Treatment for Cytomegalovirus Infection (CMV)

Drugs

Dosage

Adverse Effects

Remarks

Ganciclovir

Induction phase
5 mg/kg every 12 hours IV for 14-21 days [in disseminated disease & CMV retinitis]

6 mg/kg every 12 hours IV for 6 weeks [in symptomatic congenital infection]

Prophylaxis
30 mg/kg tid PO
OR 5 mg/kg/day IV x 5 days/week

Neutropenia, Myelosuppression, Renal toxicity, CNS effects, GI dysfunction, thrombophlebitis and elevated liver enzymes

Combination therapy with Ganciclovir & Foscarnet can be used in children with sight threatening disease.

Foscarnet

60 mg/kg tid IV for 14-21 days, then 90-120 mg/kg once a day for chronic suppression.

Renal dysfunction, Electrolyte imbalance (especially in calcium, phosphorus, magnesium and potassium levels), seizures, cardiac arrhythmia's, elevated liver enzymes and CNS symptoms

Used in induction phase as alternative in case of ganciclovir resistant CMV

Valganciclovir

500mg/m2/day PO in 2 divided doses followed by 250 mg/m2/day OD as maintenance

Myelosuppression

May be used in adolescents. Data in children is lacking.