Ganciclovir, adverse reaction

EC chewable solution oral 10 mg/ml Videx EC 125 mg 200 mg 250 mg 400 mg capsules tetracyclines, oral quinolones, ganciclovir Adverse reaction optic neuritis... 

The spectrum of adverse reactions reported in 120 immunocompromised pediatric clinical trial participants with serious CMV infections receiving IV ganciclovir were similar to those reported in adults. Granulocytopenia (17%) and thrombocytopenia (10%) were most commonly reported. 

Severe leukopenia, neutropenia, anemia, thrombocytopenia, pancytopenia, bone marrow depression, and aplastic anemia have been observed in patients treated with valganciclovir tablets (and ganciclovir) (see Precautions and Adverse Reactions). 

Drug interactions In a randomized, double-blind study, Zenapax or placebo was added to an immunosuppressive regimen of cyclosporine, mycophenolate mofetil, and steroids to assess tolerability, pharmacokinetics, and drug interactions. The addition of Zenapax did not result in an increased incidence of adverse events or a change in the types of adverse events reported. The following medications have been administered in clinical trials with Zenapax with no incremental increase in adverse reactions cyclosporine, mycophenolate mofetil, ganciclovir, acyclovir, azathioprine, and corticosteroids. 

While foscamet appears less likely to cause neutropenia than ganciclovir, it has a variety of potential adverse effects. The most common side effects are renal insufficiency and metabolic disturbances (both increases and decreases) in calcium and phosphorus. Other adverse reactions include anemia, thrombocytopenia, infusion-site reactions, nausea and vomiting, penile ulcerations, and seizures. Hydration reduces the incidence of serum creatinine elevations from 66% in anonhydrated control group to 13% in hydrated individuals. Foscamet, fike ganciclovir, is currently administered in two phases,... 

Ganciclovir is similar in mode of action. Adverse reactions can be severe so this drug is reserved for serious viral infections such as cytomegalovirus in immunocompromized patients. 

In a retrospective case-series of 23 infants with culture-proven congenital cytomegalovirus infection who had been treated with ganciclovir for 6 weeks, followed by oral valganciclovir to the age of 12 months, the most common adverse reaction was neutropenia ( =12) it was severe in two infants, with absolute neutrophil counts below 500 X 10 /1 [12 ]. Treatment was withheld imtil the neutrophil count returned to normal no further intervention was required. Neutropenia occurred only within the first 3 months of treatment and mainly during the first 6 weeks of intravenous ganciclovir administration. 

Foscamet is used i.v. for retinitis due to CMV in patients with HIV infection when ganciclovir is contraindicated it has also been used to treat aciclovir-resistant herpes simplex virus infection (see p. 258). It causes numerous adverse effects, including renal toxicity, nausea and vomiting, neurological reactions and marrow suppression. 

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