Viroptic (trifluridine ophthalmic) dosing, indications, interactions, adverse effects, and more

Sections

Sections trifluridine ophthalmic
Dosing & Uses
Adverse Effects
Warnings
Pregnancy
Pharmacology
Images
Patient Handout
Formulary

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic solution

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

Dosage Forms & Strengths

ophthalmic solution

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

1-10%

Transient burning/stinging

Palpebral edema

Frequency Not Defined

Superficial punctate keratopathy

Epithelial keratopathy

Stromal edema

Keratitis sicca

Hyperemia

Increased IOP

Hypersensitivity reactions

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 & 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.

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

Images

No images available for this drug.

Patient Handout

A Patient Handout is not currently available for this monograph.

Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

View explanations for tiers and restrictions

Tier	Description
1	This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2	This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6	This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC	NOT COVERED – Drugs that are not covered by the plan.

Code	Definition
PA	Prior Authorization Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL	Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST	Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR	Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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