Substructure SMILES Example: n1cnccc1

ganciclovir 🐶 Veterinary Use | Indications/Contra | FAERs-F | FAERs-M | Orange Bk | BioActivity |

Stem definition	Drug id	CAS RN
antivirals bicyclic heterocycle compounds	1277	82410-32-0

Description:

Molecule	Description
Molfile Inchi Smiles Synonyms: ganciclovir denosine gancyclovir hydroxyacyclovir natclovir ganciclovir sodium	An ACYCLOVIR analog that is a potent inhibitor of the Herpesvirus family including cytomegalovirus. Ganciclovir is used to treat complications from AIDS-associated cytomegalovirus infections. Molecular weight: 255.23 Formula: C9H13N5O4 CLOGP: -2.15 LIPINSKI: 0 HAC: 9 HDO: 4 TPSA: 134.99 ALOGS: -1.35 ROTB: 5 Status: OFP Legend: OFP - off patent OFM - off market ONP - on patent

Drug dosage:

Dose	Unit	Route
3	g	O
0.50	g	P

ADMET properties:

Property	Value	Reference
BDDCS (Biopharmaceutical Drug Disposition Classification System)	3	Benet LZ, Broccatelli F, Oprea TI
S (Water solubility)	6 mg/mL	Benet LZ, Broccatelli F, Oprea TI
EoM (Fraction excreted unchanged in urine)	91 %	Benet LZ, Broccatelli F, Oprea TI
MRTD (Maximum Recommended Therapeutic Daily Dose)	78.36 µM/kg/day	Contrera JF, Matthews EJ, Kruhlak NL, Benz RD
BA (Bioavailability)	4 %	Kim MT, Sedykh A, Chakravarti SK, Saiakhov RD, Zhu H
Vd (Volume of distribution)	1 L/kg	Lombardo F, Berellini G, Obach RS
CL (Clearance)	4.60 mL/min/kg	Lombardo F, Berellini G, Obach RS
fu (Fraction unbound in plasma)	0.99 %	Lombardo F, Berellini G, Obach RS
t_half (Half-life)	3.70 hours	Lombardo F, Berellini G, Obach RS

Approvals:

