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Neonatal Intensive Care Drug Manual
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| bet | 231/654 | | Sana | 03.01.2022 | | Hajmi | 1,5 Mb. | | #14803 |
Ganciclovir
Revision Date : 10-12-2020
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Approved : TC, KOH
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Alert
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High risk medicine. Cytotoxic agent.
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Indication
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Treatment of severe or moderately severe, symptomatic congenital CMV
Treatment of acute severe CMV disease.
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Action
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Synthetic nucleoside analogue of 2-deoxyguanosine that inhibits replication of herpes viruses such as cytomegalovirus, herpes simplex virus 1 and 2, herpes virus type 6, 7 and 8, Epstein-Barr virus, varicella zoster virus and hepatitis B virus.
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Drug type
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Antiviral
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Trade name
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Cymevene, Ganciclovir SXP
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Presentation
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500 mg ganciclovir sodium vial for reconstitution
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Dose
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6 mg/kg/dose 12 hourly.
Infants may be switched to oral valganciclovir if clinically stable and able to take oral medications.
IV ganciclovir should generally not be used for more than 6 weeks.
Please note, oral valganciclovir is the oral prodrug of ganciclovir and prescribed at a different dose.
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Dose adjustment
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Maximum dose
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Total cumulative dose
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Route
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IV
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Preparation
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IV Provided by pharmacy of the reconstituted/pre-diluted product. Final concentration should not be higher than 10 mg/mL. Cytotoxic agent so infusion should not be manipulated on the ward.
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Administration
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IV
Follow full cytotoxic precautions as per local policy.
IV infusion over 30 minutes preferably via central venous access.
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Monitoring
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Full blood count, particularly neutrophils, should be followed weekly for 6 weeks, then at week 8, then monthly for the duration of therapy.
IV site for phlebitis
Liver function tests monthly throughout therapy.
Renal function tests.
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