ganciclovir ophthalmic (Rx)

Brand and Other Names:Vitrasert DSC, Zirgan
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic gel

  • 0.15% (5g)

Acute Herpetic Keratitis

Indicated for treatment of acute herpetic keratitis (dendritic ulcers)

Initial: 1 drop to affected eye 5x/day (~q3hr while awake) until the corneal ulcer heals

Maintenance: 1 drop to affected eye TID for 7 days

Dosage Forms & Strengths

ophthalmic gel

  • 0.15% (5g)

Acute Herpetic Keratitis

<2 years

  • Safety and efficacy not established

≥2 years

  • Indicated for treatment of acute herpetic keratitis (dendritic ulcers)
  • Intitial: 1 drop to affected eye 5x/day (~q3hr while awake) until the corneal ulcer heals
  • Maintenance: 1 drop to affected eye TID for 7 days
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Adverse Effects

>10%

Visual acuity loss (10-20%)

Retinal detachment (10-20%)

Vitreous hemorrhage (10-20%)

1-10%

Punctate keratitis (5%)

Conjunctival hyperemia (5%)

Frequency Not Defined

Uveitis

Hyphema

IOP spike

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Warnings

Contraindications

Hypersensitivity to ganciclovir or acyclovir

Cautions

Indicated for topical ophthalmic use only

Contact lenses should not be worn during therapy

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Pregnancy & Lactation

Pregnancy

There are no adequate and well-controlled studies in pregnant women

Use only during pregnancy if potential benefit justifies the potential risk to the fetus

Lactation

Unknown whether topical ophthalmic ganciclovir administration may result in sufficient systemic absorption to produce detectable quantities in breast milk

Exercise caution when administered to nursing mothers

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

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Pharmacology

Mechanism of Action

Inhibits replication of viral DNA after ganciclovir is phosphorylated to a substrate, which competitively inhibits the binding of deoxyguanosine triphosphate to DNA polymerase

Pharmacokinetics

Negligible

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Administration

Administration

Do not to allow dropper tip to touch any surface, as this may contaminate the gel

If pain develops, or if redness, itching, or inflammation becomes aggravated, the patient should consult a physician

Do not to wear contact lenses

Storage

Store at 15-25°C (59-77°F)

Do not freeze

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Images

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Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.