Zirgan Side Effects

Generic Name: ganciclovir ophthalmic

Note: This document contains side effect information about ganciclovir ophthalmic. Some of the dosage forms listed on this page may not apply to the brand name Zirgan.

Some side effects of Zirgan may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

For the Consumer

Applies to ganciclovir ophthalmic: intraocular implant

Other dosage forms:

Along with its needed effects, ganciclovir ophthalmic (the active ingredient contained in Zirgan) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Also, ganciclovir has been found to cause cancerous tumors in animals. Discuss these possible effects with your doctor.

Check with your doctor as soon as possible if any of the following side effects occur while taking ganciclovir ophthalmic:

More common—Usually occur within the first 2 months after the surgery
  • Decrease in vision (severe)
  • seeing flashes or sparks of light
  • seeing floating spots before the eyes, or a veil or curtain appearing across part of vision
Less common—Usually occur within the first 2 months after the surgery
  • Blurred vision or other change in vision
  • decreased vision or other change in vision
  • eye pain or tearing
  • red or bloodshot eye
  • sensitivity of eye to light
Rare—Usually occur within the first 2 months after the surgery
  • Eye irritation
  • swelling of the membrane covering the white part of the eye

Some side effects of ganciclovir ophthalmic may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Decrease in vision lasting approximately 2 to 4 weeks

For Healthcare Professionals

Applies to ganciclovir ophthalmic: intraocular implant, ophthalmic gel


Ocular side effects that occur with ganciclovir ophthalmic (the active ingredient contained in Zirgan) implant are generally confined to the implanted eye. Some of these events (e.g. retinal detachment) will also occur with the natural progression of CMV retinitis and may not necessarily be direct complications of the surgical procedure. However, it is possible that the implant may precipitate some of these conditions.

The most common side effect is a decrease in visual acuity, which occurs in nearly all patients immediately following the implant procedure and lasts 2 to 4 weeks in most cases. In 10% to 20% of the patients, visual acuity loss of 3 lines or more may occur during the first two months postoperatively, as well as vitreous hemorrhage and retinal detachment. Additionally, cataract formation or lens opacities, macular abnormalities, increases in intraocular pressure, optic disc and nerve changes, hyphemas, and uveitis may occur in up to 5% of patients.

Observed in less than 1% of patients are retinopathy, synechia, suprachoroidal hemorrhage, cotton wool spots, keratopathy, astigmatism, endophthalmitis, microangiopathy, sclerosis, choroiditis, chemosis, phthisis bulbi, angle closure traction, hypotony, retinal tear, corneal dellen, choroidal folds, and gliosis. Permanent loss of vision due to endophthalmitis has been reported.

Intravitreous injections of ganciclovir have resulted in scleral induration, corneal ulceration, chemical irritation, cataract formation, transient elevations in intraocular pressure, optic disc and nerve atrophy, vitreous haze, iritis, vitreous and conjunctival hemorrhage, retinal detachment, and infectious endophthalmitis. One case of retinal toxicity and necrosis resulting in visual loss was reported in a patient inadvertently given 40 mg of ganciclovir.

Side effects of ganciclovir ophthalmic gel have included blurred vision (60%), eye irritation (20%), punctate keratitis (5%), and conjunctival hyperemia (5%).


Complications related to the removal of ganciclovir implants have been reported. Rare cases of medical pellet separation from its tab have been reported.

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