Date	Agency	Company	Orphan
June 23, 1989	FDA	ROCHE PALO

FDA Adverse Event Reporting System (Female)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Cytomegalovirus infection	475.26	22.87	167	10190	17795	50576972
Drug resistance	421.32	22.87	155	10202	18834	50575933
Post transplant lymphoproliferative disorder	306.61	22.87	85	10272	4119	50590648
Pathogen resistance	298.49	22.87	89	10268	5600	50589167
Cytomegalovirus viraemia	279.21	22.87	81	10276	4628	50590139
Smooth muscle cell neoplasm	261.41	22.87	54	10303	717	50594050
Epstein-Barr virus infection	235.53	22.87	78	10279	6919	50587848
Encephalitis cytomegalovirus	213.48	22.87	43	10314	499	50594268
Multiple organ dysfunction syndrome	210.57	22.87	130	10227	50207	50544560
Graft versus host disease	157.80	22.87	56	10301	6110	50588657
Pancytopenia	142.70	22.87	126	10231	83904	50510863
Nephropathy toxic	136.36	22.87	54	10303	7975	50586792
Pneumonia cytomegaloviral	126.70	22.87	36	10321	1905	50592862
Off label use	126.23	22.87	290	10067	474136	50120631
Cytomegalovirus test positive	116.42	22.87	36	10321	2556	50592211
Neutropenia	114.60	22.87	146	10211	147819	50446948
Cystitis haemorrhagic	107.69	22.87	37	10320	3665	50591102
Haemophagocytic lymphohistiocytosis	105.80	22.87	46	10311	8587	50586180
Fatigue	101.33	22.87	13	10344	707588	49887179
Transplant rejection	101.07	22.87	46	10311	9563	50585204
Leukopenia	96.52	22.87	92	10265	67436	50527331
Cytomegalovirus colitis	96.07	22.87	29	10328	1898	50592869
Acute graft versus host disease	93.92	22.87	34	10323	3924	50590843
Cytomegalovirus chorioretinitis	89.63	22.87	26	10331	1481	50593286
Product use in unapproved indication	87.57	22.87	113	10244	115706	50479061
Cytomegalovirus infection reactivation	87.18	22.87	29	10328	2602	50592165
Epstein-Barr virus associated lymphoproliferative disorder	86.71	22.87	26	10331	1663	50593104
Haemorrhage intracranial	84.24	22.87	44	10313	12330	50582437
Pain	77.29	22.87	13	10344	578890	50015877
Septic shock	74.37	22.87	74	10283	57101	50537666
Sepsis	72.63	22.87	111	10246	132814	50461953
Transplant dysfunction	70.87	22.87	29	10328	4655	50590112
Acute graft versus host disease in skin	68.16	22.87	25	10332	2993	50591774
Renal failure	66.82	22.87	95	10262	106538	50488229
Bronchopulmonary aspergillosis	66.40	22.87	32	10325	7560	50587207
Renal impairment	65.42	22.87	79	10278	75582	50519185
Pneumocystis jirovecii pneumonia	64.08	22.87	39	10318	14624	50580143
Adenovirus infection	63.35	22.87	24	10333	3144	50591623
Bone marrow failure	62.56	22.87	49	10308	27575	50567192
Aspergillus infection	60.41	22.87	29	10328	6792	50587975
Respiratory failure	59.73	22.87	83	10274	91098	50503669
Thrombotic microangiopathy	59.09	22.87	31	10326	8760	50586007
Graft versus host disease in gastrointestinal tract	58.99	22.87	22	10335	2759	50592008
Kidney transplant rejection	58.00	22.87	24	10333	3963	50590804
Arthralgia	53.93	22.87	12	10345	438690	50156077
Graft versus host disease in skin	53.42	22.87	20	10337	2536	50592231
Cytomegalovirus enterocolitis	53.18	22.87	14	10343	555	50594212
Cytomegalovirus gastrointestinal infection	51.61	22.87	12	10345	282	50594485
Dyspnoea	51.47	22.87	24	10333	547584	50047183
Cytomegalovirus oesophagitis	49.99	22.87	11	10346	200	50594567
Posterior reversible encephalopathy syndrome	48.63	22.87	33	10324	14895	50579872
Mucormycosis	46.73	22.87	18	10339	2465	50592302
Parvovirus B19 infection	45.60	22.87	12	10345	475	50594292
Ureaplasma infection	44.86	22.87	12	10345	506	50594261
Epstein-Barr virus infection reactivation	44.55	22.87	12	10345	520	50594247
Chronic graft versus host disease	44.22	22.87	18	10339	2849	50591918
BK virus infection	44.14	22.87	18	10339	2863	50591904
Nausea	43.97	22.87	48	10309	705350	49889417
Pyrexia	42.67	22.87	172	10185	380031	50214736
Gastric ulcer	42.30	22.87	35	10322	21270	50573497
Myelosuppression	41.94	22.87	29	10328	13488	50581279
Intentional product use issue	41.62	22.87	64	10293	76854	50517913
Lung transplant rejection	40.17	22.87	12	10345	757	50594010
Cytomegalovirus gastritis	40.14	22.87	9	10348	179	50594588
Hepatic function abnormal	40.09	22.87	41	10316	32640	50562127
Headache	39.30	22.87	28	10329	506507	50088260
Alopecia	38.81	22.87	3	10354	245044	50349723
Epstein-Barr viraemia	38.63	22.87	12	10345	864	50593903
Product use issue	37.88	22.87	90	10267	149385	50445382
Abdominal discomfort	36.22	22.87	3	10354	231638	50363129
Thrombocytopenia	35.79	22.87	80	10277	127593	50467174
Hyperammonaemia	35.62	22.87	18	10339	4706	50590061
Polyomavirus-associated nephropathy	35.58	22.87	13	10344	1539	50593228
Pulmonary haemorrhage	35.58	22.87	20	10337	6472	50588295
Brain oedema	34.81	22.87	25	10332	12345	50582422
Enterococcal infection	34.45	22.87	20	10337	6878	50587889
Fall	34.08	22.87	13	10344	334919	50259848
Pseudomonas infection	33.49	22.87	22	10335	9408	50585359
Hyperlactacidaemia	33.22	22.87	14	10343	2419	50592348
Transplant failure	32.84	22.87	12	10345	1421	50593346
Hydrocephalus	32.50	22.87	17	10340	4771	50589996
Hypogammaglobulinaemia	32.44	22.87	18	10339	5681	50589086
Aplasia pure red cell	31.60	22.87	16	10341	4199	50590568
Hypersensitivity	30.52	22.87	4	10353	215157	50379610
Swelling	30.33	22.87	3	10354	200869	50393898
Immune reconstitution inflammatory syndrome	30.24	22.87	17	10340	5499	50589268
Liver transplant rejection	30.13	22.87	11	10346	1299	50593468
Cytomegalovirus nephritis	30.07	22.87	5	10352	17	50594750
Dizziness	29.76	22.87	17	10340	346352	50248415
Acute respiratory distress syndrome	28.69	22.87	28	10329	21071	50573696
Drug hypersensitivity	28.59	22.87	8	10349	251002	50343765
Venoocclusive liver disease	28.56	22.87	15	10342	4246	50590521
Klebsiella infection	28.55	22.87	18	10339	7176	50587591
Viral haemorrhagic cystitis	28.50	22.87	9	10348	684	50594083
Bacterial sepsis	27.92	22.87	14	10343	3598	50591169
Acute graft versus host disease in intestine	27.73	22.87	11	10346	1628	50593139
Pruritus	27.23	22.87	12	10345	283556	50311211
Pain in extremity	27.07	22.87	11	10346	272854	50321913
Immunosuppressant drug level increased	26.97	22.87	13	10344	3069	50591698
Confabulation	26.31	22.87	7	10350	289	50594478
Central nervous system necrosis	26.14	22.87	6	10351	133	50594634
Renal transplant failure	25.37	22.87	8	10349	605	50594162
Red blood cells urine positive	25.18	22.87	12	10345	2763	50592004
Incision site pain	25.17	22.87	9	10348	1002	50593765
Renal tubular necrosis	25.12	22.87	19	10338	10149	50584618
Complications of transplanted kidney	24.74	22.87	11	10346	2162	50592605
Agranulocytosis	24.69	22.87	26	10331	21395	50573372
Systemic mycosis	24.45	22.87	9	10348	1088	50593679
Genital lesion	23.37	22.87	6	10351	215	50594552
Leukaemia recurrent	23.28	22.87	9	10348	1245	50593522
Back pain	23.28	22.87	8	10349	220022	50374745
Cytomegalovirus enteritis	23.19	22.87	6	10351	222	50594545
Hypomagnesaemia	23.02	22.87	26	10331	23130	50571637
Malaise	22.90	22.87	21	10336	335511	50259256
Cytomegalovirus syndrome	22.88	22.87	5	10352	88	50594679

