV 5-7x/wk; Info: not 1st-line agent
- PO route: 1000mg PO tid; Info: not 1st-line agent; give with food
- CMV retinitis, immunocompromised patients
- Induction treatment: 5mg/kg IV q12h x14-21 days; Info: not 1st-line agent
- Maintenance treatment, IV route: 5mg/kg IV 5-7x/wk; Alt: 6mg/kg IV 5x/wk; Info: not 1st-line agent
- Maintenance treatment, PO route: 1000mg PO tid; Alt: 500mg PO q3h while awake (6 doses/day); Info: not 1st-line agent; give with food
Indications by Disease
| Disease | Dose | Context |
|---|---|---|
| CMV colitis | 5mg/kg IV q12hrs x 21 days | Until symptom resolution |
| CMV neurologic disease | 5mg/kg IV q12hrs x 21 days then 5mg/kg IV q24hrs | Combined with Foscarnet |
| CMV pneumonia | 5mg/kg IV q12hrs x 3 weeks | CMV pneumonia |
| Encephalitis | 5mg/kg IV every 12hr | CMV |
Pediatric Dosing
Off label use as pediatric medication
- CMV prophylaxis, solid organ transplant
- Induction: 5mg/kg IV q12h x7-14 days
- Maintenance: 5mg/kg IV q24h; Alt: 6mg/kg IV 5x/wk
- CMV prophylaxis, HIV-assoc
- 5mg/kg IV q24h
- CMV infection
- Induction: 5mg/kg IV q12h x14-21 days; Info: may increase dose to 7.5mg/kg IV q12h
- Maintenance: 5mg/kg IV q24h; Alt: 6mg/kg IV 5x/wk
- CMV infection, congenital (<1 mo)
- 6mg/kg IV q12h x6wk
Indications by Disease
| Disease | Dose | Context |
|---|---|---|
| Encephalitis | 5mg/kg IV q12hrs | Pediatric CMV |
Special Populations
- Pregnancy Rating: C
- Lactation risk: Infant risk cannot be ruled out
Renal Dosing
- IV route, induction treatment: CrCl 50-69: 2.5mg/kg q12h; CrCl 25-49: 2.5mg/kg q24h; CrCl 10-24: 1.25mg/kg q24h; CrCl <10: 1.25mg/kg 3x/wk; HD: give dose after dialysis, no supplement
- IV route, maintenance treatment: CrCl 50-69: 2.5mg/kg q24h; CrCl 25-49: 1.25mg/kg q24h; CrCl 10-24: 0.625mg/kg q24h; CrCl <10: 0.625mg/kg 3x/wk; HD: give dose after dialysis, no supplement
- PO route: CrCl 50-69: 1500mg/day divided QD-tid; CrCl 25-49: 1000mg/day divided QD-bid; CrCl 10-24: 500mg QD; CrCl <10: 500mg 3x/wk; HD: give dose after dialysis, no supplement
Contraindications
- Allergy to class/drug
- ANC < 500
- Platelets < 25,000
Adverse Reactions
Serious
- thrombocytopenia
- neutropenia
- pancytopenia
- sepsis
- nephrotoxicity
- seizures
- retinal detachment
- hypertension
- pancreatitis
Common
- diarrhea
- fever
- leukopenia
- anorexia
- vomiting
Pharmacology
- Half-life: 3hr
- Metabolism: CYP450
- Excretion: Urine
Mechanism of Action
Inhibits DNA polymerase and incorporates into viral DNA
Comments
See Also
References
Epocrates, UpToDate