ADAP drugs: ganciclovir

ganciclovir (Cytovene, DHPG)

Drug description

Ganciclovir is a treatment for CMV (cytomegalovirus) infection. Most adults are infected with CMV. Like other infections, the virus which causes this condition takes advantage of a weakened immune system. Active CMV infection typically develops only when a person has a deficiency of cytotoxic T cells that recognize and target CMV-infected cells. CMV can infect different parts of the body, and CMV retinitis, a disease caused by this herpesvirus, can cause blindness. Hoffman-La Roche Laboratories, which makes Cytovene, has a Provisional Assistance Program that can be reached at (800) 444-4200.

Side effects
Ganciclovir suppresses bone-marrow production of the white blood cells called neutrophils. This condition is called neutropenia. Some people can take AZT with ganciclovir, especially if they are taking G-CSF to treat the neutropenia associated with both drugs. You must discontinue ddC until you are stable on ganciclovir. Ganciclovir can also harm the kidneys, reduce testosterone levels, and cause nausea, vomiting, diarrhea and rash.

Dosage
Ganciclovir is either given intravenously on a long-term basis through a catheter or in a pill form. A catheter is basically a tube. One end is surgically inserted into a large vein in your chest. The other end of the catheter remains outside your chest or has an injectable port just under the skin, providing access to your bloodstream so you can give yourself the drug. An oral form of ganciclovir is also approved by the FDA for prevention and maintenance treatment of CMV. Although the pill form may be very slightly less effective than the IV drug, doctors can now prescribe it if you choose not to have a permanent catheter. The dosage of the oral drug is 3 grams per day, which is 12 pills.

How long it may take to work
CMV retinitis usually stabilizes or sometimes improves with treatment in 10-20 days. Long-term maintenance therapy is necessary. Maintenance treatment means you keep taking the drug to control an infection so that you don't become ill. Retinitis will ultimately recur in most people despite maintenance and can be re-treated with higher doses of ganciclovir or foscarnet. You must get periodic eye exams. For prevention, the pill form of ganciclovir may be prescribed for people at risk for active disease.

Managing side effects
G-CSF and GM-CSF, synthetic versions of two of the messenger chemicals of the immune system that are used to boost production of certain white blood cells, are used to treat neutropenia caused by ganciclovir. Other side effects improve for many people over a matter of weeks as they become accustomed to the drug.

This information is specific to the use of this medication for HIV-related conditions. For additional information about this drug for other conditions, refer to: www.nursespdr.com/ and www.healthanswers.com/Library/library_fset.asp

The drug descriptions on these pages are intended for informational purposes only. The Network does not promote or endorse the use of any specific treatment for any health-related condition. The medications described here can only be dispensed by a licensed health care professional. The information may have changed since these pages were updated, though every effort is made to keep these pages current. Please contact The Network at (800) 734-7104 to make sure you have the most up-to-date information

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