FDA Adverse Event Reporting System (Male)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Cytomegalovirus infection	665.68	19.34	295	14916	22920	29536396
Drug resistance	456.03	19.34	222	14989	21318	29537998
Cytomegalovirus viraemia	386.89	19.34	139	15072	6181	29553135
Pathogen resistance	321.71	19.34	130	15081	7986	29551330
Pneumonia cytomegaloviral	198.58	19.34	68	15143	2614	29556702
Leukopenia	156.15	19.34	166	15045	55037	29504279
End stage renal disease	150.05	19.34	75	15136	7589	29551727
Pancytopenia	141.32	19.34	193	15018	82975	29476341
Transplant rejection	134.28	19.34	74	15137	9138	29550178
Multiple organ dysfunction syndrome	128.22	19.34	160	15051	62956	29496360
Cytomegalovirus test positive	125.90	19.34	52	15159	3371	29555945
Graft versus host disease	125.84	19.34	72	15139	9556	29549760
Aspergillus infection	124.73	19.34	74	15137	10507	29548809
Encephalitis cytomegalovirus	123.03	19.34	32	15179	462	29558854
Product use in unapproved indication	113.30	19.34	178	15033	86697	29472619
Bone marrow failure	112.10	19.34	101	15110	27348	29531968
Cytomegalovirus infection reactivation	109.99	19.34	47	15164	3317	29555999
Cytomegalovirus colitis	109.79	19.34	43	15168	2426	29556890
Pneumocystis jirovecii pneumonia	98.12	19.34	76	15135	16703	29542613
Cystitis haemorrhagic	93.63	19.34	47	15164	4795	29554521
Fatigue	93.62	19.34	24	15187	316797	29242519
Cytomegalovirus chorioretinitis	92.06	19.34	41	15170	3197	29556119
Respiratory failure	88.62	19.34	170	15041	96961	29462355
Off label use	88.42	19.34	346	14865	300454	29258862
Acute graft versus host disease	88.22	19.34	48	15163	5776	29553540
Post transplant lymphoproliferative disorder	79.69	19.34	44	15167	5449	29553867
Kidney transplant rejection	72.28	19.34	45	15166	6960	29552356
Thrombotic microangiopathy	70.53	19.34	48	15163	8633	29550683
Chronic graft versus host disease	68.89	19.34	36	15175	3993	29555323
Incision site pain	68.67	19.34	28	15183	1755	29557561
Glomerulosclerosis	68.24	19.34	22	15189	698	29558618
Parvovirus B19 infection	68.12	19.34	22	15189	702	29558614
Nephropathy toxic	65.67	19.34	50	15161	10706	29548610
Dizziness	65.03	19.34	10	15201	189674	29369642
Haemophagocytic lymphohistiocytosis	64.51	19.34	49	15162	10455	29548861
Fall	63.89	19.34	8	15203	177170	29382146
Acute graft versus host disease in intestine	58.20	19.34	27	15184	2314	29557002
Encephalitis	58.12	19.34	38	15173	6392	29552924
Renal impairment	57.23	19.34	128	15083	81205	29478111
Neutropenia	56.37	19.34	172	15039	131539	29427777
Acute graft versus host disease in skin	55.94	19.34	33	15178	4631	29554685
Klebsiella infection	53.52	19.34	38	15173	7311	29552005
Drug ineffective	53.06	19.34	343	14868	362827	29196489
Adenovirus infection	52.12	19.34	31	15180	4416	29554900
Neutrophil Pelger-Huet anomaly present	51.91	19.34	14	15197	234	29559082
Cytomegalovirus syndrome	51.61	19.34	12	15199	105	29559211
Epstein-Barr virus infection	49.95	19.34	35	15176	6594	29552722
Immune reconstitution inflammatory syndrome	49.24	19.34	37	15174	7765	29551551
Septic shock	48.02	19.34	102	15109	62458	29496858
Myelosuppression	47.94	19.34	44	15167	12183	29547133
Necrotising retinitis	47.36	19.34	17	15194	751	29558565
Aplastic anaemia	46.04	19.34	35	15176	7475	29551841
Product use issue	45.55	19.34	89	15122	51355	29507961
Bronchopulmonary aspergillosis	43.75	19.34	42	15169	12302	29547014
Asthenia	43.08	19.34	29	15182	215221	29344095
BK virus infection	42.99	19.34	28	15183	4679	29554637
Enterococcal infection	40.96	19.34	34	15177	8234	29551082
Lymphocyte count decreased	40.88	19.34	50	15161	19221	29540095
Death	40.88	19.34	71	15140	342013	29217303
Graft versus host disease in skin	40.76	19.34	24	15187	3355	29555961
Acanthamoeba infection	40.55	19.34	13	15198	405	29558911
Viral load increased	39.93	19.34	20	15191	2029	29557287
Epstein-Barr viraemia	39.87	19.34	16	15195	962	29558354
Aplasia pure red cell	39.08	19.34	28	15183	5463	29553853
Pyrexia	39.07	19.34	267	14944	287355	29271961
Human herpesvirus 8 infection	38.53	19.34	15	15196	832	29558484
Product dose omission issue	38.23	19.34	3	15208	96380	29462936
Macular fibrosis	37.83	19.34	12	15199	361	29558955
Botulism	37.49	19.34	10	15201	160	29559156
Pneumocystis jirovecii infection	36.93	19.34	17	15194	1431	29557885
Brain herniation	36.62	19.34	23	15188	3610	29555706
Cytomegalovirus oesophagitis	36.54	19.34	12	15199	404	29558912
Pain	35.78	19.34	22	15189	171410	29387906
Pseudomonas infection	34.87	19.34	35	15176	10817	29548499
Adenoviral hepatitis	34.75	19.34	10	15201	214	29559102
Red blood cells urine positive	34.59	19.34	17	15194	1656	29557660
Intentional product use issue	34.58	19.34	71	15140	42427	29516889
Nausea	34.55	19.34	60	15151	289195	29270121
Pneumonia bacterial	33.50	19.34	32	15179	9311	29550005
Candida infection	33.10	19.34	40	15171	15185	29544131
Retinal scar	32.41	19.34	10	15201	274	29559042
Retinitis	32.21	19.34	10	15201	280	29559036
Kidney fibrosis	31.35	19.34	17	15194	2030	29557286
Retinal detachment	31.31	19.34	23	15188	4663	29554653
Myocardial infarction	31.23	19.34	9	15202	110287	29449029
Pneumonia pseudomonal	31.12	19.34	20	15191	3267	29556049
Epstein-Barr virus associated lymphoproliferative disorder	31.06	19.34	16	15195	1722	29557594
Toxoplasmosis	30.70	19.34	14	15197	1153	29558163
Cytomegalovirus gastritis	30.58	19.34	9	15202	209	29559107
Renal tubular disorder	30.53	19.34	22	15189	4330	29554986
Pruritus	30.50	19.34	11	15200	116838	29442478
Dyspnoea	30.45	19.34	78	15133	326654	29232662
Arthralgia	30.41	19.34	17	15194	139600	29419716
Scedosporium infection	29.11	19.34	12	15199	773	29558543
Infection reactivation	28.47	19.34	13	15198	1074	29558242
Cytopenia	28.42	19.34	30	15181	9829	29549487
Headache	27.94	19.34	29	15182	173978	29385338
Cytomegalovirus gastrointestinal infection	27.22	19.34	8	15203	185	29559131
Glomerulonephropathy	26.98	19.34	8	15203	191	29559125
Disseminated cytomegaloviral infection	26.59	19.34	8	15203	201	29559115
Malaise	26.30	19.34	26	15185	159576	29399740
Back pain	26.07	19.34	10	15201	102274	29457042
Meningoencephalitis herpetic	25.98	19.34	11	15200	758	29558558
Epstein-Barr virus infection reactivation	25.90	19.34	10	15201	542	29558774
Renal failure	25.82	19.34	125	15086	118474	29440842
Septic embolus	25.76	19.34	12	15199	1038	29558278
Fungal sepsis	25.44	19.34	11	15200	798	29558518
Red blood cell schistocytes present	25.43	19.34	8	15203	234	29559082
Cytomegalovirus enterocolitis	25.39	19.34	11	15200	802	29558514
Oesophagopleural fistula	25.27	19.34	6	15205	58	29559258
Cerebral toxoplasmosis	25.20	19.34	13	15198	1403	29557913
Pharyngeal abscess	25.11	19.34	9	15202	396	29558920
Procedural pain	24.31	19.34	19	15192	4225	29555091
Cytomegalovirus hepatitis	23.54	19.34	8	15203	300	29559016
Flavobacterium infection	23.51	19.34	6	15205	80	29559236
Brain compression	23.45	19.34	7	15204	171	29559145
ADAMTS13 activity decreased	23.44	19.34	6	15205	81	29559235
Viral mutation identified	23.21	19.34	15	15196	2473	29556843
Hyperhidrosis	23.01	19.34	3	15208	64537	29494779
Large intestinal ulcer	22.91	19.34	13	15198	1696	29557620
Protein urine present	22.62	19.34	19	15192	4675	29554641
Lymphadenopathy mediastinal	22.54	19.34	14	15197	2155	29557161
Cardiac failure congestive	22.13	19.34	6	15205	76575	29482741
Scopulariopsis infection	22.10	19.34	6	15205	103	29559213
Fungal infection	22.02	19.34	31	15180	13654	29545662
Pain in extremity	21.88	19.34	15	15196	110418	29448898
Graft versus host disease in gastrointestinal tract	21.78	19.34	16	15195	3242	29556074
Chimerism	21.65	19.34	7	15204	224	29559092
Enterococcal bacteraemia	21.46	19.34	12	15199	1521	29557795
Organising pneumonia	21.42	19.34	19	15192	5029	29554287
Bone marrow disorder	21.33	19.34	12	15199	1540	29557776
Complications of transplanted kidney	21.14	19.34	17	15194	3937	29555379
Drug ineffective for unapproved indication	21.11	19.34	31	15180	14183	29545133
Malnutrition	20.98	19.34	27	15184	10914	29548402
Blood pressure increased	20.92	19.34	6	15205	73797	29485519
Diffuse alveolar damage	20.76	19.34	13	15198	2030	29557286
Hypogammaglobulinaemia	20.74	19.34	20	15191	5887	29553429
Depression	20.59	19.34	9	15202	85138	29474178
Myocarditis toxoplasmal	20.39	19.34	5	15206	56	29559260
Bacterial toxaemia	20.08	19.34	6	15205	147	29559169
Cerebral aspergillosis	20.04	19.34	11	15200	1345	29557971
Burkholderia cepacia complex infection	19.67	19.34	6	15205	158	29559158
Sepsis	19.59	19.34	133	15078	142549	29416767

