Ganciclovir intravenous administration

Ganciclovir Intravenous administration Intravitreal injection Intravitreal implant Oral administration (valganciclovir) Primary toxicity = neutropenia... 

Oral and parenteral do.sagc forms of ganciclovir are available. but oral bioavailability is poor. Only 5 to IO r of an oral dose is absorbed. Intravenous administration is preferable. More than 90% of the unchanged drug is excreted in the urine. Ganciclovir for injection is available as a lyophili/ed sodium salt for reconstitution in normal saline. S% dextrose in water, or lactated Ringer s solution. These. solutions are stningly alkaline (pH 11) and must be administered by slow, constant, intravenous infusion to avoid thrombophlebitis. 

E. Ganciclovir. All toxic reports have been after intravenous administration. The doses producing toxic effects after high chronic or inadvertent acute IV overdose have been variable. No toxic effects were noted in two adults who were given 3.5 g and 11 mg/kg for 7 doses over 3 days, respectively. However, single doses of 25 mg/kg and 6 g, or daily doses of 8 m g for 4 days or 3 g for 2 days, resulted in neutropenia, granulocytopenia, pancytopenia, and/or thrombocyctopenia. An adult and a 2-kg infant developed hepatitis after 10 mg/kg and 40-mg doses, respectively. An adult developed seizures after a 9-mg/kg dose, and others have had increased serum creatinine levels after 5-to 7-g doses. 

J.) Ganciclovir This is a guanosine derivative exhibiting a good action profile in HBV, EBV, CMV and VZV infection. Ganciclovir triphosphate inhibits virus replication. The half-life is about 4 hours. Elimination is via the kidneys. Only a minor fraction of this substance is absorbed after oral administration application (e.g. in CMV infection) is usually intravenous (10 mg/kg BW/ day). It has severe toxic side effects. Ganciclovir was... 

Intravenous foscamet is effective for CMV retinitis, including ganciclovir-resistant infections, other types of CMV infection, and acyclovir-resistant HSV and VZV infections. Foscamet is poorly soluble in aqueous solutions and requires large volumes for administration. 

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. 

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