Verteporfin


Thông tin thuốc gốc
Chỉ định và Liều dùng
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.
Suy gan
Severe: Contraindicated.
Hướng dẫn pha thuốc
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.
Tương kỵ
May cause precipitation with saline solutions.
Chống chỉ định
Porphyria. Severe hepatic impairment.
Thận trọng
Mild to moderate hepatic impairment. Pregnancy and lactation.
Tác dụng không mong muốn
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.
Thông tin tư vấn bệnh nhân
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.
Chỉ số theo dõi
Monitor inj site (to avoid extravasation). Perform fluorescein angiography every 3 months to monitor neovascular leakage.
Quá liều
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.
Tương tác
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).
Tương tác với thức ăn
Alcohol may decrease the therapeutic efficacy of verteporfin.
Tác dụng
Description:
Mechanism of Action: 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.
Đặc tính

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.

Bảo quản
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.
Phân loại MIMS
Các thuốc nhãn khoa khác
Phân loại ATC
S01LA01 - verteporfin ; Belongs to the class antineovasculatisation agents. Used in the management of neovascular macular degeneration.
Tài liệu tham khảo
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.

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