FDA Adverse Event Reporting System (Geriatric)

MedDRA adverse event term	Likelihood ratio	Likelihood ratio threshold	Patients taking drug having adverse event	Patients taking drug not having adverse event	Patients not taking drug having adverse event	Patients not taking drug not having adverse event
Cytomegalovirus infection	1077.93	18.23	433	23422	36766	64438111
Drug resistance	898.61	18.23	374	23481	34728	64440149
Pathogen resistance	607.66	18.23	213	23642	12330	64462547
Cytomegalovirus viraemia	606.64	18.23	205	23650	10623	64464254
Post transplant lymphoproliferative disorder	328.30	18.23	126	23729	9418	64465459
Encephalitis cytomegalovirus	318.22	18.23	74	23781	931	64473946
Multiple organ dysfunction syndrome	315.57	18.23	277	23578	101136	64373741
Pneumonia cytomegaloviral	302.66	18.23	97	23758	4242	64470635
Pancytopenia	283.08	18.23	305	23550	143004	64331873
Graft versus host disease	239.15	18.23	112	23743	13701	64461176
Epstein-Barr virus infection	237.26	18.23	108	23747	12380	64462497
Leukopenia	236.74	18.23	236	23619	101006	64373871
Smooth muscle cell neoplasm	223.27	18.23	54	23801	812	64474065
Cytomegalovirus test positive	221.14	18.23	80	23775	5064	64469813
Transplant rejection	208.91	18.23	110	23745	17291	64457586
Product use in unapproved indication	193.82	18.23	280	23575	176338	64298539
Nephropathy toxic	188.61	18.23	103	23752	17411	64457466
Cytomegalovirus colitis	187.41	18.23	66	23789	3862	64471015
Cytomegalovirus infection reactivation	183.75	18.23	72	23783	5684	64469193
Off label use	182.95	18.23	580	23275	632226	63842651
Aspergillus infection	181.03	18.23	98	23757	16281	64458596
Cystitis haemorrhagic	180.70	18.23	78	23777	7878	64466999
Fatigue	177.13	18.23	32	23823	748698	63726179
Cytomegalovirus syndrome	166.76	18.23	35	23820	263	64474614
Bone marrow failure	161.12	18.23	137	23718	47815	64427062
Cytomegalovirus chorioretinitis	158.76	18.23	62	23793	4850	64470027
Acute graft versus host disease	152.12	18.23	72	23783	9012	64465865
End stage renal disease	148.26	18.23	74	23781	10401	64464476
Haemophagocytic lymphohistiocytosis	147.77	18.23	88	23767	17521	64457356
Neutropenia	129.19	18.23	278	23577	239346	64235531
Pneumocystis jirovecii pneumonia	127.17	18.23	95	23760	27539	64447338
Renal impairment	121.02	18.23	195	23660	134822	64340055
Pain	115.84	18.23	31	23824	553480	63921397
Septic shock	115.25	18.23	167	23688	105270	64369607
Parvovirus B19 infection	112.91	18.23	34	23821	1205	64473672
Respiratory failure	112.01	18.23	208	23647	160975	64313902
Kidney transplant rejection	110.95	18.23	59	23796	9452	64465425
Adenovirus infection	104.87	18.23	52	23803	7203	64467674
Thrombotic microangiopathy	101.54	18.23	68	23787	16587	64458290
BK virus infection	100.88	18.23	51	23804	7361	64467516
Incision site pain	98.30	18.23	37	23818	2617	64472260
Epstein-Barr virus associated lymphoproliferative disorder	95.98	18.23	38	23817	3081	64471796
Fall	95.77	18.23	19	23836	416807	64058070
Nausea	94.81	18.23	91	23764	785709	63689168
Dizziness	93.97	18.23	22	23833	430141	64044736
Arthralgia	93.92	18.23	24	23831	442236	64032641
Chronic graft versus host disease	93.74	18.23	46	23809	6230	64468647
Graft versus host disease in skin	91.42	18.23	43	23812	5304	64469573
Acute graft versus host disease in skin	89.90	18.23	46	23809	6809	64468068
Dyspnoea	82.31	18.23	87	23768	718587	63756290
Klebsiella infection	80.42	18.23	54	23801	13227	64461650
Aplasia pure red cell	80.37	18.23	43	23812	6971	64467906
Bronchopulmonary aspergillosis	79.84	18.23	62	23793	19023	64455854
Cytomegalovirus oesophagitis	79.00	18.23	22	23833	588	64474289
Myelosuppression	77.79	18.23	67	23788	23763	64451114
Epstein-Barr viraemia	77.42	18.23	28	23827	1769	64473108
Product use issue	74.82	18.23	170	23685	151545	64323332
Headache	73.99	18.23	53	23802	529414	63945463
Pyrexia	73.67	18.23	403	23452	558241	63916636
Enterococcal infection	73.63	18.23	52	23803	13814	64461063
Cytomegalovirus gastritis	72.44	18.23	19	23836	402	64474475
Renal failure	71.89	18.23	187	23668	181501	64293376
Immune reconstitution inflammatory syndrome	71.45	18.23	49	23806	12421	64462456
Sepsis	68.65	18.23	214	23641	230127	64244750
Transplant dysfunction	68.21	18.23	38	23817	6670	64468207
Drug ineffective	67.46	18.23	535	23320	839712	63635165
Pruritus	66.17	18.23	17	23838	312383	64162494
Graft versus host disease in gastrointestinal tract	65.98	18.23	35	23820	5577	64469300
Epstein-Barr virus infection reactivation	64.95	18.23	22	23833	1144	64473733
Intentional product use issue	64.83	18.23	122	23733	95242	64379635
Necrotising retinitis	62.94	18.23	21	23834	1042	64473835
Cytomegalovirus enterocolitis	61.71	18.23	22	23833	1333	64473544
Glomerulosclerosis	60.89	18.23	20	23835	945	64473932
Pseudomonas infection	59.83	18.23	51	23804	17832	64457045
Encephalitis	59.57	18.23	44	23811	12527	64462350
Aplastic anaemia	57.74	18.23	45	23810	13875	64461002
