Last update Aug. 6, 2020
Synthetic nucleoside which is analogue of guanine, structurally very closed related to acyclovir.
Indicated for the treatment and prevention of Cytomegalovirus (CMV) in immunocompromised patients.
Oral or intravenous administration once or twice a day. Also, topical ophthalmic use for the treatment of herpetic keratitis.
At latest update no published data on excretion into breast milk were found.
Its pharmacokinetic data do not allow a good prediction of excretion in breast milk, since while the low molecular weight and its almost zero protein binding would facilitate it, its high volume of distribution would prevent it.
In any ay, its low oral bioavailability (< 10%: Anderson 1995, Jacobson 1987) hinders the passage from ingested milk towards the infant’s plasma, except in preterm babies and immediate neonatal period, which may show an increased intestinal permeability.
In addition to this, it is used in newborns and premature infants who are affected with CMV infection (Mahler 2014, Lombardi 2012, Oulu 2012, Alarcón 2011).
The small dose and poor plasma absorption of most topical ophthalmic preparations make it unlikely that a significant amount will pass into breast milk.
Ophthalmic administration of 5 drops daily supposes a maximum daily dose of 0.375 mg, more than 2,000 times lower than oral or intravenous doses (Hale 2019).
Topical ophthalmic use of ganciclovir is compatible with breastfeeding.
Suggestions made at e-lactancia are done by APILAM team, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it.
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