zidovudine and Ganciclovir Interactions

Interactions between zidovudine and Ganciclovir (ganciclovir)

zidovudine and ganciclovir (Major Drug-Drug)

GENERALLY AVOID: Limited data concerning the coadministration of ganciclovir and zidovudine do not suggest the potential for a clinically significant pharmacokinetic interaction. However, the possibility of increased risk and severity of hematologic toxicity, especially neutropenia and anemia, due to additive myelosuppressive effects should be considered during concomitant therapy. The majority of patients may be unable to tolerate full dosages of these drugs in combination.

MANAGEMENT: It is best to avoid the use of zidovudine with ganciclovir or its prodrug, valganciclovir, whenever possible. If simultaneous therapy is deemed necessary, reduced dosages of one (usually zidovudine) or both drugs may be required. Close clinical and laboratory monitoring for the development of severe hematologic adverse effects is recommended. Alternatively, a less myelotoxic agent such as foscarnet may be considered in lieu of ganciclovir to treat cytomegalovirus infections in immunocompromised patients receiving zidovudine.