Anaemia,
neutropenia, leucopenia and
gastrointestinal disturbances were seen when
zidovudine and
ganciclovir were used concurrently. The dose of
zidovudine had to be reduced to 300 mg daily in many patients.
Ganciclovir appears to moderately increase the levels of
zidovudine. Valganciclovir is a prodrug of
ganciclovir and would therefore be expected to interact similarly.
The UK manufacturer of
ganciclovir suggests that
zidovudine should not be iven during
ganciclovir induction treatment, and patients should be closely monitored for
neutropenia when maintenance
ganciclovir is used with
zidovudine.