Cytomegalovirus, or CMV, is a type of herpes virus that can be particularly problematic for people with weakened or compromised immune systems. When this type of patient contracts the virus, particularly as an infection of the eyes called CMV retinitis, a doctor will sometimes prescribe a drug called ganciclovir. This antiviral medication, which can be administered intravenously or in pill form, is also sometimes used to prevent CMV infection in immuno-compromised patients at high risk.
Ganciclovir is treated as a cytotoxic drug, meaning it can have a toxic effect on the cells. The drug is considered to have the potential to cause cancer. It may also lead to birth defects if taken during pregnancy, and it is thought to cause infertility in men.
Some very severe side effects are also associated with the use of ganciclovir. The biggest danger with taking the drug is its potential effect on the blood; it may cause significant decreases in red cells, white cells, and platelets. Digestive issues such as abdominal pain, vomiting, and diarrhea may occur with its use. Neurological symptoms such as hallucinations and seizures can be an issue, as well as psychological changes such as anxiety or depression. Other unpleasant symptoms can include fever, rash, and loss of appetite.
Due to its potential harmful effects, ganciclovir is usually used only when absolutely necessary. Patients taking this drug generally have reduced immune function due to factors such as infection with HIV/AIDS or a recent organ or bone marrow transplant. These patients are unable to fight a CMV infection, which normally has very little impact on those with a normal immune system, without assistance. Many cases where it is prescribed involve patients who are at risk of going blind from a CMV retinitis infection, though the disease can affect other areas such as the lungs. It is also used for prevention when possible, as it will not cure CMV once a person is infected, only help control it.
A course of ganciclovir for CMV infection usually occurs in two stages. The first doses are administered intravenously, usually over several weeks, to ensure a higher dose of the drug is received. This is to address an acute attack of CMV and get it under control. Once the disease is in check, the patient can then move to a maintenance dose, taken orally. In cases where the drug is being used preventively, oral administration is usually sufficient.
