IV 250 or 500 mg IV infusion over 20-30 min or 1 g over 40-60 min. Adult 1.5-2 g daily in 3-4 equally divided doses. May increase to a max dose of 50 mg/kg daily (max 4 g daily). Moderate infection 500 mg every 8 hr. Severe infection 500 mg every 6 hr. Severe &/or life-threatening 1,000 mg every 8 hr. Infections due to less susceptible organisms 1,000 mg every 6 hr. Childn ≥3 yr weighing >40 kg Adult dose, <40 kg 15 mg/kg every 6 hr. Max daily dose: 2 g. Moderate renal impairment (CrCl 21-30 mL/min) 500 mg every 8-12 hr. Max daily dose: 1-1.5 g. Severe renal impairment (CrCl 0-20 mL/min) 250-500 mg every 12 hr. Max daily dose: 0.5-1 g.
Discontinue use if allergic reaction occurs. Not recommended for treatment of meningitis. Not indicated against CNS infections. History of GI disease, particularly colitis. CNS disorders &/or compromised renal function. Reduce dose or w/draw therapy if focal tremors, myoclonus or convulsions occur. Asthenia & aggravation of myasthenia gravis may occur. Do not administer in patients w/ CrCl ≤5 mL/min unless hemodialysis is instituted w/in 48 hr. Potential risk of convulsions in patients undergoing hemodialysis. Childn ≥3 yr.
Risk of seizures w/ ganciclovir & valganciclovir. Increased plasma level & t1/2 w/ probenecid. Decreases plasma conc of valproic acid. May cause false +ve result in Coombs test.
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