PHARMACOKINETICS OF GANCICLOVIR IN A PATIENT UNDERGOING CHRONIC-HEMODIALYSIS

The pharmacokinetics of ganciclovir was evaluated in a 73-year old anu ric, haemodialyzed patient given 1.25 mg.kg(-1) at the end of each hae modialysis session, three times per week. A biexponential decrease in plasma ganciclovir was observed, with a peak concentration of 3.7 mg.l (-1) followed by a steady state value of 2.6 mg.l(-1) for almost 40 h. The total plasma clearance was 0.05 ml.min(-1).kg(-1), the volume of distribution at steady state was 0.61 kg(-1), the elimination half lif e was 132 h, the area under curve was 372 mu g.h.ml(-1), the mean resi dence time was 190 h, and the percentage of ganciclovir cleared from p lasma after a 5 h haemodialysis session was 52.1 %. The simulated phar macokinetics over one month, following the same scheme of administrati on, did not suggest marked accumulation of ganciclovir. These results were obtained after a reduction of 58 % in the recommended dose in pat ients with impaired renal function.