Cytomegalovirus gastrointestinal infection	57.01	18.23	16	23839	440	64474437
Product dose omission issue	56.56	18.23	4	23851	194743	64280134
Peripheral swelling	56.12	18.23	6	23849	209147	64265730
Red blood cells urine positive	55.69	18.23	29	23826	4449	64470428
Acute graft versus host disease in intestine	55.54	18.23	27	23828	3582	64471295
Viral load increased	55.21	18.23	24	23831	2463	64472414
Anxiety	53.90	18.23	6	23849	202643	64272234
Hypogammaglobulinaemia	53.24	18.23	38	23817	10261	64464616
Lymphocyte count decreased	52.70	18.23	70	23785	40629	64434248
Malaise	52.30	18.23	42	23813	396205	64078672
Asthenia	52.10	18.23	49	23806	427995	64046882
Neutrophil Pelger-Huet anomaly present	51.59	18.23	14	23841	339	64474538
Pain in extremity	51.27	18.23	24	23831	303061	64171816
Brain herniation	50.54	18.23	31	23824	6502	64468375
Back pain	50.36	18.23	15	23840	250156	64224721
Liver transplant rejection	47.85	18.23	23	23832	2976	64471901
Mucormycosis	47.22	18.23	31	23824	7310	64467567
Acanthamoeba infection	47.16	18.23	14	23841	472	64474405
Gait disturbance	46.02	18.23	5	23850	172150	64302727
Complications of transplanted kidney	45.16	18.23	27	23828	5408	64469469
Pneumonia pseudomonal	45.06	18.23	26	23829	4877	64470000
Abdominal discomfort	44.65	18.23	7	23848	182315	64292562
Alopecia	43.82	18.23	5	23850	165685	64309192
Haemorrhage intracranial	43.82	18.23	49	23806	23835	64451042
Viral haemorrhagic cystitis	43.69	18.23	18	23837	1617	64473260
Human herpesvirus 8 infection	43.55	18.23	16	23839	1057	64473820
Vomiting	43.05	18.23	87	23768	551030	63923847
Retinal detachment	42.55	18.23	30	23825	7946	64466931
Polyomavirus-associated nephropathy	42.49	18.23	25	23830	4863	64470014
Candida infection	42.16	18.23	55	23800	31364	64443513
Swelling	41.96	18.23	5	23850	160213	64314664
Blood pressure increased	41.42	18.23	7	23848	172545	64302332
Ureaplasma infection	41.40	18.23	14	23841	724	64474153
Scedosporium infection	41.12	18.23	16	23839	1238	64473639
Pneumonia bacterial	40.61	18.23	38	23817	14997	64459880
Immunosuppressant drug level increased	40.35	18.23	28	23827	7231	64467646
Drug intolerance	40.21	18.23	10	23845	187982	64286895
Cytomegalovirus hepatitis	39.99	18.23	13	23842	594	64474283
Cytopenia	39.69	18.23	38	23817	15433	64459444
Bacterial sepsis	39.67	18.23	28	23827	7429	64467448
Nasopharyngitis	39.01	18.23	12	23843	196061	64278816
Muscle spasms	37.93	18.23	4	23851	141019	64333858
Urticaria	37.59	18.23	5	23850	147312	64327565
Weight increased	37.46	18.23	16	23839	213332	64261545
Hypersensitivity	37.36	18.23	13	23842	196439	64278438
Pneumocystis jirovecii infection	37.35	18.23	18	23837	2343	64472534
Pulmonary haemorrhage	37.09	18.23	34	23821	13075	64461802
Drug hypersensitivity	36.97	18.23	21	23834	237794	64237083
Viral mutation identified	36.90	18.23	20	23835	3326	64471551
Lung transplant rejection	36.74	18.23	15	23840	1317	64473560
Gastric ulcer	36.10	18.23	50	23805	30184	64444693
Human herpesvirus 6 infection	35.79	18.23	22	23833	4632	64470245
Cerebral toxoplasmosis	35.32	18.23	16	23839	1810	64473067
Thrombocytopenia	35.28	18.23	170	23685	223631	64251246
Protein urine present	35.09	18.23	28	23827	8928	64465949
Hepatic function abnormal	34.97	18.23	75	23780	64238	64410639
Cytomegalovirus enteritis	34.50	18.23	12	23843	676	64474201
Macular fibrosis	34.06	18.23	12	23843	702	64474175
Botulism	33.30	18.23	10	23845	351	64474526
Myocardial infarction	33.25	18.23	10	23845	165811	64309066
Acute respiratory distress syndrome	33.14	18.23	55	23800	38880	64435997
Renal tubular disorder	33.06	18.23	23	23832	5964	64468913
Fungal infection	32.73	18.23	51	23804	34200	64440677
Kidney fibrosis	32.71	18.23	18	23837	3083	64471794
Retinal scar	32.38	18.23	10	23845	386	64474491
Death	32.15	18.23	83	23772	482622	63992255
Neutrophil count increased	32.13	18.23	43	23812	25131	64449746
Transplant failure	31.92	18.23	19	23836	3775	64471102
Hepatic failure	31.74	18.23	66	23789	55328	64419549
Contusion	31.25	18.23	3	23852	113962	64360915
Respiratory distress	30.75	18.23	63	23792	52268	64422609
Disseminated intravascular coagulation	30.68	18.23	48	23807	32300	64442577
Posterior reversible encephalopathy syndrome	30.52	18.23	40	23815	22906	64451971
Injection site pain	30.38	18.23	3	23852	111405	64363472
Depression	30.22	18.23	15	23840	183276	64291601
Somnolence	30.22	18.23	19	23836	203626	64271251
Hyperhidrosis	30.12	18.23	5	23850	124915	64349962
Insomnia	29.99	18.23	18	23837	197818	64277059
Cardiac failure congestive	29.82	18.23	6	23849	130574	64344303
Abdominal pain upper	29.35	18.23	14	23841	175016	64299861
Therapeutic product effect decreased	29.23	18.23	4	23851	115347	64359530
Neurological decompensation	29.18	18.23	19	23836	4417	64470460
Lymphoproliferative disorder	29.11	18.23	20	23835	5083	64469794
Syncope	29.00	18.23	11	23844	157624	64317253
