Ganciclovir Disease Interactions

The use of ganciclovir is commonly associated with bone marrow toxicity. Neutropenia, anemia and thrombocytopenia have been reported. Therapy with ganciclovir should be administered cautiously in patients with preexisting blood dyscrasias or bone marrow suppression. Routine blood counts are recommended, and dosing adjusted or discontinued accordingly. Ganciclovir should not be used in patients with an absolute neutrophil count < 500/mcL or a platelet count < 25,000/mcL. Some neutropenic patients requiring ganciclovir may be candidates for granulocyte colony stimulating factor.

Ganciclovir is primarily eliminated by the kidney. Patients with renal impairment may be at greater risk for toxicity from ganciclovir due to decreased drug clearance. Therapy with ganciclovir should be administered cautiously in these patients at reduced dosages. Serum creatinine values should be monitored frequently, and the dosing further adjusted or discontinued accordingly.

Ganciclovir is substantially removed by hemodialysis. Plasma levels of ganciclovir have been shown to reduce by 50% following hemodialysis. Ganciclovir should be administered on non-dialysis days or following dialysis sessions.