Dosing and uses of Vitrasert, Zirgan (ganciclovir ophthalmic)
Adult dosage forms and strengths
implant
- 4.5mg
ophthalmic geL
- 0.15% (5g)
CMV Retinitis
Ocular Implant: Intravitreally 1 implant q5-8mth
Acute Herpetic Keratitis
Initial: 1 gtt to affected eye(s) 5 x per day while awake until corneal ulcer heals
Maintenance: 1 gtt to affected eye(s) TID for 7 days
Pediatric dosage forms and strengths
implant
- 4.5mg
ophthalmic geL
- 0.15% (5g)
CMV Retinitis
<9 years: Safety and efficacy not established
9 years or older: As adults; ocular implant: intravitreally 1 implant q5-8mth
Acute Herpetic Keratitis
<2 years: Safety and efficacy not established
2 years or older: As adults
Initial: 1 gtt to affected eye(s) 5 x per day while awake until corneal ulcer heals
Maintenance: 1 gtt to affected eye(s) TID for 7 days
Vitrasert, Zirgan (ganciclovir ophthalmic) adverse (side) effects
>10%
Zirgan
- Blurred vision (60%)
- Eye irritation (20%)
Vitrasert
- Visual acuity loss (10-20%)
- Retinal detachment (10-20%)
- Vitreous hemorrhage (10-20%)
1-10%
Zirgan
- Punctate keratitis (5%)
- Conjunctival hyperemia (5%)
Frequency not defined
Vitrasert
- Uveitis
- Hyphema
- Macular degeneration
- IOP spike
Warnings
Contraindications
Hypersensitivity to ganciclovir or acyclovir
Intraocular surgery eg, external infection or severe thrombocytopenia
Cautions
Handle implant only by suture taB
Pregnancy and lactation
Pregnancy category: C
Lactation: excretion in milk unknown; use with caution
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.
Pharmacology of Vitrasert, Zirgan (ganciclovir ophthalmic)
Release Rate (Vitrasert): 1.4 mcg/hr; range 0.5-2.88 mcg/hr
Mechanism of action
Inhibits replication of viral DNA
