Verteporfin


Concise Prescribing Info
Indications/Uses
Neovascular age-related macular degeneration.
Dosage/Direction for Use
Adult : IV 6 mg/m2, followed by activation using laser (at a wavelength of 689 nm) 15 mins after starting infusion. Recommended light dose: 50 J/cm2 over 83 sec. Repeat 3 mthly for recurrent choroidal neovascular leakage.
Dosage Details
Intravenous
Photosensitiser in the photodynamic therapy of neovascular age-related macular degeneration
Adult: 6 mg/m2 by infusion over 10 min, followed by activation using a laser tuned to a wavelength of 689 nm 15 min after the start of the infusion. Recommended light dose is 50J/cm2, given over 83 sec. Repeat every 3 mth for recurrent choroidal neovascular leakage.
Hepatic Impairment
Biliary obstruction; moderate to severe impairment: use with caution as no studies done.
Contraindications
Porphyria; lactation.
Special Precautions
Moderate to severe hepatic disorders; biliary disorders. Pregnancy. Use the largest arm vein possible (e.g. antecubital) especially in elderly and avoid small veins in the back of the hand. Stop infusion if extravasation occurs and protect extravasation area from direct light and apply cold compresses. Patient to be under close monitoring during verteporfin infusion and exercise caution when general anaesthesia is considered. Avoid exposure of unprotected skin, eyes or other body organs to direct sunlight or bright indoor light for 5 days after treatment. Protect all parts of skin and eyes by wearing protective clothing and dark sunglasses (sunscreens are ineffective) if going outdoors in daylight is necessary. Exposure to ambient indoor light is encouraged as it helps in gradual inactivation of any remaining drug.
Adverse Reactions
Visual disturbances; severe vision loss with or without subretinal or vitreous bleeding; inj site reactions; nausea; photosensitivity; asthenia; cataracts; blepharitis; conjunctivitis; dry eyes; ocular itching; flu-like syndrome; atrial fibrillation; hypertension; peripheral vascular disorder; varicose veins; eczema; constipation; GI cancers; fever; lachrymation disorder; hypersensitivity reactions; increased LFT.
IV/Parenteral: C
Overdosage
Overdose of drug and/or light in the treated eye may cause non-perfusion of normal retinal vessels. This may result in loss in visual acuity that may be permanent. Too much verteporfin may also result in the patient being photosensitive to bright light for a prolonged period of time. In this case, extend the photosensitivity precautions for a longer period of time.
Drug Interactions
Increased rate of verteporfin uptake by the vascular endothelium with calcium channel blockers, polymyxin B or radiation therapy. Increased photosensitivity with photosensitizing agents (e.g. tetracyclines, sulfonamides, phenothiazines, sulfonylurea hypoglycaemic agents, thiazide diuretics and griseofulvin). Decreased verteporfin efficacy with compounds that quench active oxygen species or scavenge radicals e.g. dimethyl sulfoxide, betacarotene, ethanol, formate and mannitol. Decreased verteporfin efficacy with drugs that decrease clotting, vasoconstriction or platelet aggregation e.g. thromboxane A2 inhibitors. Anaesthetics may cause haemodynamic effects.
Action
Description: Verteporfin, when activated by low-intensity nonheat-generating laser light at a wavelength corresponding to its absorption peak, generates highly reactive, short-lived singlet O2 and reactive O2 radicals that cause local damage to neovascular endothelium, resulting in vessel occlusion. It appears to accumulate preferentially in the neovasculature e.g. choroidal neovasculature.
Pharmacokinetics:
Distribution: Terminal half life: 5-6 hr. Protein binding: 90%.
Metabolism: Metabolised minimally by liver and plasma esterases to its diacid metabolite.
Excretion: Excreted via bile into faeces mainly as unchanged drug, with <0.01% in urine.
Storage
Store between 20-25°C (68-77°F).
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 © 2020 MIMS. All rights reserved. Powered by MIMS.com
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