Aciclovir

• Eye ointment 30mg/g (£45.00 = 4.5g)

Indications

• Herpes simplex keratitis (see note 1)

Dose

• Apply 1cm of ointment to the lower conjunctival sac of the affected eye(s) five times a day (at approximately 4-hourly intervals); continue for at least 3 days after the healing is complete

Notes

1. All cases of suspected ocular herpes simplex should be referred for same-day ophthalmology specialist assessment and management (without initiating drug treatment). Same-day assessment may not always be possible or practical. If this is the case, local specialists and NICE CKS suggest specialist advice may be sought from an ophthalmologist regarding initiating treatment (such as topical antivirals) in primary care to prevent a delay in treatment prior to specialist assessment.

Ganciclovir

• Eye gel 0.15% (£19.99 = 5g)

Indications

• Acute herpetic keratitis (dendritic and geographic ulcers) (see note 1)

Dose

• Adults: instil one drop of gel to the lower conjunctival sac of the affected eye(s) five times a day until complete corneal re-epithelialisation, then three instillations a day for 7 days after healing. Treatment does not usually exceed 21 days

Notes

1. All cases of suspected ocular herpes simplex should be referred for same-day ophthalmology specialist assessment and management (without initiating drug treatment). Same-day assessment may not always be possible or practical. If this is the case, local specialists and NICE CKS suggest specialist advice may be sought from an ophthalmologist regarding initiating treatment (such as topical antivirals) in primary care to prevent a delay in treatment prior to specialist assessment.
2. Manufacturer advises that use in children under 18 years is not recommended since no specific studies have been conducted.
3. Manufacturer advises:
   1. women of childbearing potential should use effective contraception during and for at least 6 months treatment
   2. men should be advised to use barrier contraception during and for at least 3 months after treatment.
   3. See also resources for: contraception for drugs with teratogenic potential, and prescribing in pregnancy and lactation.