How does this medication work? What will it do for me?

Ganciclovir belongs to a group of medications known as antivirals. It is used to treat and prevent a viral eye infection called cytomegalovirus (CMV) retinitis. This infection usually occurs for people with weakened immune systems, such as people who have had transplants or chemotherapy, and people who have AIDS. It works by preventing the virus (CMV) that causes the infection from reproducing, which helps to prevent CMV from spreading to healthy cells as quickly as it would without treatment.

Ganciclovir is also used for the prevention of cytomegalovirus disease in people receiving a solid organ transplant who are at risk of developing the disease.

This medication should only be used by people with a weakened immune system.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each 10 mL clear, glass vial of sterile powder contains ganciclovir sodium equivalent to ganciclovir 500 mg. Nonmedicinal ingredient: sodium 46 mg (2 mEq).

How should I use this medication?

The recommended dose of ganciclovir is 5 mg per kilogram of body weight, calculated by your doctor.

For treatment of CMV retinitis, ganciclovir is used for 14 to 21 days.

For prevention of CMV retinitis, ganciclovir is used for 7 to 14 days.

For prevention of CMV disease in transplant recipients, the length of treatment is determined by the doctor and depends on how long immunosuppressant medications are required.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Ganciclovir is given as an intravenous (IV) infusion (injected slowly into the vein over a period of one hour). It is done in a hospital or clinic setting under the supervision of a health care professional. The dose will be determined by your doctor according to individual needs.

It is important this medication be given exactly as recommended by your doctor. If you miss an appointment to receive ganciclovir, contact your doctor as soon as possible to reschedule your appointment.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to ganciclovir or any ingredients of this medication
  • are allergic to valganciclovir, acyclovir, or valacyclovir

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • abdominal or stomach pain
  • diarrhea
  • fever
  • headache
  • itching
  • loss of appetite
  • nausea
  • pain and swelling at injection site
  • sore throat

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • anxiety
  • confusion
  • decreased sensitivity to touch
  • fluid build-up, swelling in the arms, feet, or legs
  • increased blood pressure
  • infection at the injection site
  • mood or other mental changes
  • nervousness
  • numbness or tingling feeling in the arms, feet, legs
  • pain at place of injection
  • rapid heartbeat
  • signs of anemia (low red blood cells; e.g., pale skin, unusual tiredness or weakness)
  • signs of bleeding (e.g., unusual bleeding or bruising, bleeding gums, unexplained nosebleeds)
  • signs of decreased kidney function (e.g., decreased urine production, loss of appetite, nausea)
  • signs of infection (e.g., fever, chills, or sore throat)
  • sinus congestion
  • skin rash
  • sore throat and fever
  • thrush (yeast infection in mouth which appears as white patches in mouth, on tongue)
  • tremor
  • unusual bleeding or bruising
  • unusual tiredness and weakness
  • yeast infections

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • chest pain
  • difficulty breathing
  • signs of a serious allergic reaction, e.g.:
    • abdominal cramps
    • difficulty breathing
    • nausea and vomiting
    • swelling of the face and throat
  • signs of a severe skin reaction, e.g.:
    • a rash combined with fever or discomfort
    • a rash covering a large area of the body
    • a rash that spreads quickly
    • blistering
    • peeling

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Bleeding: Ganciclovir can cause a decrease in the number of platelets that are produced in the body. Platelets are responsible for forming clots. If you experience unusual bruising or bleeding, bleeding gums, unusual nosebleeds, stools that look like coffee grounds or blood in urine, contact your doctor as soon as possible.

Blood disorders: If you have any blood disorders (e.g., anemia, thrombocytopenia), discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Cancer: Although it has not been clearly demonstrated in humans, there is the possibility that ganciclovir might cause certain types of cancer. If you have concerns, discuss this with your doctor.

Drowsiness/reduced alertness: This medication may reduce alertness by causing drowsiness, dizziness, or confusion. Some people have had seizures while using this medication. Avoid hazardous activities such as driving or operating machinery until you know whether the medication affects your ability to perform such tasks.

Fertility: This medication may decrease fertility in both males and females, and these effects may persist after the medication has been stopped. For people who are using the intraveneous (injection into the vein) form of this medication, the changes may be permanent.

Kidney function: The kidneys remove ganciclovir from the body. People who have decreased kidney function may experience higher than expected levels of ganciclovir in the blood and therefore an increased level of side effects.

If you have reduced kidney function or kidney disease, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Red blood cells: Ganciclovir may cause low levels of red blood cells. If you experience symptoms of reduced red blood cell count (anemia) such as shortness of breath, feeling unusually tired, pale skin, decreased blood pressure or pounding heartbeat, contact your doctor as soon as possible.

Reduced white blood cells: Ganciclovir can cause low levels of white blood cells. This usually happens within 1 to 2 weeks of starting treatment. Your doctor should order regular blood tests to monitor for changes in the numbers of blood cells during treatment. If you experience symptoms of an infection (e.g., fever, sore throat) contact your doctor immediately.

Pregnancy: This medication should not be used during pregnancy because it can be harmful to the developing child. Women who are taking this medication should use an effective method of birth control (e.g, birth control pill, condoms) while they are taking this medication. Men who are taking this medication should use a barrier method of birth control (e.g., a condom) while they are using this medication, and for at least 90 days after stopping the medication.

Breast-feeding: It is not known if ganciclovir passes into breast milk. Due to the severity of side effects with ganciclovir and the risk of harm to the baby, women should not breast feed while they are using this medication.

Children: The safety and effectiveness of using this medication have not been established for children under 12 years of age.

Seniors: The safety of using ganciclovir has not been established for seniors. Seniors are generally at an increased risk of side effects Your doctor should closely monitor the effects of this medication when it is being given to a senior.

What other drugs could interact with this medication?

There may be an interaction between ganciclovir and any of the following:

  • adriamycin
  • amphotericin B
  • anti-HIV medications: non-nucleoside reverse transcriptase inhibitors (NNRTIs; e.g., abacavir, didanosine, entacavir, lamivudine, zidovudine)
  • cotrimoxazole (trimethoprim - sulfamethoxazole)
  • cyclosporine
  • dapsone
  • flucytosine
  • imipenem
  • mycophenolate
  • pentamidine
  • probenecid
  • trimethoprim
  • vinblastine
  • vincristine
  • zalcitabine

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.