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DHPG Sodium (Generic Ganciclovir)

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Ganciclovir is an antiviral medication commonly used to treat infections caused by cytomegalovirus (CMV) in people with weakened immune systems, such as those with HIV/AIDS or undergoing organ transplantation. However, like any medication, it carries certain risks:

  • Bone Marrow Suppression: Ganciclovir can suppress the bone marrow’s ability to produce blood cells, leading to conditions like anemia (low red blood cells), leukopenia (low white blood cells), and thrombocytopenia (low platelets).
  • Kidney Toxicity: It may cause kidney damage or worsen pre-existing kidney problems, particularly when used at high doses or for prolonged periods.
  • Neutropenia: Ganciclovir can lower the levels of neutrophils (a type of white blood cell), increasing the risk of infections.
  • Reproductive Risks: Ganciclovir may cause harm to unborn babies if taken during pregnancy, so it’s typically avoided in pregnant individuals unless the benefits outweigh the risks.
  • Neurological Effects: Rarely, ganciclovir may cause neurological side effects such as seizures, confusion, or hallucinations.
  • Allergic Reactions: Some individuals may experience allergic reactions to ganciclovir, which can range from mild rash to severe anaphylaxis.
  • Drug Interactions: Ganciclovir can interact with other medications, potentially affecting their effectiveness or increasing the risk of side effects.

It’s essential to discuss the potential risks and benefits of ganciclovir treatment with a healthcare provider, especially considering individual health factors and medical history.

Why is this medication prescribed?

Ganciclovir is primarily prescribed to treat certain viral infections, notably cytomegalovirus (CMV) retinitis in people with weakened immune systems, such as those with HIV/AIDS. CMV retinitis is a severe eye infection that can lead to blindness if left untreated. Ganciclovir works by inhibiting the replication of the virus responsible for the infection.

How should this medicine be used?

Ganciclovir is available in various forms, including capsules, intravenous (IV) injections, and oral suspension. The dosage and administration method depend on the severity of the infection and the patient’s overall health condition.

For the capsules specifically, here’s a general guideline on how Ganciclovir should be used:

  • Dosage: The dosage of Ganciclovir capsules is typically determined by a healthcare provider based on factors such as the patient’s weight, the severity of the infection, and their kidney function.
  • Frequency: Ganciclovir capsules are usually taken orally, either with or without food. The frequency of dosing can vary, but it’s typically taken multiple times per day.
  • Follow Instructions: It’s crucial to follow the dosage instructions provided by the healthcare provider or as indicated on the prescription label. Do not alter the dosage or stop taking the medication without consulting your healthcare provider.
  • Stay Hydrated: It’s important to drink plenty of fluids while taking Ganciclovir to help prevent kidney problems, as the medication can be hard on the kidneys.
  • Adherence: To get the most benefit from Ganciclovir, it’s essential to take it regularly and complete the full course of treatment, even if you start feeling better before the treatment is finished.
  • Monitoring: Regular check-ups with your healthcare provider are necessary to monitor your response to the medication and to check for any potential side effects or complications.
  • Precautions: Inform your healthcare provider about any other medications you are taking, including over-the-counter drugs, supplements, or herbal remedies, as they can interact with Ganciclovir.
  • Storage: Store Ganciclovir capsules at room temperature away from moisture, heat, and light, and keep them out of reach of children.

Always consult with your healthcare provider for specific instructions tailored to your individual needs and medical condition. They can provide you with the most accurate guidance regarding the proper use of Ganciclovir.

Other uses for this medicine

Aside from treating CMV retinitis, Ganciclovir may also be used in the following situations:

  • Prevention of CMV: In individuals who have undergone organ transplantation (such as kidney, heart, or lung transplant) or bone marrow transplantation, Ganciclovir may be prescribed to prevent CMV infection, which can occur due to immunosuppression caused by the transplant medications.
  • Treatment of Other CMV Infections: Ganciclovir may be used to treat other CMV infections that affect different organs or systems in people with weakened immune systems.
  • Treatment of Herpes Simplex Virus (HSV): Ganciclovir may also be used to treat severe cases of herpes simplex virus infections, particularly in individuals with compromised immune systems.

What special precautions should I follow?

Now, regarding special precautions for Ganciclovir:

  • Kidney Function: Ganciclovir can be nephrotoxic, meaning it can cause kidney damage. Patients with pre-existing kidney problems should be closely monitored while taking Ganciclovir. Dosage adjustments may be necessary in individuals with impaired renal function.
  • Bone Marrow Suppression: Ganciclovir can suppress bone marrow function, leading to decreased production of blood cells (hematologic toxicity). Regular blood tests are necessary to monitor blood cell counts during treatment. If significant hematologic toxicity occurs, the dosage may need adjustment or discontinuation of the medication.
  • Pregnancy and Breastfeeding: Ganciclovir may harm the fetus if used during pregnancy. It should only be used during pregnancy if the potential benefits outweigh the risks. Breastfeeding is not recommended while taking Ganciclovir due to the potential for harm to the nursing infant.
  • Contraception: Ganciclovir can cause birth defects, so effective contraception should be used by both males and females during treatment and for a period after treatment ends.
  • Allergic Reactions: Patients with a known hypersensitivity to Ganciclovir or any of its components should not take the medication. Allergic reactions may include rash, itching, swelling, dizziness, or trouble breathing.
  • Interactions: Ganciclovir may interact with other medications, including certain antiviral drugs, immunosuppressants, and medications that affect kidney function. Inform your healthcare provider about all medications you are taking to avoid potential interactions.
  • Driving and Machinery: Ganciclovir may cause dizziness or blurred vision as side effects. If you experience these symptoms, avoid driving or operating machinery until you know how the medication affects you.

