Ganciclovir
General Information
Antiviral
Special restricted formulary antimicrobial: For details see OUH netFormulary
IV ganciclovir requires manufacture by a specialist aseptic service unit. Contact the ward pharmacist as soon as the decision to treat with ganciclovir is made.
For clinically urgent requests out of hours, contact the on-call pharmacist.
See local protocols for further advice:
• Management of CMV reactivation and infection in allogeneic BMT recipients
• Virus Management in solid organ transplant recipients and islet cell transplant recipients
For all information regarding interactions, contraception, pregnancy and breastfeeding and additional information, see BNF.
Standard Dose
| Intravenous dose | |
| Standard dose | 5mg/kg BD* |
*Doses should be rounded up or down to the nearest 10mg
Obesity
In overweight patients, where actual body weight is more than 120% ideal body weight, use adjusted body weight as follows:
Adjusted Body Weight = Ideal Body Weight + 0.4 x (Actual Body Weight – Ideal Body Weight)
Renal and hepatic impairment
Renal impairment
|
Creatinine clearance (mL/min)** |
Treatment dose |
|
50 and above |
5mg/kg BD |
|
25-49 |
2.5mg/kg BD |
|
10-24 |
2.5mg/kg OD |
|
less than 10 |
1.25mg/kg OD |
|
HD/PD |
1.25mg/kg three times a week Dialysed; give post-dialysis on dialysis days |
**dose ranges use creatinine clearance, rather than eGFR
Note: The reference for this dosing information is from Management of CMV reactivation and infection in allogeneic BMT recipients and Virus Management in solid organ transplant recipients and islet cell transplant recipients. Dosing is different to those in the BNF, Summary of Product Characteristics and Renal Drug Database.
Hepatic impairment
No information available for use in hepatic impairment.
References
- Reig Jofre UK Ltd. Ganciclovir 500 mg Powder for solution for infusion vial summary of product characteristics. Electronic medicines compendium. Last revision of the text 30/7/25. Accessed via www.medicines.org.uk Accessed 5/2/26.
- The Renal Drug Database. GANCICLOVIR. Last updated 06/11/24. Accessed via https://renaldrugdatabase.com Accessed 5/2/26.
- Sanford Guide [online]. Ganciclovir. Last updated 2/2/26. Accessed via: https://webedition.sanfordguide.com Accessed 5/2/26.
- Sanford Guide [online]. Obesity dosing adjustment. Last updated: 21/1/26. Accessed via https://webedition.sanfordguide.com Accessed 5/2/26.
- Peniket A, Jeffery K, Littlewood T, Humphries C, Wareham D. Management of cytomegalovirus (CMV) reactivation and infection in allogeneic blood and marrow transplant (BMT) recipients. Network site specific group (NSSG) - Haematology. Last updated 10/2024. Accessed via: https://ouh.quris.com/media/qmultumr/b-4-0-cmv-reactivation.pdf Accessed 5/2/26.
- Jeffery K, Mason P, Devaney A. Virus Management in solid organ transplant recipients and islet cell transplant recipients. OUH clinical guideline. Accessed via: https://ouhnhsuk.sharepoint.com/sites/RenalTransplantUnit/Shared%20Documents/Transplant/Clinical%20Guidelines/Virus%20management%20module.pdf Accessed 5/2/26.