Ganciclovir ophthalmic gel
Anti-infective · Rx
Trade namesZirgan
Drug classAntiviral, nucleoside analog (topical)
Strength0.15% gel
AvailabilityRx
Mechanism of actionGuanosine analog phosphorylated preferentially in HSV-infected cells; the triphosphate inhibits viral DNA polymerase. Low corneal epithelial toxicity vs trifluridine.
Indication / reason for useAcute herpetic keratitis (dendritic epithelial ulcers).
Usual adult dosing1 drop of gel in the affected eye 5×/day until the ulcer heals, then 1 drop TID for 7 days.
PreservativeBAK 0.00075%
Contact lensesDo not wear contact lenses during active herpetic keratitis.
Common / important adverse effectsBlurred vision on instillation (~30 min), eye irritation, punctate keratitis, hyperemia.
Contraindications & cautionsHypersensitivity to ganciclovir / aciclovir.
Pregnancy / lactationLimited data; systemic ganciclovir is teratogenic in animals, use only if clearly needed.
Practice notesFar better tolerated than trifluridine for a 2-3 week course; does not treat stromal disease or require a steroid alone.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.