Formulary

11.3.3 Antivirals

First Line
Second Line
Specialist
Hospital Only
Ganciclovir
  • Eye gel 0.15% w/w (£19.99 = 5g)

Indications

  • Acute herpetic keratitis (dendritic and geographic ulcers)

Dose

  • Instil one drop of gel in the eye to be treated, 5 times a day until complete corneal re-epithelialisation. Then 3 instillations a day for 7 days after healing. Treatment does not usually exceed 21 days.

Notes

  1. NICE CKS indicates that all cases of suspected ocular herpes simplex should be referred for same day ophthalmology specialist assessment and management (without initiating drug treatment). Local specialists have indicated that same day assessment may not always be possible or practical. If this is the case, specialist advice may be sought from an ophthalmologist regarding initiating treatment (such as topical antivirals) in primary care to prevent a delay in treatment.
  2. Manufacturer advises women of childbearing potential should use effective contraception during treatment; men should be advised to use barrier contraception during and for at least 90 days after treatment.
    1. See also resources for: contraception for drugs with teratogenic potential, and prescribing in pregnancy and lactation