ganciclovir ophthalmic

Pronunciation

Generic Name: ganciclovir ophthalmic (gan SYE klo veer off THAL mik)
Brand Name: Vitrasert, Zirgan

What is ganciclovir?

Ganciclovir is an antiviral drug. It slows the growth and spread of the cytomegalovirus.

Ganciclovir ophthalmic (for the eyes) is used to treat certain viral infections affecting the eyes.

Ganciclovir implant (Vitrasert) is used to treat cytomegalovirus (CMV) infection of the eye. This infection usually occurs in patients who have suppressed immune systems such as patients with AIDS and organ transplant patients.

Ganciclovir gel (Zirgan) is used to treat eye ulcers caused by the herpes simplex virus.

Ganciclovir is not a cure for CMV or herpes. This medication will not treat symptoms of these infections in any other part of the body.

Ganciclovir may also be used for purposes not listed in this medication guide.

What is the most important information I should know about ganciclovir?

You should not use this medication if you are allergic to ganciclovir or acyclovir (Zovirax).

Ganciclovir implant (Vitrasert) is used to treat cytomegalovirus (CMV) infection of the eye. Ganciclovir gel (Zirgan) is used to treat eye ulcers caused by the herpes simplex virus.

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Ganciclovir is not a cure for cytomegalovirus or herpes. This medication will not treat symptoms of these infections in any other part of the body.

To make sure you can safely use ganciclovir, tell your doctor if you have low levels of platelets in your blood (easy bruising or bleeding), or an infection in any part of your body (other than your eyes).

Do not wear contact lenses while you are using this medication. You should not wear contact lenses at any time you have an active eye ulcer or infection.

What should I discuss with my health care provider before using ganciclovir?

You should not use this medication if you are allergic to ganciclovir or acyclovir (Zovirax).

To make sure you can safely use ganciclovir, tell your doctor if you have any of these other conditions:

  • an infection in any part of your body (other than your eyes); or

  • low levels of platelets in your blood (easy bruising or bleeding).

Do not wear contact lenses while you are using this medication. You should not wear contact lenses at any time you have an active eye ulcer or infection.

FDA pregnancy category C. It is not known whether ganciclovir will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

This medication can decrease sperm count and may affect a man's fertility (ability to have children).

It is not known whether ganciclovir passes into breast milk or if it could harm a nursing baby. Do not use Zirgan without telling your doctor if you are breast-feeding a baby. You should not breast-feed after you have received a Vitrasert implant.

Ganciclovir gel (Zirgan) should not be given to a child younger than 2 years old.

How should I use ganciclovir?

The Vitrasert implant is surgically placed into the eye. The implant will slowly release ganciclovir into the affected eye over a period of 5 to 8 months.

Use Zirgan gel exactly as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Follow the directions on your prescription label.

Zirgan is usually applied 5 times each day until your eye ulcer heals. Then the gel is applied 3 times per day for 7 days. Follow your doctor's instructions.

Wash your hands before using the eye drops.

To apply Zirgan:

  • Tilt your head back slightly and pull down your lower eyelid to create a small pocket. Hold the dropper above the eye with the tip down. Look up and away from the dropper as you squeeze out a drop, then close your eye.

  • Use only the number of drops your doctor has prescribed.

  • Gently press your finger to the inside corner of the eye (near your nose) for about 1 minute to keep the liquid from draining into your tear duct. If you use more than one drop in the same eye, wait about 5 minutes before putting in the next drop.

Do not allow the tip of the dropper to touch any surface, including your eyes or hands. If the dropper becomes contaminated it could cause an infection in your eye, which can lead to vision loss or serious damage to the eye.

Ganciclovir does not cure herpes or CMV. Your disease may continue to progress even after you are treated with this medication. Your doctor will need to check your progress on a regular basis, and you will need routine eye exams.

Store Zirgan at room temperature away from moisture and heat. Do not freeze. Keep the bottle tightly closed when not in use.

What happens if I miss a dose?

Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

Since the Vitrasert implant is surgically put into place, you will not be on a dosing schedule for this medication. The implant may be removed and replaced after 5 to 8 months.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking ganciclovir?

Do not use any eye medications that your doctor has not prescribed.

Ganciclovir may cause blurred vision, which may last up to 4 weeks after Vitrasert implant surgery. Be careful if you drive or do anything that requires you to be able to see clearly.

Ganciclovir side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have a serious side effect such as:

  • eye pain, swelling, redness, or watering;

  • severe burning or itching of your eyes;

  • vision changes, increased sensitivity to light;

  • tunnel vision, problems with peripheral (side) vision;

  • seeing flashes of light, halos around lights, or "floaters" in your vision;

  • white patches on your eyes;

  • cloudiness in the pupils or iris of your eyes;

  • bleeding, oozing, or crusting of your eyes; or

  • sudden vision loss.

Less serious side effects may include:

  • blurred vision (may last up to 4 weeks after Vitrasert implant surgery);

  • mild eye irritation; or

  • increased tearing.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Ganciclovir ophthalmic Dosing Information

Usual Adult Dose for CMV Retinitis:

1 surgical implant in the posterior segment of the affected eye(s) every 5 to 8 months. Following depletion of ganciclovir from the implant, as evidenced by progression of retinitis, the implant may be removed and replaced.

Usual Adult Dose for Herpes Simplex Dendritic Keratitis:

1 drop in the affected eye 5 times per day (approximately every 3 hours while awake) until the corneal ulcer heals, and then 1 drop 3 times per day for 7 days.

Usual Pediatric Dose for CMV Retinitis:

Less than 9 years: Safety and efficacy have not been established.
9 years or older: 1 surgical implant in the posterior segment of the affected eye(s) every 5 to 8 months. Following depletion of ganciclovir from the implant, as evidenced by progression of retinitis, the implant may be removed and replaced.

Usual Pediatric Dose for Herpes Simplex Dendritic Keratitis:

2 years or older:
1 drop in the affected eye 5 times per day (approximately every 3 hours while awake) until the corneal ulcer heals, and then 1 drop 3 times per day for 7 days.

What other drugs will affect ganciclovir?

It is not likely that other drugs you take orally or inject will have an effect on ganciclovir used in the eyes. But many drugs can interact with each other. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.

Where can I get more information?

  • Your pharmacist can provide more information about ganciclovir.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.02. Revision Date: 2010-12-15, 5:01:39 PM.

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