- Approval Id
- ed148df46e9c7f25
- Drug Name
- GANCICLOVIR-AFT POWDER FOR SOLUTION FOR INJECTION 500MG/VIAL
- Product Name
- GANCICLOVIR-AFT POWDER FOR SOLUTION FOR INJECTION 500MG/VIAL
- Approval Number
- SIN17325P
- Approval Date
- 2025-09-09
- Registrant
- APEX PHARMA MARKETING PTE. LTD.
- Licence Holder
- APEX PHARMA MARKETING PTE. LTD.
- Drug Type
- Therapeutic
- Forensic Classification
- PRESCRIPTION ONLY MEDICINES
- Dosage Form
- INJECTION, POWDER, FOR SOLUTION
- Dosage
- <p>2.2 DOSE AND METHOD OF ADMINISTRATION</p>
<p><strong>General</strong></p>
<p>Ganciclovir-AFT must be reconstituted and diluted under the supervision of a healthcare professional and administered as an intravenous infusion (see section 4.2 Special Instructions for Use, Handling and Disposal – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p>Caution: Ganciclovir-AFT must only be administered by IV infusion over 1 hour, preferably via a plastic cannula, into a vein with adequate blood flow (intramuscular or subcutaneous injection may result in severe tissue irritation due to the high pH (~ 11) of ganciclovir solution. Do not administer by rapid or bolus IV injection because the resulting excessive plasma levels may increase the toxicity of Ganciclovir-AFT (see section 4.2 Special Instructions for Use, Handling and Disposal – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p>The recommended dosage, frequency, or infusion rates should not be exceeded.</p>
<p><strong>STANDARD DOSAGE FOR TREATMENT OF CMV DISEASE</strong></p>
<p><u>Dosage for patients with normal renal function</u></p>
<p><em>Induction treatment:</em> 5 mg/kg given as an IV infusion over one hour, every 12 hours for 14–21 days.</p>
<p><em>Maintenance treatment:</em> For immunocompromised patients at risk of relapse maintenance therapy may be given. 5 mg/kg given as an IV infusion over one hour, once daily on 7 days per week or 6 mg/kg once daily on 5 days per week.</p>
<p>The duration of maintenance treatment should be determined on an individual basis.</p>
<p><strong>STANDARD DOSAGE FOR PREVENTION OF CMV DISEASE USING PRE-EMPTIVE THERAPY</strong></p>
<p><u>Dosage for patients with normal renal function</u></p>
<p><em>Induction treatment:</em> 5 mg/kg given as an IV infusion over one hour, every 12 hours for 7–14 days.</p>
<p><em>Maintenance treatment:</em> 5 mg/kg given as an IV infusion over one hour, once daily on 7 days per week or 6 mg/kg once daily on 5 days per week.</p>
<p>The duration of maintenance treatment is based on the risk of CMV disease and should be determined on an individual basis.</p>
<p><strong>Special dosage instructions</strong></p>
<p><em>Pediatric Patients</em></p>
<p>Safety and efficacy of ganciclovir in pediatrics have not been established, including use for the treatment of congenital or neonatal CMV infections. The use of Ganciclovir-AFT in children warrants extreme caution due to the potential for long-term carcinogenicity and reproductive toxicity. The benefits of treatment should outweigh the risks (see section 3.2.5 Pharmacokinetics in Special Populations, Pediatric Population – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><em>Geriatric patients</em></p>
<p>No studies have been conducted in adults older than 65 years of age. Since renal clearance decreases with age, Ganciclovir-AFT should be administered to geriatric patients with special consideration of their renal status (see Table 1 and section 3.2.5 Pharmacokinetics in Special Populations, Geriatric population – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
<p><em>Renal impairment</em></p>
<p>For patients with renal impairment, the dose of Ganciclovir-AFT should be modified as shown in the table below.</p>
<p><strong>Table 1 Ganciclovir dosing for renally impaired patients</strong></p>
<table class="borderless-100">
<tbody>
<tr>
<td><strong>CrCl</strong></td>
<td><strong>Induction dose</strong></td>
<td><strong>Maintenance dose</strong></td>
</tr>
<tr>
<td>≥ 70ml/ min</td>
<td>5.0 mg/kg q12h</td>
<td>5.0 mg/kg/day</td>
</tr>
<tr>
<td>50–69 ml/ min</td>
<td>2.5 mg/kg q12h</td>
<td>2.5 mg/kg/day</td>
</tr>
<tr>
<td>25–49 ml/min</td>
<td>2.5 mg/kg/day</td>
<td>1.25 mg/kg/day</td>
</tr>
<tr>
<td>10–24 ml/min</td>
<td>1.25 mg/kg/day</td>
<td>0.625 mg/kg/day</td>
</tr>
<tr>
<td>< 10 ml/min</td>
<td>1.25 mg/kg 3x/wk after hemodialysis</td>
<td>0.625 mg/kg 3x/wk after hemodialysis</td>
</tr>
</tbody>
</table>
<p>Estimated creatinine clearance can be related to serum creatinine by the following formulae:</p>
<img src="/TGIF/Ganciclovir-AFT-Formula.png" alt="Ganciclovir-AFT Dosage Table 1" /><br><br>
<p>For females = 0.85 x male value</p>
<p>As dosage modifications are recommended in patients with renal impairment, serum creatinine or estimated creatinine-clearance levels should be monitored carefully.</p>
<p><em>Hepatic impairment</em></p>
<p>The safety and efficacy of Ganciclovir-AFT have not been studied in patients with hepatic impairment (see section 3.2.5 Pharmacokinetics in Special Populations, Hepatic impairment – <em>please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information</em>).</p>
- Route Of Administration
- INTRAVENOUS
- Indication Info
- <p>2.1 THERAPEUTIC INDICATIONS</p>
<p>Ganciclovir-AFT vials are indicated for the prevention and treatment of life- or sight-threatening cytomegalovirus (CMV) disease in immunocompromised individuals.</p>
<p>The benefits of Ganciclovir-AFT for CMV prevention in patients with HIV may be limited.</p>
- Contraindications
- <p>2.3 CONTRAINDICATIONS</p>
<p>Ganciclovir-AFT is contraindicated in patients with hypersensitivity to ganciclovir, valganciclovir or to any of the excipients.</p>