Clinical pharmacokinetics of ganciclovir in patients with normal and impaired renal function

Rev Infect Dis. 1988 Jul-Aug:10 Suppl 3:S507-14. doi: 10.1093/clinids/10.supplement_3.s507.


The pharmacokinetics of ganciclovir was evaluated in 21 patients with life- or sight-threatening cytomegalovirus infections. Thirteen patients had normal renal function and eight patients had various degrees of renal insufficiency. Most patients received 5 mg of ganciclovir/kg as a 1-hour intravenous infusion twice daily for periods of up to 2 weeks. Quantification of ganciclovir was assessed by high-performance liquid chromatography and radioimmunoassay. In patients with normal renal function, a biexponential decay of ganciclovir from plasma was observed, with an initial distribution half-life (t1/2) of 0.76 +/- 0.67 hour and a terminal elimination t1/2 of 3.60 +/- 1.40 hours. A large fraction of the administered dose was excreted in urine, and total clearance of ganciclovir correlated well with creatinine clearance. In patients with renal insufficiency who were receiving 5 mg of ganciclovir/kg, the terminal elimination t1/2 of ganciclovir was markedly increased (11.50 +/- 3.90 hours), as compared with values obtained in patients with normal renal function. Hemodialysis efficiently reduced levels of ganciclovir in plasma by approximately 53.0% +/- 11.5%, a finding that indicates this drug should be administered after dialysis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acyclovir / administration & dosage
  • Acyclovir / analogs & derivatives*
  • Acyclovir / pharmacokinetics
  • Adult
  • Antiviral Agents / administration & dosage
  • Antiviral Agents / pharmacokinetics*
  • Chromatography, High Pressure Liquid
  • Cytomegalovirus Infections / metabolism*
  • Female
  • Ganciclovir
  • Humans
  • Infusions, Intravenous
  • Kidney Diseases / metabolism*
  • Male
  • Middle Aged
  • Renal Dialysis


  • Antiviral Agents
  • Ganciclovir
  • Acyclovir