Always follow your healthcare provider’s instructions and inform them of any pre-existing medical conditions or medications you are taking before starting Ganciclovir.

What special dietary instructions should I follow?

As for special dietary instructions, there are no specific dietary restrictions associated with Ganciclovir. However, it’s essential to maintain adequate hydration while taking the medication, as it can be hard on the kidneys. Drinking plenty of fluids, especially water, can help prevent kidney problems.

What should I do if I forget a dose?

If you forget to take a dose of Ganciclovir, take it as soon as you remember, unless it’s almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you have any concerns or questions about missed doses, consult your healthcare provider or pharmacist for guidance.

What side effects can this medication cause?

Ganciclovir, like any medication, can cause side effects. Common side effects may include:

  • Nausea and vomiting: Ganciclovir can sometimes cause gastrointestinal upset, leading to nausea and vomiting.
  • Diarrhea: Some individuals may experience diarrhea while taking Ganciclovir.
  • Headache: Headaches are a common side effect reported by some people using Ganciclovir.
  • Fever and chills: Ganciclovir may cause flu-like symptoms such as fever and chills in some individuals.
  • Fatigue: Feeling tired or fatigued is another potential side effect of Ganciclovir.
  • Anemia: Ganciclovir can suppress bone marrow function, leading to a decrease in red blood cell count (anemia).
  • Neutropenia: Neutropenia, a decrease in the number of neutrophils (a type of white blood cell), can occur with Ganciclovir use.
  • Thrombocytopenia: Ganciclovir may cause a decrease in the number of platelets in the blood, known as thrombocytopenia.
  • Kidney toxicity: Ganciclovir can be nephrotoxic, meaning it can cause kidney damage or impairment in some individuals.
  • Liver function abnormalities: Rarely, Ganciclovir may cause abnormalities in liver function tests.
  • Electrolyte abnormalities: Ganciclovir may affect electrolyte levels in the body, such as potassium and magnesium.
  • Allergic reactions: Although uncommon, some individuals may experience allergic reactions to Ganciclovir, which can manifest as rash, itching, swelling, dizziness, or trouble breathing.

It’s essential to report any side effects experienced while taking Ganciclovir to your healthcare provider. They can provide guidance on managing side effects or adjust your treatment if necessary. Additionally, if you experience severe or persistent side effects, seek medical attention promptly.

What should I know about storage and disposal of this medication?

Regarding storage and disposal of Ganciclovir:

  • Storage: Store Ganciclovir capsules at room temperature away from moisture, heat, and light. Keep them out of reach of children and pets.
  • Disposal: Dispose of unused or expired Ganciclovir capsules properly according to local regulations or guidelines. Do not flush them down the toilet or pour them into a drain unless instructed to do so.

In case of emergency/overdose

  • Seek medical attention: If you suspect an overdose of Ganciclovir or experience severe symptoms such as dizziness, confusion, seizures, difficulty breathing, or loss of consciousness, seek immediate medical attention or contact your local poison control center.
  • Symptomatic treatment: Treatment for Ganciclovir overdose is generally supportive and symptomatic. It may involve measures to stabilize vital signs, such as intravenous fluids, monitoring electrolyte levels, and providing supportive care as needed.

What other information should I know?

  • Regular monitoring: Your healthcare provider will likely monitor your response to Ganciclovir treatment regularly, including blood tests to check kidney function, blood cell counts, and other relevant parameters.
  • Avoid exposure to infections: Since Ganciclovir can suppress the immune system, it’s essential to avoid exposure to infections as much as possible while undergoing treatment. Practice good hygiene, avoid close contact with sick individuals, and consider vaccinations as recommended by your healthcare provider.
  • Medication adherence: Take Ganciclovir exactly as prescribed by your healthcare provider. Do not alter the dosage or stop taking the medication without consulting them first, even if you start feeling better.
  • Follow-up appointments: Attend all scheduled follow-up appointments with your healthcare provider to monitor your progress and address any concerns or questions you may have about your treatment.
  • Inform healthcare providers: Inform all healthcare providers involved in your care, including dentists and pharmacists, that you are taking Ganciclovir. This is important to prevent potential drug interactions and ensure coordinated care.
  • Patient education: Educate yourself about Ganciclovir, including its uses, potential side effects, and precautions. Ask your healthcare provider or pharmacist if you have any questions or need clarification about your treatment.

By following these guidelines and staying informed, you can use Ganciclovir safely and effectively as part of your treatment regimen.

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