INTRAVENOUS minutes before you plan to infuse it. Please If confusion, mood swings, abnormal try to take your ganciclovir dose at the thought or dreams , or a rash occur while GANCICLOVIR same time(s) every day. taking ganciclovir, please call your doctor or pharmacist. Other names: Cytovene  Injection Ganciclovir will be supplied to you by______Nausea, vomiting, diarrhea, dizziness, WHY is this drug prescribed? fever or headaches may occur. If these effects occur and are bothersome, please Intravenous (I.V.) ganciclovir is an antiviral What should you do if you FORGET a call your doctor or pharmacist or discuss used for the initial treatment of dose? them at your next visit. (CMV) infection (ie: retinitis). This drug can also be used to If you miss a dose of ganciclovir, take it as Irritation (redness) or pain may develop at prevent a relapse of CMV after the initial soon as possible. However, if it is time for the injection site (forearm) when the treatment. You should have your eyes your next dose, do not double the dose, just ganciclovir is given into the smaller veins in examined regularly. carry on with your regular schedule. the arm. This problem may be prevented by slowing the rate of infusion and changing HOW should this drug be taken? the I.V. site more frequently. This problem What ADVERSE EFFECTS can this drug is also avoided by infusing the drug into a The usual dose of intravenous ganciclovir cause? What should you do about them? central vein (e.g. using Port-a-Cath or for the initial treatment of CMV is 5 mg / kg Hickman central venous catheters). every 12 hours for 14 to 21 days. To The most serious adverse effect of prevent a relapse of CMV, the usual dose is ganciclovir is a fall in the number of white Your blood will also be checked for any 5 mg / kg once daily every day of the week, blood cells . This can increase your risk of changes in liver or function. or 6 mg / kg once daily 5 days a week. The developing infections as white blood cells dose may need to be adjusted if you have are needed to fight infections. Ganciclovir It is important that you keep your doctor kidney problems. can also decrease the number of appointments and come for your platelets in the blood. This can increase laboratory tests so that your progress The drug should be given as a constant your risk of bleeding or bruising as platelets can be followed. intravenous injection over a minimum of 1 are needed to help clot your blood. Your hour. red blood cells may also decrease which could make you feel tired or short of breath. What other PRECAUTIONS should you Your dosage is: Blood tests will be done regularly to check follow while using this drug? for any changes in these values. If there ____mg every ____ hours given over are any problems, the dose of ganciclovir If while handling the drug, it accidentally ____ hour(s), ____ days a week will be reduced or the drug will be stopped. spills, avoid contact with your skin, eyes, or Inform your doctor if you notice any mucous membranes (eg. nose). Wear Each dose of ganciclovir is put in 100 or symptoms of fever, chills, shortness of rubber gloves while cleaning up any spills. 250 mL bags. The I.V. solution should be breath, racing heartbeat, fatigue, bleeding If the drug comes in contact with your skin warmed up to room temperature before or bruising. or mucous membranes, wash the area administration. You may accomplish this by thoroughly with soap and water, and rinse taking your dose out of the refrigerator 30 thoroughly with water. Do not stop taking this drug without you are taking. As well, you should inform checking with your doctor first, even if you them of natural products you are taking. If begin to feel better. Maintain your regular you wish to start a new drug or natural visits and inform your doctor of new medical product, please consult with your problems that develop while you are taking pharmacist before doing so. ganciclovir.

It is especially important to let them know if Ganciclovir may cause temporary or you are taking (Benemid ), permanent sterility or infertility in both men didanosine (Videx ), or zidovudine INTRAVENOUS and women. Birth defects have occurred in (Retrovir ). GANCICLOVIR animals, therefore ganciclovir is NOT recommended during pregnancy, and men How should this drug be STORED? and women should use barrier contraception (ie: condoms) during and for The diluted ganciclovir intravenous solution 90 days following treatment. It is not known should be kept in the refrigerator (2 - 8 °C). if ganciclovir is excreted in breast milk. It is recommended that the solution be used MEDICATION Because of abnormalities that have within 24 hours of dilution. Keep well out of occurred in animals treated with ganciclovir, the reach of children. it is possible that nursing infants may also FACT SHEET be affected, therefore ganciclovir should If you have any questions or concerns NOT be given to breastfeeding mothers. about this drug or if you are Please discuss this with your doctor or experiencing adverse effects, please pharmacist if these issues are a concern to discuss them with your pharmacist, you. doctor or nurse.

Let your doctor know if you have had an allergic reaction or adverse effect to other Write questions or concerns down to antiviral agents such as acyclovir ensure they are addressed. (Zovirax ), valacyclovir (Valtrex ), (Famvir ), or The following pharmacist is available to answer questions: (Valcyte ).

Since ganciclovir is removed from the body Pharmacist: ______: ______by your kidneys, it is important to inform Telephone your doctor if you have kidney problems prior to taking this drug.

Reference: Product monograph Cytovene  (ganciclovir). Certain drugs can increase or decrease the Mississauga, On, Canada: Hoffmann–La Roche Limited, effect of ganciclovir. Also, ganciclovir might 2008. Prepared by the Ontario HIV Pharmacy Professional influence the effect of other drugs you are Specialty Group, 2003. Reviewed 2009. taking. Inform your doctor and pharmacist Additional medication fact sheets and updates may be found of all prescribed and non-prescribed drugs at: www.hivclinic.ca