Dosing
CrCl > 80: 900 mg po bid for induction, 900 qd for prevention and maintenance.
CrCl | Induction Dose (mg) | Maintenance Dose (mg) |
60 | 900 bid | 900 qd |
40-59 | 450 bid | 450 qd |
25-39 | 450 qd | 450 q 2d |
10-24 | 450 q 2d | 450 q week |
If giving for CMV prophylaxis in transplant, if you under-dose as the GFR improves, there is an increased chance of CMV (Pubmed).
Hemodialysis:
Peritoneal dialysis:
Important side effects
Abdominal pain, diarrhea, nausea, vomiting, anemia, neutropenia (very common), thrombocytopenia, headache, insomnia.
Important drug interactions
Probenecid, zidovudine.
Rants and Screeds
I would avoid where absorption may be an issue, such as colitis.
Pearls
Treatment of choice
Use for
CMV retinitis. Perhaps other manifestations of CMV, it achieves blood levels nearly as good as iv.
Don't use for
Class
Last update 11/30/19