Verteporfin


Generic Medicine Info
Indications and Dosage
Intravenous
Subfoveal choroidal neovascularisation
Adult: For the treatment of predominantly classic or occult cases due to age-related macular degeneration, pathologic myopia, or presumed ocular histoplasmosis: 6 mg/m2 via infusion over 10 minutes, followed by light activation using a nonthermal diode laser (refer to specific product guidelines on treatment procedure). Re-evaluate patient every 3 months and repeat treatment if choroidal neovascular leakage occurs. Treatment may be given up to 4 times per year.
Hepatic Impairment
Severe: Contraindicated.
Reconstitution
Reconstitute with 7 mL sterile water for inj to a total volume of 7.5 mL (2 mg/mL). Withdraw the desired dose from the vial and further dilute in 5% dextrose solution for infusion to a total volume of 30 mL.
Incompatibility
May cause precipitation with saline solutions.
Contraindications
Porphyria. Severe hepatic impairment.
Special Precautions
Mild to moderate hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Significant: Extravasation (if exposed to light, may cause severe pain, swelling, inflammation, blistering, discolouration; localised necrosis), visual disturbances (e.g. abnormal vision, decreased vision, or visual field defects), photosensitivity, hypersensitivity reactions (e.g. anaphylaxis), vasovagal reactions, chest pain, dyspnoea, flushing, syncope. Rarely, convulsions.
Eye disorders: Reduced visual acuity, blurred vision, fuzzy vision, photopsia, scotoma, grey or dark haloes, and black spots.
Gastrointestinal disorders: Nausea, vomiting.
General disorders and administration site conditions: Inj site pain, oedema, inflammation; asthenia.
Metabolism and nutrition disorders: Hypercholestrolaemia.
Musculoskeletal and connective tissue disorders: Back pain.
Nervous system disorders: Headache, dizziness.
IV/Parenteral: C
Patient Counseling Information
This drug may cause abnormal vision, decreased vision, or visual field defects; if affected, do not drive or operate machinery. Avoid exposure to direct sunlight for 2-5 days after treatment. If exposure cannot be avoided, use protective clothing and dark sunglasses. Ambient light exposure is encouraged.
Monitoring Parameters
Monitor inj site (to avoid extravasation). Perform fluorescein angiography every 3 months to monitor neovascular leakage.
Overdosage
Symptoms: Non-selective non-perfusion of normal retinal vessels, including the possibility of severe vision decrease; prolonged period of photosensitivity. Management: Prolonged or continued skin or eye protection from direct sunlight or bright indoor light.
Drug Interactions
Increased risk of photosensitivity reactions with other photosensitising drugs (e.g. tetracyclines, sulfonamides, phenothiazines, sulfonylurea, thiazide diuretics, griseofulvin). May enhance verteporfin tissue-uptake with Ca channel blockers, polymyxin B, and radiation therapy. Decreased efficacy with antioxidants (e.g. β-carotene), free radical scavenging agents (e.g. dimethylsulfoxide, formate, mannitol), drugs that decrease clotting, vasoconstriction, or platelet aggregation (e.g. thromboxane A2 inhibitors).
Food Interaction
Alcohol may decrease the therapeutic efficacy of verteporfin.
Action
Description: Verteporfin, a synthetic benzoporphyrin derivative, is a cytotoxic photosensitizing agent. It produces cytotoxic agents upon light activation in the presence of oxygen. When energy absorbed by the porphyrin is transferred to oxygen, highly reactive short-lived singlet oxygen is produced causing damage to biological structures within the diffusion range, thereby resulting in vascular occlusion, cell damage, and in certain conditions, cell death.
Pharmacokinetics:
Distribution: Enters breast milk (small amounts). Plasma protein binding: approx 90%.
Metabolism: Metabolised via hydrolysis by plasma and hepatic esterases to benzoporphyrin derivative diacid (BPD-DA).
Excretion: Mainly via the bile (as unchanged drug); urine (<1%). Terminal elimination half-life: 5-6 hours.
Chemical Structure

Chemical Structure Image
Verteporfin

Source: National Center for Biotechnology Information. PubChem Compound Summary for CID 5362420, Visudyne. https://pubchem.ncbi.nlm.nih.gov/compound/Visudyne. Accessed Sept. 27, 2021.

Storage
Store intact vials between 20-25°C. Protect from light. Reconstituted and diluted solutions are stable for 4 hours at 25°C. Protect from light.
MIMS Class
Other Eye Preparations
ATC Classification
S01LA01 - verteporfin ; Belongs to the class antineovasculatisation agents. Used in the management of neovascular macular degeneration.
References
Anon. Verteporfin. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 30/07/2021.

Anon. Verteporfin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 30/07/2021.

Buckingham R (ed). Verteporfin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 30/07/2021.

Joint Formulary Committee. Verteporfin. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 30/07/2021.

Visudyne (Cephlarpharm Arzneitmittel GmbH). MIMS Singapore. http://www.mims.com/singapore. Accessed 30/07/2021.

Visudyne (Zuellig Pharma Sdn. Bhd.). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. www.npra.gov.my. Accessed 30/07/2021.

Visudyne 15 mg Powder for Solution for Infusion (Chephlapharm Arzneimittel GmbH). European Medicines Agency [online]. Accessed 30/07/2021.

Visudyne Injection, Powder, Lyophilized, for Solution (Bausch Health US LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 30/07/2021.

Disclaimer: This information is independently developed by MIMS based on Verteporfin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by MIMS.com
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