Excreted Unchanged %
90-100
Half-Life (Normalesrd) Hours
3.6/30
Plasma Protein Binding %
1-2
Volume Of Distribution L/Kg
0.47
Dose For Normal Renal Function
5.0 mg/kg q12h
Adjustment For Renal Failure Method
I
Adjustment For Renal Failure Gfr, Ml/Min >50 [Recommended Level]
50% q12-24h [D]
Adjustment For Renal Failure Gfr, Ml/Min 10-50 [Recommended Level]
25-50% q24h [D]
Adjustment For Renal Failure Gfr, Ml/Min <10 [Recommended Level]
25% 3 week [D]
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: 25% 3 week
Supplement For Dialysis [Recommendation Level]: Pd
PD: Dose for GFR <10
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: Induction: 2.5 mg/kg q24h; main: 1.25 mg/kg q24h, [B]
References
Bastien O, Boulieu R, Bleyzac N, Estanove S. Clinical use of ganciclovir during renal failure and continuous hemodialysis. Intensive Care Med. 1994; 20: 47-8. [PMID: 8163759] / Boulieu R, Bastien O, Bleyzac N. Pharmacokinetics of ganciclovir in heart transplant patients undergoing continuous venovenous hemodialysis. Ther Drug Monit. 1993; 15: 105-7. [PMID: 8389067] / Fletcher C, Sawchuk R, Chinnock B, de Miranda P, Balfour HH Jr. Human pharmacokinetics of the antiviral drug DHPG. Clin Pharmacol Ther. 1986; 40: 281-6. [PMID: 3017630] / Gando S, Kameue T, Nanzaki S, Hayakawa T, Nakanishi Y. Pharmacokinetics and clearance of ganciclovir during continuous hemodiafiltration. Crit Care Med. 1998; 26: 184-7. [PMID: 9428565] / Jacobson MA, de Miranda P, Cederberg DM, Burnette T, Cobb E, Brodie HR, et al. Human pharmacokinetics and tolerance of oral ganciclovir. Antimicrob Agents Chemother. 1987; 31: 1251-4. [PMID: 2820301] / Lake KD, Fletcher CV, Love KR, Brown DC, Joyce LD, Pritzker MR. Ganciclovir pharmacokinetics during renal impairment. Antimicrob Agents Chemother. 1988; 32: 1899-900. [PMID: 2854457] / Sommadossi JP, Bevan R, Ling T, Lee F, Mastre B, Chaplin MD, et al. Clinical pharmacokinetics of ganciclovir in patients with normal and impaired renal function. Rev Infect Dis. 1988; 10 Suppl 3: S507-14. [PMID: 2847287] / Swan SK, Munar MY, Wigger MA, Bennett WM. Pharmacokinetics of ganciclovir in a patient undergoing hemodialysis. Am J Kidney Dis. 1991; 17: 69-72. [PMID: 1846060]
Toxicity Notes
Marrow toxicity.