Ganciclovir and Valganciclovir Use in Children

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

Disclosures

Pediatr Pharm. 2009;15(10) 

In This Article

Adverse Effects

Among the most commonly reported adverse effects with ganciclovir and valganciclovir are lab test abnormalities, including neutropenia (in 3–41% of patients in adult trials), thrombocytopenia (1–65%), and an increase in serum creatinine (4–69%). Other adverse effects include fever (30–48%), nausea and diarrhea (41–48%), tremor (28%), headache (22%), anorexia (14–19%), hypertension (18%), insomnia (16%), vomiting (11–21%), diaphoresis (11–14%), pruritus (5–10%), and infections (4–15%). Retinal detachment has been reported in patients with CMV retinitis, but a relationship to treatment has not been established. Rare, but severe adverse reactions include hypersensitivity and paresthesias.[1–4]

Adverse effects reported in pediatric clinical trials have been similar to those reported in adults. In a study of 120 immunocompromised children with CMV infection, the most common adverse effects were granulocytopenia (17%) and thrombocytopenia (10%). In another study of 16 children, the adverse effects included hypokalemia (25%), decreased renal function, sepsis, or thrombocytopenia (19%), leukopenia, coagulation disorders, hypertension, pneumonia, or immune system disorders (13%).[1–4]

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