Ganciclovir and Valganciclovir Use in Children

Marcia L. Buck, Pharm.D., FCCP, FPPAG

Disclosures

Pediatr Pharm. 2009;15(10) 

In This Article

Drug Interactions

Ganciclovir and valganciclovir should be used with caution in patients receiving other cytotoxic drugs, such as amphotericin, dapsone, doxorubicin, flucytosine, pentamidine, trimethoprim/sulfamethoxazole, vinblastine, and vincristine, Seizures have been reported in patients taking imipenem-cilastatin and ganciclovir. The combination of imipenemcilastatin and either ganciclovir or valganciclovir should not be used. Nephrotoxic drugs, including cyclosporine and amphotericin, as well as probenecid should be used with caution in patients taking ganciclovir or valganciclovir, as the resulting increase in ganciclovir concentrations may produce toxicity.[1–4]

When ganciclovir is administered simultaneously with, or within 2 hours prior to, didanosine, the AUC of didanosine may be reduced by 10–40%. If the drugs are given simultaneously, the AUC of ganciclovir may be decreased by up to 20%, although studies conducted with didanosine administered 2 hours prior to a ganciclovir dose produced no significant effect. A similar result occurs with simultaneous administration of ganciclovir and zidovudine. The steady-state AUC of ganciclovir may be decreased by up to 20%, while the AUC of zidovudine may be increased by 11–74%. Use of valganciclovir with didanosine or zidovudine should be expected to produce the same interactions.[1–4]

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