Ganciclovir (Ophthalmic)

Overview

Caused by the herpes simplex virus, acute herpetic keratitis starts with an infection of the epithelial cells, on the surface of the eye. Following this, the nerves of the cornea become infected and the patient's symptoms tend to worsen.

Initially, patients are likely to experience swelling at the front of the eye and on the eyelids but they may also develop itchy lesions on the surface of the cornea. If untreated, these lesions can cause damage to the eye and dendritic ulcers may form. Patients mat also exhibit dry eyes, dull pain within the eye and symptoms of sinusitis.

As the herpes simplex virus remains in the patient's system, they may experience acute herpetic keratitis repeatedly. In general, the symptoms of the condition tend to worsen in subsequent flare ups. If treatment isn't successful, persistent infections can lead to an excessive immune response which can damage the corneal stroma. Due to this, patients can experience a permanent loss of vision of a result of recurrent infections.

When Ganciclovir is used, however, the swelling associated with the condition is reduced significantly. By reducing inflammation of the epithelial cells, Ganciclovir provides relief from symptoms and can help the infection to be resolved more quickly.

Whilst Ganciclovir gel isn't a cure for the herpes simplex virus, it can be used to treat acute herpetic keratitis effectively. When applied appropriately, the gel can relieve swelling, itching and dry eyes caused by the infection. Due to this, Ganciclovir is a first-choice treatment for patients displaying symptoms of acute herpetic keratitis.

Conditions Treated

  • Acute herpetic keratitis

Type Of Medicine

  • Topical antiviral

Side Effects

When patients begin using a new medication, they may notice some side effects occurring. Although this is not uncommon, they may need to access medical advice to ensure the adverse effects are not harmful. If patients experience the following side effects when using Ganciclovir gel, for example, they should seek medical advice:

  • Sore, red eyes
  • Blurred vision
  • Redness inside the eyelids or on the white part of the eye
  • Painful irritation of the clear, front part of the eye

If side effects which are not listed above occur, patients should also seek medical advice. In addition to this, patients can report any additional side effects to the Food and Drug Administration on 1-800-FDA-1088.

Dosage

When using Ganciclovir gel, it's important that patients follow their doctor's instructions. Generally, patients are advised to use Ganciclovir five times per day, with at least three hours between doses. This dosing regimen is used until symptoms improve, at which point patients should begin using Ganciclovir three times per day, for a period of seven days.

In order to apply Ganciclovir, patients should wash their hands thoroughly and then gently press down on their lower eyelid. This creates a space between the eye and the eyelid and enables the medicine to be administered. After applying the relevant amount of Ganciclovir, patients should let go of their eyelid and keep their eye closed for approximately one to two minutes.

Patients should gently apply their finger to the inside corner of their eyelid, whilst their eye is closed. This helps the medicine to reach the relevant areas and also stops it from entering the tear ducts.

If patients need to administer another drop of Ganciclovir, they should wait at least five minutes before doing so.

Once the medicine has been applied, patients should wash their hands thoroughly and place the medication in a secure location. When applying Ganciclovir, it's important that the applicator does not come into contact with anything, including the surface of the eye. This helps to ensure that the applicator is kept germ-free and that the patient doesn't develop any further infections.

If patients forget to administer a dose of Ganciclovir, they should do so as soon as they remember. However, if their next dose is almost due, patients should simply continue with the normal dosing schedule and skip the missed dose. Patients should not attempt to administer a double dose of Ganciclovir.

Patients should not wear contact lenses when using Ganciclovir as it could lead to additional eye irritation.

When Ganciclovir is prescribed, patients should be told how to use the medicine and when to apply it. However, if patients are unsure when to apply Ganciclovir, they should seek advice from their physician or pharmacist.

Potential drug interactions:

Due to the possibility of drug interactions occurring, patients should tell their doctor if they are using any other medicines before Ganciclovir is prescribed. This includes over-the-counter medicines, supplements and vitamins. Once the doctor has this information, they will be able to confirm whether it is safe for the patient to use Ganciclovir gel.

In addition to this, patients should seek medical advice before using any new medicines, vitamins or supplements once they have started using Ganciclovir.

Warnings

If patients have any other medical conditions, they should inform their physician before they begin treatment with Ganciclovir. There are some conditions which may affect the suitability of treatment with Ganciclovir so patients must disclose their medical history to their doctor before using this medicine.

If patients have an active infection in another part of their body, treatment with Ganciclovir may not be appropriate, for example. Similarly, if patients bleed or bruise easily, they should inform their physician. This may indicate that they have low levels of platelets in their blood and this could affect their treatment with Ganciclovir.

Although children can be prescribed Ganciclovir, the safety of this medicine for patients under the age of two years has yet to be confirmed. Due to this, pediatric patients under the age of two years may not be prescribed Ganciclovir for the treatment of acute herpetic keratitis.

When using Ganciclovir, patients will need to have regular consultations with their physician. This will enable doctors to confirm that the treatment is effective and that the patient isn't experiencing any complications as a result of the infection.

Normally, the patient's symptoms should begin to improve within a few days of using Ganciclovir gel. However, if patients worsen, fail to improve or if the patient is experiencing pain, they should access medical advice.

Before using Ganciclovir gel, patients should tell their doctor if they have any existing allergies. This includes allergies to medicines, foods, preservatives, dyes and animals. On rare occasions, patients may experience an allergic reaction when using Ganciclovir to treat acute herpetic keratitis. If patients exhibit any of the following symptoms, a serious allergic reaction may be occurring:

  • Additional swelling of the eyes
  • Swelling of the face, mouth, lips, tongue or throat
  • Wheezing
  • Itching
  • Rash on the skin
  • Hoarseness
  • Difficulty swallowing
  • Difficulty breathing

Due to the life-threatening nature of serious allergic reactions, patients should obtain urgent medical treatment if they experience any of the above symptoms.

Storage

As patients normally need to apply Ganciclovir gel numerous times per day, they may need to store the medicine at home or they may need to carry it around with them. When keeping medicines at home, it's important that they are kept out of reach of children and/or pets. Similarly, if patients need to carry the medicine with them, they should ensure that it is in a safe location at all times and that no-one else can gain access to it.

When storing Ganciclovir gel, patients should follow the manufacturer's guidelines and any instructions given to them by their doctor. In most cases, however, Ganciclovir gel can be kept at room temperature, in a closed container. This medication should, however, be kept away from moisture, heat and direct light. In addition to this, Ganciclovir gel should not be frozen or saved for future use.

If patients are advised to stop applying Ganciclovir or if the medicine reaches its use-by date, it will need to be disposed of. However, patients should not attempt to throw Ganciclovir out with regular household waste as it may pose a risk to other people.

When disposing of medications, patients should contact their physician's office or their pharmacist and make use of a designated medicine disposal service.

Summary

Although acute herpetic keratitis is not uncommon in patients who have been diagnosed with the herpes simplex virus, it can be an uncomfortable condition. As patients can experience serious complications as a result of an acute herpetic keratitis infection, it's vital that treatment is started quickly and that patients adhere to the dosing schedule given to them by their physician.

Whilst Ganciclovir gel will not cure the patient of the herpes simplex virus and will not prevent acute herpetic keratitis returning, it does provide effective treatment once the symptoms of the infection are evidence.

By using the topical antiviral medicine, patients can gain considerable relief from symptoms and can ensure that the infection is resolved far more quickly than it otherwise would be. As well as reducing the swelling associated with acute herpetic keratitis, Ganciclovir gel can limit the pain and itching caused by the infection and may prevent complications, such as sinusitis or conjunctivitis, occurring.