In case of overdose, in some cases, no adverse events did not occur. The majority of patients had one or more of the following adverse events: Haematological toxicity: pancytopenia, myelosuppression, bone marrow aplasia, leucopenia, neutropenia, granulocytopenia. Hepatotoxicity: hepatitis, abnormal liver function. Renal rimobolan dosage toxicity: the growth of haematuria in a patient with pre-existing renal disease, acute renal insufficiency, increased creatinine. Gastrointestinal toxicity: abdominal pain, diarrhea, vomiting. Neurotoxicity: generalized tremor, convulsion.
In addition, one adult patient was administered intravitreally ganciclovir excess volume of solution for intravenous administration, after which he developed a temporary loss of vision and central retinal artery occlusion due to an increase in intraocular pressure caused by the volume of fluid introduced.
To reduce the level of ganciclovir in the plasma at an oral overdose may be used dialysis and hydration .
Interaction with other drugs
Interactions with intravenous ganciclovir
Ganciclovir degree of binding to plasma proteins is only 1-2%, so the interactions caused by the displacement of the locations of drugs due to the proteins, can not be expected.
Didanosine: found that while the appointment and didanosine oral administration or intravenous ganciclovir didanosine plasma concentrations increased firmness. When intravenous ganciclovir at doses of 5 – 10 mg / kg per day didanosine primobolan dosage increased by 38 – 67%. This increase can not be explained by a change of tubular secretion of the drug, since the percentage of elimination of didanosine increased. This increase may be caused by either increased bioavailability, or decrease in metabolic rate. No clinically significant changes in the concentration of ganciclovir it was not. However, given the increase of plasma concentrations of didanosine in the presence of ganciclovir, patients should be closely monitored for toxicity didanosine.
Imipenem / cilastatin: in patients while treated with ganciclovir and imipenem / cilastatin, seizures have been observed. These drugs should be administered in combination with Tsimevenom only if the possible benefits outweigh the risks.
Mycophenolate mofetil: co-administration of these drugs, potentially competing with tubular secretion may increase concentrations of ganciclovir and primobolan dosage (the phenolic glucuronide of mycophenolic acid).Significant changes pharmacokinetics mycophenolic acid are not expected to adjust the dose of mycophenolate mofetil is required. In patients with impaired renal function, which simultaneously receive ganciclovir you must follow the recommendations for dosage of ganciclovir and conduct careful observation.