Complications of transplanted liver	28.98	18.23	9	23846	354	64474523
Organising pneumonia	28.61	18.23	25	23830	9030	64465847
Lymphopenia	28.51	18.23	41	23814	25616	64449261
Blood urea increased	28.15	18.23	55	23800	44098	64430779
Toxoplasmosis	28.04	18.23	15	23840	2429	64472448
Complications of transplanted lung	27.86	18.23	9	23846	403	64474474
Enterococcal bacteraemia	27.70	18.23	15	23840	2490	64472387
Disseminated cytomegaloviral infection	27.59	18.23	9	23846	416	64474461
Rash	27.44	18.23	83	23772	458466	64016411
Strongyloidiasis	27.37	18.23	16	23839	3074	64471803
Retinitis	27.36	18.23	14	23841	2071	64472806
Fungal sepsis	27.32	18.23	13	23842	1645	64473232
Toxic epidermal necrolysis	27.06	18.23	49	23806	37117	64437760
Constipation	26.98	18.23	27	23828	229310	64245567
Adenoviral hepatitis	26.74	18.23	9	23846	459	64474418
Meningoencephalitis herpetic	26.57	18.23	13	23842	1748	64473129
Septic embolus	26.57	18.23	13	23842	1749	64473128
Glomerulonephropathy	26.34	18.23	8	23847	292	64474585
Hypoproteinaemia	26.04	18.23	16	23839	3366	64471511
Systemic mycosis	25.94	18.23	14	23841	2309	64472568
Sinusitis	25.51	18.23	11	23844	145917	64328960
Musculoskeletal stiffness	25.49	18.23	7	23848	123199	64351678
Chest pain	25.31	18.23	30	23825	235950	64238927
Escherichia sepsis	25.13	18.23	21	23834	7144	64467733
Infection reactivation	24.82	18.23	13	23842	2017	64472860
Flavobacterium infection	24.75	18.23	6	23849	91	64474786
Cerebrovascular accident	24.65	18.23	10	23845	137573	64337304
Myalgia	24.65	18.23	14	23841	158603	64316274
Lower respiratory tract infection	24.65	18.23	3	23852	94611	64380266
Venoocclusive liver disease	24.56	18.23	24	23831	9991	64464886
Pharyngeal abscess	24.18	18.23	9	23846	617	64474260
Drug ineffective for unapproved indication	23.88	18.23	42	23813	31091	64443786
Scopulariopsis infection	23.54	18.23	6	23849	113	64474764
Malnutrition	23.39	18.23	32	23823	19093	64455784
Squamous cell carcinoma of skin	22.88	18.23	25	23830	11851	64463026
Focal segmental glomerulosclerosis	22.85	18.23	14	23841	2930	64471947
Tubulointerstitial nephritis	22.81	18.23	41	23814	30868	64444009
Chimerism	22.70	18.23	7	23848	269	64474608
Asthma	22.54	18.23	4	23851	95221	64379656
Oesophagopleural fistula	22.28	18.23	5	23850	53	64474824
Infusion related reaction	22.20	18.23	17	23838	164450	64310427
Actinic keratosis	22.08	18.23	17	23838	5148	64469729
ADAMTS13 activity decreased	21.74	18.23	6	23849	155	64474722
Bacterial toxaemia	21.66	18.23	6	23849	157	64474720
Ascites	21.64	18.23	61	23794	61940	64412937
Myocarditis toxoplasmal	21.64	18.23	5	23850	61	64474816
Diffuse alveolar damage	21.64	18.23	14	23841	3221	64471656
Idiopathic pneumonia syndrome	21.59	18.23	8	23847	541	64474336
Opportunistic infection	21.53	18.23	13	23842	2649	64472228
Haematotoxicity	21.19	18.23	25	23830	12871	64462006
Acute graft versus host disease in liver	21.19	18.23	11	23844	1676	64473201
Cerebral aspergillosis	21.16	18.23	11	23844	1682	64473195
Balance disorder	21.05	18.23	3	23852	83923	64390954
Meningitis viral	20.88	18.23	11	23844	1727	64473150
Hyperlactacidaemia	20.83	18.23	16	23839	4828	64470049
Macular oedema	20.76	18.23	16	23839	4851	64470026
Contraindicated product administered	20.72	18.23	7	23848	107822	64367055
Paraesthesia	20.72	18.23	12	23843	134510	64340367
Platelet count decreased	20.63	18.23	119	23736	167592	64307285
Retinal haemorrhage	20.56	18.23	19	23836	7379	64467498
Loss of consciousness	20.45	18.23	15	23840	148350	64326527
Oliguria	20.31	18.23	26	23829	14550	64460327
Cytomegalovirus duodenitis	20.21	18.23	5	23850	83	64474794
Hydrocephalus	20.14	18.23	19	23836	7572	64467305
Epstein-Barr virus test positive	20.12	18.23	9	23846	989	64473888
Tractional retinal detachment	20.09	18.23	5	23850	85	64474792
Wheezing	19.93	18.23	3	23852	80576	64394301
Chronic allograft nephropathy	19.34	18.23	10	23845	1511	64473366
Lymphadenopathy mediastinal	19.34	18.23	14	23841	3862	64471015
Eye infection fungal	19.33	18.23	7	23848	444	64474433
Varicella zoster oesophagitis	19.30	18.23	4	23851	28	64474849
Hypoalbuminaemia	19.28	18.23	28	23827	17646	64457231
Confabulation	19.21	18.23	7	23848	452	64474425
Engraftment syndrome	19.18	18.23	9	23846	1104	64473773
Mycobacterium avium complex infection	19.14	18.23	14	23841	3926	64470951
Varicella zoster gastritis	18.73	18.23	4	23851	33	64474844
Renal transplant failure	18.63	18.23	10	23845	1630	64473247
Disease recurrence	18.58	18.23	38	23817	31472	64443405
Necrotising herpetic retinopathy	18.46	18.23	5	23850	120	64474757
Blood creatinine increased	18.46	18.23	99	23756	135683	64339194
CD4 lymphocytes increased	18.44	18.23	6	23849	275	64474602
Pleural effusion	18.40	18.23	94	23761	126465	64348412
Central nervous system necrosis	18.38	18.23	6	23849	278	64474599
Brain compression	18.34	18.23	7	23848	514	64474363
Bone marrow disorder	18.34	18.23	12	23843	2813	64472064

