Ganciclovir
Ganciclovir is an antiviral medication primarily used to treat infections caused by cytomegalovirus (CMV), particularly in patients with weakened immune systems such as those with HIV/AIDS or organ transplant recipients. It is available in IV, oral, and intravitreal formulations for treating serious CMV disease, including retinitis and other organ involvement.
An antiviral agent used to treat cytomegalovirus infections, primarily in immunocompromised patients.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- J05AB06
- RxNorm
- 4678
- Generic
- Ganciclovir
- Class
- atc-j05
- Brands
- Zirgan
- Availability
- rx
- Lactation
- unknown
- Routes
- ophthalmic, oral
- Forms
- injection, gel, capsule
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 1000mg three times daily
- Maximum
- consult physician
- Frequency
- every 8 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 5mg/kg three times daily
- Maximum
- consult physician
- Frequency
- every 8 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
7 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks; discuss potential fetal harm with patient
regular fetal monitoring, ultrasound assessments
Use of this medication in this population requires careful consideration of risks and benefits.
pregnancy
second third trimesteruse lowest effective dose
use only if benefits outweigh potential risks; consider alternative therapies when possible
fetal growth monitoring, regular prenatal check-ups
Use with caution and monitor for adverse effects.
lactation
breastfeedingdiscontinue breastfeeding
do not breastfeed during treatment and for at least 24 hours after last dose; ganciclovir is excreted in breast milk
infant monitoring for adverse effects
Use of this medication in this population requires careful consideration of risks and benefits.
pediatric_age
pediatricweight-based or body surface area dosing required
use only for immunocompromised pediatric patients with documented CMV infection; monitor blood counts closely
complete blood counts twice weekly during induction, weekly during maintenance
Use with caution and monitor for adverse effects.
geriatric
elderlyreduce dose based on renal function
assess renal function before dosing; start at lower end of dosing range; monitor for neurological adverse effects
monitor renal function and complete blood counts regularly
Use with caution and monitor for adverse effects.
renal_impairment
mild to moderatedose reduction required based on creatinine clearance
adjust dose according to creatinine clearance; for CrCl 50-79 mL/min reduce dose by 50%; for CrCl 25-49 mL/min reduce dose by 75%
monitor renal function and hematologic parameters every 2-3 days during treatment
Use with caution and monitor for adverse effects.
renal_impairment
severesignificant dose reduction or extended dosing interval
for CrCl <25 mL/min use extreme caution; consider alternative therapy; if used reduce dose to 1.25 mg/kg every 24-48 hours
frequent monitoring of renal function and blood counts, serum drug level monitoring if available
Use with caution and monitor for adverse effects.
Statistics and clinical data
Commonly prescribed since
FDA approval year for Ganciclovir intravenous formulation
Drug class
Pharmacological classification as antiviral agent
Common uses
Primary therapeutic indication for Ganciclovir
Mechanism of action
Pharmacodynamic properties
Treatment and prevention of CMV infections including CMV retinitis in immunocompromised patients (HIV/AIDS, transplant recipients), and CMV colitis or pneumonitis. Also used for CMV prevention in solid organ and bone marrow transplant patients.
Ganciclovir is a synthetic guanosine analog that is converted to ganciclovir triphosphate inside infected cells. It competitively inhibits viral DNA polymerase, incorporates into viral DNA causing chain termination, and suppresses viral replication.
Significant bone marrow suppression (neutropenia, thrombocytopenia) is common; requires regular CBC monitoring. Use with caution in renal impairment (dose adjustment needed). Contraindicated in pregnancy due to teratogenicity; both male and female patients should use effective contraception during and after treatment. IV administration associated with phlebitis and requires adequate hydration.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy