Details

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Ganciclovir 250mg, 500mg Capsules are deoxy guanosine analogue antiviral drugs.

It is more effective than acyclovir in the same group of antiviral drugs.

It  comes under the antiherpetic drugs group in antiviral drugs.

It is mostly prescribed for severe cytomegalovirus(CMV) infections in immunocompromised patients. Also for prophylaxis treatment against CMV.

It is used in patients in which intravenous administration is not necessary.

Mechanism of action : when ganciclovir gets activated by phosphorylation ,it competitively inhibits viral DNA polymerase leading to the ending of viral DNA elongation resulting in the death of the viral cell.

It is available as the brand name of Cymevene In India.Cytovene and Vitrasert as international brands for the same.

 

USES

• Ganciclovir 250mg, 500mg Capsules is used in treatment of Cytomegalovirus (CMV) Infections in AIDS patients like: CMV retinitis, colitis , esophagitis.
• It is used in All herpes viruses including simplex, H.zoster and E-b virus.
• It is also given to protect from cytomegalovirus infections in organ transplant and immunocompromised patients as prophylaxis treatment.
• It reduces hearing loss in infants infected with CMV.
• It also reduces the risk of Kaposi’s sarcoma in AIDS patients.

 

DOSAGE

• Cymevene comes as hard gelatin capsules that are opaque green cap with opaque green body(250mg) and opaque ivory yellow cap with opaque green body(500mg).
• For CMV retinitis treatment : it  is given in doses of 5 mg/kg q12h × 14–21 days and Maintenance: 5 mg/kg/d or 6 mg/kg five times per week.
• Dosage either for treatment or prophylaxis is determined by the doctor based on severity of infection, age and weight.
• In renal disease patients’ dosages of Vitrasert are adjusted.
• It must be stored at room temperature away from direct light and moisture,

SIDE EFFECTS

Ganciclovir 250mg, 500mg Capsules has severe systemic toxicity leading to:

• Myelosuppression leading to thrombocytopenia, neutropenia , granulocytopenia
• Nausea
• Vomiting
• Rashes
• Sweating
• Fever
• Insomnia
• Peripheral neuropathy
• dose dependent kidney toxicity
• Neuropsychiatric disturbances like convulsions, mental confusion
• Rarely hepatic toxicity

 

CONTRAINDICATIONS

Due to adverse effects Cymevene is contraindicated in

• Allergy to ganciclovir
• Pre existing cytopenias
• in patients already on myelosuppressive drugs
• Breastfeeding mothers
• Kidney diseases

 

Drug Interaction

Cymevene interact with

• didanosine, imipenem/cilastatin
• drugs used in cancer chemotherapy, trimethoprim/sulfamethoxazole, zidovudine
• cyclosporine

 

REVIEWS

• Ganciclovir 250mg, 500mg Capsules has less adverse effects and is more effective against CMV infections unlike acyclovir

Due to high systemic toxicity use of Cytovene is restricted to severe CMV infections in immunocompromised patients.