FDA Adverse Event Reporting System (Pediatric)

None

Pharmacologic Action:

Source	Code	Description
ATC	J05AB06	ANTIINFECTIVES FOR SYSTEMIC USE ANTIVIRALS FOR SYSTEMIC USE DIRECT ACTING ANTIVIRALS Nucleosides and nucleotides excl. reverse transcriptase inhibitors
ATC	S01AD09	SENSORY ORGANS OPHTHALMOLOGICALS ANTIINFECTIVES Antivirals
FDA MoA	N0000020060	DNA Polymerase Inhibitors
FDA EXT	N0000175459	Nucleoside Analog
FDA EPC	N0000175461	Cytomegalovirus Nucleoside Analog DNA Polymerase Inhibitor
FDA EPC	N0000175466	Nucleoside Analog Antiviral
CHEBI has role	CHEBI:35441	antiinfective agents
CHEBI has role	CHEBI:36044	antiviral drugs
MeSH PA	D000890	Anti-Infective Agents
MeSH PA	D000998	Antiviral Agents

Drug Use | Suggest Off label Use Form| |View source of the data|

Disease	Relation	SNOMED_ID	DOID
Cytomegaloviral retinitis	indication	22455005
Herpes simplex dendritic keratitis	indication	29943008
Paroxysmal supraventricular tachycardia	indication	67198005
CMV Retinitis in AIDS Patients	indication
Prevention of CMV Disease After Kidney-Pancreas Transplantation	indication
CMV Retinitis in Immunocompromised Patients	indication
Prevention of CMV Disease After Organ Transplant	indication
Prevention of CMV Disease After Kidney Transplantation	indication
Myocardial Perfusion Imaging Adjunct	indication
Prevention of CMV Disease in Advanced HIV Patients	indication
Prevention of CMV Disease After Cardiac Transplantation	indication
Supraventricular tachycardia	off-label use	6456007
Cytomegalovirus infection	off-label use	28944009
CMV-Related Polyradiculopathy in AIDS Patients	off-label use
Prevention of Cytomegalovirus Disease	off-label use
Endophthalmitis	contraindication	1847009	DOID:4692
Pericarditis	contraindication	3238004	DOID:1787
Reduced visual acuity	contraindication	13164000
Chronic obstructive lung disease	contraindication	13645005	DOID:3083
Disorder of autonomic nervous system	contraindication	15241006
Complete atrioventricular block	contraindication	27885002
Hypovolemia	contraindication	28560003
Acute cerebrovascular insufficiency	contraindication	29322000
Vitreous hemorrhage	contraindication	31341008
Transplantation of heart	contraindication	32413006
Dehydration	contraindication	34095006
Sick sinus syndrome	contraindication	36083008	DOID:13884
Retinal detachment	contraindication	42059000	DOID:5327
Low blood pressure	contraindication	45007003
Acute nephropathy	contraindication	58574008
Aortic valve stenosis	contraindication	60573004	DOID:1712
Left to right cardiovascular shunt	contraindication	66130006
Mitral valve stenosis	contraindication	79619009	DOID:1754
Pulmonary emphysema	contraindication	87433001
Kidney disease	contraindication	90708001	DOID:557
Bilateral cataracts	contraindication	95722004
Respiratory alkalosis	contraindication	111378004
Eye infection	contraindication	128351009
Uveitis	contraindication	128473001	DOID:13141
Second degree atrioventricular block	contraindication	195042002
Asthma	contraindication	195967001	DOID:2841
Anemia	contraindication	271737000	DOID:2355
Thrombocytopenic disorder	contraindication	302215000	DOID:1588
Neutropenic disorder	contraindication	303011007	DOID:1227
Aplastic anemia	contraindication	306058006	DOID:12449
Left main coronary artery disease	contraindication	371804009
Acute coronary syndrome	contraindication	394659003
Respiratory insufficiency	contraindication	409623005
Breastfeeding (mother)	contraindication	413712001
Granulocytopenic disorder	contraindication	417672002
Severe Bone Marrow Depression	contraindication
Syncope due to Bradycardia	contraindication

