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Ganciclovir (Ophthalmic)

Medically reviewed by Last updated on Sep 5, 2020.


(gan SYE kloe veer)

Index Terms

  • Nordeoxyguanosine

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Gel, Ophthalmic:

Zirgan: 0.15% (5 g) [contains benzalkonium chloride]

Brand Names: U.S.

  • Zirgan

Pharmacologic Category

  • Antiviral Agent, Ophthalmic


Ganciclovir is phosphorylated to a substrate, which competitively inhibits the binding of deoxyguanosine triphosphate to DNA polymerase resulting in inhibition of DNA replication by herpes simplex viruses.


Negligible systemic absorption (0.1% in comparison to IV doses and 0.04% in comparison to oral valganciclovir)

Use: Labeled Indications

Herpetic keratitis: Treatment of acute herpetic keratitis (dendritic ulcers)


There are no contraindications listed in the manufacturer’s labeling.

Dosing: Adult

Herpetic keratitis: Ophthalmic: Apply 1 drop in affected eye 5 times daily (approximately every 3 hours while awake) until corneal ulcer heals, then apply 1 drop 3 times daily for 7 days

Dosing: Geriatric

Refer to adult dosing.

Dosing: Pediatric

Herpetic keratitis: Children ≥2 years and Adolescents: Ophthalmic gel: Apply 1 drop in affected eye 5 times daily (approximately every 3 hours while awake) until corneal ulcer heals, then 1 drop 3 times daily for 7 days


For ophthalmic application only; avoid touching tip of applicator to eye or other surfaces.


Store at 15°C to 25°C (59°F to 77°F). Do not freeze.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.

>10%: Ophthalmic: Blurred vision (60%), eye irritation (20%)

1% to 10%: Ophthalmic: Punctate keratitis (5%), conjunctival hyperemia (5%)


Concerns related to adverse effects:

• Ocular adverse events: Blurred vision commonly occurs; may also cause eye irritation.

Special populations:

• Contact lens wearers: Contact lenses should not be worn during the course of therapy or in any patient with signs/symptoms of herpetic keratitis.

Other warnings/precautions:

• Appropriate use: For topical ophthalmic use only.

Monitoring Parameters

Ophthalmologic exams

Pregnancy Risk Factor


Pregnancy Considerations

Adverse events were observed in animal reproduction studies conducted with systemic ganciclovir. The amount of ganciclovir available systemically following topical application of the ophthalmic gel is significantly less in comparison to IV doses (0.1%).

Patient Education

What is this drug used for?

• It is used to treat a viral infection of the eyes.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Blurred vision

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Vision changes

• Eye pain

• Severe eye irritation

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.