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Ganciclovir is an antiviral medication used to treat CMV (cytomegalovirus) infections in the immunocompromised. It works as a guanosine analog, that is phosphorylated by a viral kinase to form a competitive inhibitor of nucleotide incorporation into DNA. Thus, it inhibits viral DNA polymerase. Ganciclovir has serious hematological effects, along with renal toxicity.
Cytomegalovirus (CMV)

Ganciclovir is used to treat CMV (cytomegalovirus) infections, especially in patients who are immunocompromised.


Ganciclovir is often used in immunocompromised patients with AIDS or HIV, as they are more susceptible to more rare CMV manifestations, such as CMV pneumonitis, retinitis or colitis.

Guanosine Analog
G-iguana On-a-log

Ganciclovir is a synthetic analog of guanosine, which is phosphorylated by a viral kinase encoded by CMV during infection. This leads to the formation of ganciclovir triphosphate.

Disrupts DNA Synthesis
Disrupted DNA

Ganciclovir triphosphate, which is formed after processing by CMV, is a competitive inhibitor of nucleotide incorporation into DNA. This leads to disrupted DNA synthesis in the virus.

Inhibits Viral DNA Polymerase
Inhibiting-chains on DNA Polly-mirror

Ganciclovir triphosphate, which is formed by viral processing of ganciclovir, preferentially inhibits viral DNA polymerases, disrupting viral DNA synthesis.

Hematologic Effects

Patients taking this medication can suffer from serious hematological side effects, such as anemia, thrombocytopenia, neutropenia and granulocytopenia.

Kidney with Toxic-green-glow

This drug is prescribed judiciously, as it can lead to nephrotoxicity in patients, and is renally excreted.

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