🐶 Veterinary Drug Use

None

🐶 Veterinary products

None

Acid dissociation constants calculated using MoKa v3.0.0

Dissociation level	Dissociation constant	Type (acidic/basic)
pKa1	8.97	acidic
pKa2	12.38	acidic
pKa3	12.98	acidic
pKa4	3.68	Basic
pKa5	2.12	Basic

Orange Book patent data (new drug applications)

None

Orange Book exclusivity data (new drug applications)

None

Bioactivity Summary:

Target	Class	Pharos	UniProt	Action	Type	Activity value (-log[M])	Mechanism action	Bioact source	MoA source
Metabotropic glutamate receptor 1	GPCR	Q13255	GRM1_HUMAN		Ki	6.05		WOMBAT-PK
Metabotropic glutamate receptor 5	GPCR	P41594	GRM5_HUMAN		Ki	5.41		WOMBAT-PK
DNA polymerase catalytic subunit	Enzyme		DPOL_HHV11	INHIBITOR				WOMBAT-PK	CHEMBL
Thymidine kinase	Kinase		KITH_HHV1					WOMBAT-PK
Capsid scaffolding protein	Enzyme		SCAF_HHV11		EC50	6.07		WOMBAT-PK
Purine nucleoside phosphorylase	Enzyme		PUNA_MYCTU		Kd	4.80		CHEMBL

External reference:

ID	Source
4019764	VUID
N0000147855	NUI
D00333	KEGG_DRUG
107910-75-8	SECONDARY_CAS_RN
4019457	VANDF
4019764	VANDF
C0017066	UMLSCUI
CHEBI:465284	CHEBI
GA2	PDB_CHEM_ID
CHEMBL182	ChEMBL_ID
CHEMBL1200850	ChEMBL_ID
DB01004	DRUGBANK_ID
D015774	MESH_DESCRIPTOR_UI
135398740	PUBCHEM_CID
6023	INN_ID
P9G3CKZ4P5	UNII
4678	RXNORM
177021	MMSL
33722	MMSL
34097	MMSL
47373	MMSL
4775	MMSL
4776	MMSL
d00066	MMSL
003444	NDDF
003445	NDDF
372848001	SNOMEDCT_US
76587005	SNOMEDCT_US
78025001	SNOMEDCT_US

Pharmaceutical products:

Product	Category	Ingredients	NDC	Form	Quantity	Route	Marketing	Label
Ganciclovir	HUMAN PRESCRIPTION DRUG LABEL	1	0143-9299	INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION	50 mg	INTRAVENOUS	ANDA	29 sections
Ganciclovir	HUMAN PRESCRIPTION DRUG LABEL	1	14335-030	INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION	50 mg	INTRAVENTRICULAR	ANDA	30 sections
ZIRGAN	HUMAN PRESCRIPTION DRUG LABEL	1	24208-535	GEL	1.50 mg	OPHTHALMIC	NDA	22 sections
ganciclovir	HUMAN PRESCRIPTION DRUG LABEL	1	25021-185	INJECTION, SOLUTION	50 mg	INTRAVENOUS	ANDA	28 sections
Ganciclovir	HUMAN PRESCRIPTION DRUG LABEL	1	42023-173	INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION	500 mg	INTRAVENOUS	ANDA	29 sections
GANCICLOVIR	HUMAN PRESCRIPTION DRUG LABEL	1	51754-2500	INJECTION, SOLUTION	2 mg	INTRAVENOUS	NDA	18 sections
Ganciclovir	HUMAN PRESCRIPTION DRUG LABEL	1	51817-171	INJECTION, SOLUTION	500 mg	INTRAVENOUS	ANDA	29 sections
CytoveneIV	HUMAN PRESCRIPTION DRUG LABEL	1	61269-450	INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION	500 mg	INTRAVENOUS	NDA	31 sections
GANCICLOVIR	HUMAN PRESCRIPTION DRUG LABEL	1	63304-636	CAPSULE	250 mg	ORAL	ANDA	23 sections
GANCICLOVIR	HUMAN PRESCRIPTION DRUG LABEL	1	63304-637	CAPSULE	500 mg	ORAL	ANDA	23 sections
Ganciclovir	HUMAN PRESCRIPTION DRUG LABEL	1	63323-315	INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION	500 mg	INTRAVENOUS	ANDA	29 sections
Ganciclovir	HUMAN PRESCRIPTION DRUG LABEL	1	63323-315	INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION	500 mg	INTRAVENOUS	ANDA	29 sections
Ganciclovir	HUMAN PRESCRIPTION DRUG LABEL	1	70436-089	INJECTION, POWDER, LYOPHILIZED, FOR SOLUTION	500 mg	INTRAVENTRICULAR	ANDA	29 sections