Zirgan (ganciclovir 0.15%)

Warnings & Precautions

Route: Topical ophthalmic use only.
Contact lens wear: Do not wear contact lenses with signs or symptoms of herpetic keratitis or during the course of therapy.
Risk of contamination: Do not let the container tip touch any surface.

Common Side Effects

Ocular: Blurred vision 60%, eye irritation 20%, punctate keratitis 5%, conjunctival hyperemia 5%.
Systemic: None listed; the maximum daily ocular dose of 0.375 mg is about 0.04% of the 900 mg oral valganciclovir maintenance dose and 0.1% of the 5 mg/kg IV dose, so minimal systemic exposure is expected.

Pregnancy & Lactation

Pregnancy: No human data. Intravenous administration to pregnant mice or rabbits during organogenesis or the pre/postnatal period produced no adverse embryofetal or offspring effects at clinically relevant doses; fetal resorptions occurred in at least 85% of rabbits and mice at intravenous doses up to roughly 1400 times (mice) and 2400 times (rabbits) the maximum recommended human ocular dose of 0.375 mg, with rabbit teratogenicity including cleft palate and anophthalmia/microphthalmia; maternal no observed adverse effect levels were 470 times (mice) and 240 times (rabbits) that dose.

Lactation: No data on presence in human milk, effects on the breastfed infant, or effects on milk production; ganciclovir is excreted in the milk of lactating rats, so exercise caution in nursing mothers.