藥劑部參考美國 Johns Hopkins 大學研究團隊所建立的 NxP (Nephrotoxic Potential) 專家共識分級清單，本品具「顯著以上腎毒性風險」，被認定具中度至高度腎損傷潛勢，特別是同時合併其他腎毒性藥物、脫水、高齡或既有腎功能異常的患者族群，應更加注意。

【缺藥訊息】 公告日期：2024/3/8。 缺藥品項：Gancicure 針 500 mg/Vial。 缺藥原因：因製造問題缺貨，預計2024/3 下旬到貨。 替代藥品：國內有同成份規格專案進口品，原 Cymevene 針 500 mg 缺貨至 2024/4。 配套措施：院內目前有同類口服藥品Valganciclovir 錠劑 450 mg，將採購專案進口品替代 (專案進口品預計2024/3 下旬供貨)，建請優先保留注射劑給無法口服之病人使用。

免疫功能缺乏之巨細胞病毒感染症

Antiviral Agent: Ganciclovir inhibits the binding of deoxyguanosine triphosphate to DNA polymerase resulting in inhibition of viral DNA synthesis.

Distribution:
Children 9 months to 12 years: 0.64 L/kg;
Adults: 0.74 L/kg , widely to all tissues including CSF and ocular tissue.
Protein binding: 1% to 2%.
Half-life elimination:
Children 2 to 12 years: 2.4 hours.
Adults: IV: 3.5 hours.
Excretion: Urine (80% to 99% as unchanged drug).

Hypersensitivity to ganciclovir, valganciclovir, or any component of the formulation.

>10%:hyperhidrosis (12%), diarrhea (44%), anorexia (14%), vomiting (13%), thrombocytopenia (6%-57%), lukopenia (41%), neutropenia (4%-29%), anemia (5%-25%), sepsis (15%), infection (13%), retinal detachment (11%) Increased serum creatinine (2%-50%), fever (48%).

Cytomegalovirus Infection (CMV):
Induction dose: 5 mg/kg IV infusion over 1 hour, once every 12 hours for 14-21 days.
Maintenance dose:
(1) 5 mg/kg IV infusion over 1 hour, once every 24 hours;
(2) 6 mg/kg IV infusion over 1 hour, 5 days a week.

Cytomegalovirus Infection (CMV):
Clcr ≥70 (mg/min): Induction dose:5.0 (mg/kg/12hr);Maintenance dose 5.0 (mg/kg/day).
Clcr 50-69 (mg/min): Induction dose:2.5(mg/kg/12hr);Maintenance dose 2.5 (mg/kg/day).
Clcr 25-49 (mg/min): Induction dose:2.5 (mg/kg/day);Maintenance dose 1.25 (mg/kg/day).
Clcr 10-24 (mg/min): Induction dose:1.25 (mg/kg/day);Maintenance dose 0.625 (mg/kg/day).
Clcr <10 (mg/min): Induction dose:1.25 (mg/kg/3 times a week)(after dialysis);Maintenance dose:0.625 (mg/kg/3 times a week).