Dosing and uses of Viroptic (trifluridine ophthalmic)
Adult dosage forms and strengths
ophthalmic solution
- 1%
Herpes Simplex Virus
Indicated for the treatment of primary keratoconjunctivitis and recurrent epithelial keratitis due to herpes simplex virus, types 1 and 2
1 gtt onto cornea q2hr while awake until reepithelialization (not to exceed 9 gtt/day), THEn
1 gtt q4hr (minimum 5 gtt/day) x7 days
Not to exceed treatment beyond 21 days
Other Indications & Uses
Herpes Simplex Virus keratitis & keratoconjunctivis
CDC recommends for accidental smallpox virus ophthalmic infections
Pediatric dosage forms and strengths
ophthalmic solution
- 1%
Herpes Simplex Virus
Indicated for the treatment of primary keratoconjunctivitis and recurrent epithelial keratitis due to herpes simplex virus, types 1 and 2
<6 years: Safety and efficacy not established
≥6 years: 1 gtt onto cornea q2hr while awake until reepithelialization (not to exceed 9 gtt/day), THEn
1 gtt q4hr (minimum 5 gtt/day) x7 days
Not to exceed treatment beyond 21 days
Viroptic (trifluridine ophthalmic) adverse (side) effects
1-10%
Transient burning/stinging
Palpebral edema
Frequency not defined
Superficial punctate keratopathy
Epithelial keratopathy
Stromal edema
Keratitis sicca
Hyperemia
Increased IOp
Hypersensitivity reactions
Warnings
Contraindications
Hypersensitivity
Cautions
Cosnider other Tx if no improvement after 7 days or incomplete reepithelialization after 14 days
Use >21 days should be avoided because of potential ocular toxicity
Inactive against bacteria, fungi & Chlamydia
Pregnancy and lactation
Pregnancy category: C
Lactation: unlikely to be distributed into breast milk; use caution
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Viroptic (trifluridine ophthalmic)
Mechanism of action
Appears to involve inhibition of viral replication; trifluridine, instead of thymidine, is incorporated into viral DNA during replication which results in the formation of defective proteins and an increased mutation rate
Reversibly inhibits thymidylate synthetase, an enzyme required for DNA synthesis
Pharmacokinetics
Absorption: penetrates cornea & can be detected in the aqueous humor; no systemic
Metabolites: 5-carboxy-2'-deoxyuridine
