Ganciclovir
Since ganciclovir is considered a potential teratogen and carcinogen in humans, caution should be observed in its handling.
With the Except of DGT: Ganciclovir can only be made up at Maidstone Hospital Onccology aseptic unit or ordered from ITH during normal working hours. Out of hours cover will mean giving the oral equivalent Valganciclovir, or Foscarnet IV if patient can't take medication orally. Once pharmacy is open, then an order can be placed to switch the patient to ganciclovir.
Avoid inhalation or direct contact of the reconstituted solution with the skin or mucous membranes. Ganciclovir solutions are alkaline (pH ~11). If such contact occurs, wash thoroughly with soap and water, rinse eyes thoroughly with plain water.
To discard used/expired bags please use a cytotoxic bin.
These are specialist antiviral agents used for the treatment and prevention of cytomegalovirus infections usually associated with immunocompromised patients and immunosuppresive therapy following organ transplantation.
Foscarnet may also be used for Herpes simplex infections unresponsive to aciclovir in immunocompromised patients.
Letermovir is used post stem cell transplant to prevent reactivation of cytomegalovirus infection. Only available in specialist centres
