Zirgan

(Ganciclovir)

The active ingredient in Zirgan is ganciclovir.

Ganciclovir is an antiviral medication. It targets the herpes simplex virus in the cornea and blocks the virus from making more copies of itself. This helps stop the infection from spreading, allows dendritic ulcers to heal, and supports recovery of the eye surface.

Follow all directions given to you by your doctor and read all documents provided, including the full Prescribing Information, FDA-Approved Product Labeling, Instructions for Use, and Medication Guide before using Zirgan. However, the following is a synopsis of the general guidelines for the use of Zirgan:

• Wash your hands before and after using the ophthalmic gel.
• Zirgan is for topical ophthalmic use only. Do not take it by mouth and do not place it on the skin.
• Apply one drop of gel into the affected eye five times per day, about every three hours while awake, until the corneal ulcer heals. After the ulcer heals, use one drop three times per day for seven more days to finish treatment.
• If both eyes are affected, your healthcare provider will tell you how to dose each eye.
• To apply the gel, tilt your head back, pull down your lower eyelid, and place one drop into the pocket formed by the eyelid.
• Do not let the dropper tip touch your eye, eyelid, fingers, or any surface. This lowers the risk of contamination and infection.
• Close your eyes gently for a minute or two after applying the gel. Do not blink hard or rub your eye.
• If you use other eye medicines, wait at least five to ten minutes between products unless your healthcare professional tells you otherwise.
• Do not wear contact lenses while using Zirgan or anytime you have signs of herpetic keratitis or another eye infection.
• If you miss a dose, use it as soon as you remember unless it is close to the next dose. Then return to your normal schedule. Do not use extra gel to make up for a missed dose.
• Keep using Zirgan for the full treatment period, even if your eye starts to feel better sooner.

Some mild or common side effects of Zirgan seen in clinical trials as compared to placebo include:

• Blurred vision, especially right after dosing.
• Eye irritation, burning, or stinging.
• Redness of the eye, also called conjunctival hyperemia.
• Watery eyes.
• Sensitivity to light.
• Punctate keratitis.
• A gritty feeling in the eye.

Some individuals may experience serious side effects while using Zirgan. These side effects may require immediate medical attention. If you experience any of the following, contact your healthcare provider or seek emergency medical help:

• Signs of a severe allergic reaction, such as hives, swelling of the face or throat, or trouble breathing.
• Severe eye pain.
• Increasing redness, burning, or swelling that gets worse instead of better.
• New discharge from the eye or worsening signs of eye infection.

These are not all of the possible side effects of Zirgan. You should always seek medical advice from your healthcare provider for any questions or concerns about your medical condition or treatment. Read all patient information, medication guides, or drug information sheets that come with this medication. You can also report adverse effects to the Food and Drug Administration at www.fda.gov/medwatch or 1-800-FDA-1088.

Before starting Zirgan, it is crucial to discuss any existing health conditions with your healthcare provider. You should be sure that your healthcare provider is aware of all your medical conditions, including:

• Any allergies to ganciclovir or other antiviral drugs.
• Frequent eye infections or eye conditions that affect the cornea.
• Pregnancy, plans to become pregnant, or breastfeeding plans.
• Any other prescription drugs, over-the-counter products, or supplements you use in or around the eye.

Other precautions to keep in mind:

• Zirgan is only meant for eye use. Using it in other ways can cause harm.
• Avoid contaminating the tube tip. A contaminated dropper can lead to a serious eye infection.
• Temporary blurred vision is common right after dosing. Be careful with driving or activities that need clear vision until your sight returns to normal.
• If symptoms do not improve within about a week, or if they worsen at any point, contact your healthcare provider promptly.

There are no listed contraindications for Zirgan. However, it should not be used if you have a known hypersensitivity to ganciclovir or any ingredient in the gel.

Many people begin to notice symptom improvement within several days, such as less eye pain and redness. In clinical trials, healing of dendritic ulcers often occurred within about one week, though full recovery can differ from person to person. Keep using Zirgan until your healthcare provider confirms healing and you complete the full course.

When Zirgan is taken with other prescription drugs, over-the-counter medications, vitamins, and supplements, it may change how they work or increase the frequency or severity of side effects. Make sure that you tell your healthcare professional about anything that you are taking to avoid any negative drug interactions, including:

• No specific drug interactions are listed for Zirgan in the Prescribing Information.
• If you use other topical ophthalmic products, spacing them out by several minutes helps avoid washout or irritation.

Zirgan is available in one strength and dosage form:

• Ophthalmic gel containing 0.15 percent ganciclovir.
• Supplied as a sterile topical ophthalmic gel in a tube for eye use.

Store at room temperature and keep out of reach of children.

Zirgan is manufactured by Bausch + Lomb.

Zirgan is the brand name for ganciclovir ophthalmic gel. Generic availability may vary by country, but many patients receive Zirgan as the branded product.

Do not stop taking Zirgan early unless your healthcare provider tells you to. Stopping too soon can allow the herpes simplex virus infection to return or worsen. If you feel your eye is fully better before finishing the course, continue using it as directed and follow up with your healthcare professional if you are unsure.

Talk to your doctor if you are already pregnant or if you have any plans to become pregnant. Very little ganciclovir is absorbed into the body from an eye gel, but your doctor will still weigh the benefits of treating the eye infection against any potential risk.

Talk to your doctor if you are already breastfeeding or if you have any plans to breastfeed. It is not known if ganciclovir from the ophthalmic gel passes into breast milk. Your healthcare provider will guide you on whether to use Zirgan while breastfeeding.