How to Help Your Patients Find Zirgan in Stock: A Provider's Guide

You've diagnosed a patient with acute herpetic keratitis, written the Zirgan prescription, and sent them to the pharmacy. Thirty minutes later, your phone rings: they can't find it anywhere. This scenario plays out regularly for eye care providers across the country.

Here's a practical, step-by-step guide for ophthalmologists and optometrists to minimize prescription-filling delays for Zirgan and ensure patients can start treatment as quickly as possible.

Step 1: Know Your Local Pharmacy Landscape Before You Prescribe

The single most effective thing you can do is identify 1–2 pharmacies in your area that reliably carry Zirgan and share this information with patients at the point of prescribing. Call them quarterly to confirm they're still stocking it. Independent pharmacies and specialty ophthalmic pharmacies are your best bets — they're far more likely to carry Zirgan than standard retail chains.

If you have a preferred pharmacy relationship, consider calling ahead to alert them when you've sent a Zirgan prescription so they can order it before the patient arrives.

Step 2: Stock and Dispense Samples from Your Office

Bausch + Lomb provides Zirgan samples through the Bausch Sample Vault. Contact your Bausch + Lomb representative to request a regular sample allotment. Dispensing a sample directly to the patient at the time of diagnosis achieves two critical goals:

Treatment begins immediately, before the prescription is even filled

Reduces anxiety for the patient who is already dealing with a painful eye condition

Even a one-day supply bridging the gap while the pharmacy sources the full prescription can meaningfully impact outcomes.

Step 3: Write a Back-Up Prescription Simultaneously

Consider issuing two prescriptions at once: Zirgan as the first choice, and trifluridine 1% ophthalmic solution (generic) as the back-up. Instruct the patient to fill whichever they can access first and to call your office so you know which therapy they've started. Trifluridine is available at virtually every retail pharmacy and is clinically comparable in efficacy.

Step 4: Help Patients Use the Bausch + Lomb Access Program

Cost can be a significant barrier for patients who do find Zirgan in stock. The Bausch + Lomb Access Program reduces the cost substantially:

Commercially insured patients: Pay no more than $25 per fill (up to 6 fills per 12 months)

Uninsured patients: Pay as little as $70 per fill at participating pharmacies

Low-income uninsured patients: May qualify for the full Patient Assistance Program (PAP) for free medication

Direct patients to bauschaccessprogram.com or provide them with a copay card. You can activate cards in your office or patients can do so online at blsavings.com. Having printed copay cards at your front desk removes friction from the process.

Step 5: Recommend medfinder to Patients Who Can't Find Zirgan

medfinder is a service that calls pharmacies near the patient to find which ones have a given medication in stock. The patient provides their medication, dose, and location — medfinder does the calling and texts back results. This is particularly valuable for specialty medications like Zirgan that require calling multiple pharmacies to locate. Providers can learn more at medfinder.com/providers.

Step 6: Create a Patient Handout for Zirgan Prescriptions

A simple one-page handout given to every patient receiving a Zirgan prescription can save significant staff time and reduce callbacks. Include:

The names and phone numbers of 2–3 local pharmacies that carry Zirgan

The Bausch + Lomb Access Program URL (bauschaccessprogram.com) and phone number (1-866-693-4880)

medfinder's URL for patients to check availability across multiple pharmacies at once

Your office phone number to call if they cannot fill within 24 hours

Clinical Guidance on Dosing and Duration

For reference: the approved Zirgan regimen is 1 drop in the affected eye 5 times per day (approximately every 3 hours while awake) until the corneal ulcer heals, then 1 drop 3 times per day for 7 additional days. Reinforce with patients that completing the full course — even after symptoms improve — is essential to minimize recurrence risk and prevent antiviral resistance.

When to Escalate or Refer

If dendritic ulcers fail to resolve within 7–10 days of appropriate topical antiviral therapy, consider stromal involvement, secondary infection, or antiviral resistance. Corneal specialist referral is appropriate for geographic ulcers, stromal keratitis, or progressive disease. For more on clinical management in shortage scenarios, see: Zirgan Shortage: What Providers Need to Know in 2026.