OBJECTIVES: We investigated the pharmacokinetics of ganciclovir in 12 haematopoietic stem cell transplantation (HSCT) recipients to evaluate the validity of a 50% reduction in the ganciclovir dosage for mild renal impairment. PATIENTS AND METHODS: Ganciclovir at 5 mg/kg/day was pre-emptively infused in patients with estimated CL(CR) > or = 70 mL/min (Group A), whereas the dose was reduced to 2.5 mg/kg/day in patients with CL(CR) between 50 and 70 mL/min (Group B). RESULTS: The peak concentration was significantly higher in Group A (P < 0.01). However, the decrease in the plasma ganciclovir concentration was slower in Group B (P = 0.09), and the AUC of all patients in both groups was distributed within a narrow range (25.6 +/- 4.77 microg x h/mL), when two patients with exceptionally high AUC values were excluded. CONCLUSIONS: A 50% reduction in ganciclovir appeared to be appropriate for patients with mild renal impairment. Measuring the ganciclovir concentration at 4 h after starting infusion may be adequate for evaluating AUC.
OBJECTIVES: We investigated the pharmacokinetics of ganciclovir in 12 haematopoietic stem cell transplantation (HSCT) recipients to evaluate the validity of a 50% reduction in the ganciclovir dosage for mild renal impairment. PATIENTS AND METHODS: Ganciclovir at 5 mg/kg/day was pre-emptively infused in patients with estimated CL(CR) > or = 70 mL/min (Group A), whereas the dose was reduced to 2.5 mg/kg/day in patients with CL(CR) between 50 and 70 mL/min (Group B). RESULTS: The peak concentration was significantly higher in Group A (P < 0.01). However, the decrease in the plasma ganciclovir concentration was slower in Group B (P = 0.09), and the AUC of all patients in both groups was distributed within a narrow range (25.6 +/- 4.77 microg x h/mL), when two patients with exceptionally high AUC values were excluded. CONCLUSIONS: A 50% reduction in ganciclovir appeared to be appropriate for patients with mild renal impairment. Measuring the ganciclovir concentration at 4 h after starting infusion may be adequate for evaluating AUC.
Authors: Philip Roland Selby; Sepehr Shakib; Sandra L Peake; Morgyn S Warner; David Yeung; Uwe Hahn; Jason A Roberts Journal: Clin Pharmacokinet Date: 2021-01-30 Impact factor: 6.447