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Ganciclovir - Is this better than Valcyte in post liver transplant patients? More or less costly?

Responses (1)

suzanne66 9 Nov 2009

This from

"... Management: Immunocompromised patients (especially HIV)

1. Highly active Antiretroviral therapy (HAART) in HIV
1. Critical to prevent CMV organ involvement
2. Risk in HIV highest when CD4 Count <50/mm3
2. Indications for Viral DNA polymerase inhibitors
1. CMV Retinitis (Urgent therapy)
2. Clinically Significant colitis or other end-organ
3. Treatment of asymptomatic CMV not indicated
3. Preparations
1. Ganciclovir
1. Granulocytopenia and Anemia risk (25%)
2. Foscarnet (Foscavir)
1. Nephrotoxicity (33%)
2. Neurotoxicity
3. Electrolyte disturbance (Hypokalemia, Hypocalcemia)
3. Cidofovir (Vistide)
1. Nephrotoxicity
2. Neutropenia
3. Alopecia
4. Efficacy
1. CMV Retinitis responds to 14-21 day in 75-90% cases
2. Patients failing one drug should move to the other
5. Dosing
1. Acute
1. Cidofovir 5 mg/kg IV each week for 2 weeks
2. Chronic maintenance (prevents relapse in 4-8 weeks)
1. Cidofovir 5 mg/kg every other week"
Hope this is helpful.
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