Dosing & Uses
Dosage Forms & Strengths
lyophylized power for reconstitution
- 15mg/vial
Macular Degeneration with Classic Subfoveal Choroidal Neovascularization
6 mg/m² IV infusion, total volume 30 mL over 10 min
Follow with 50 J/cm² of 689 nm laser light on retina at intensity of 600 mW/cm² x 83 sec
Administration
After IV infusion, eyedrops are used to numb eye
Approximately 15 min after infusion & no later than 5 min after eyedrop application, a special ophthalmic lens is placed over eye
Next the cold laser light spot-sized to match treatment area is applied
Central Serous Chorioretinopathy (Orphan)
Designation for the potential treatment of chronic or recurrent central serous chorioretinopathy
Orphan sponsor
- QLT Inc.; Vancouver, British Columbia, Canada
Safety and efficacy not established
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (3)
- aminolevulinic acid oral
aminolevulinic acid oral, verteporfin. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid administering other phototoxic drugs with aminolevulinic acid oral for 24 hr during perioperative period.
- aminolevulinic acid topical
verteporfin, aminolevulinic acid topical. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.
- methyl aminolevulinate
verteporfin, methyl aminolevulinate. Either increases levels of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Each drug may increase the photosensitizing effect of the other.
Monitor Closely (3)
- beta carotene
beta carotene decreases effects of verteporfin by pharmacodynamic antagonism. Use Caution/Monitor. Drugs that reduce active oxygen species or scavenge radicals are expected to decrease verteporfin's therapeutic effect .
- ranibizumab intravitreal injection
ranibizumab intravitreal injection increases toxicity of verteporfin by unspecified interaction mechanism. Use Caution/Monitor. Risk of severe intraocular inflammation, even when separated by 7 days.
- tobramycin inhaled
tobramycin inhaled and verteporfin both increase nephrotoxicity and/or ototoxicity. Modify Therapy/Monitor Closely. Avoid concurrent or sequential use to decrease risk for ototoxicity
Minor (50)
- abciximab
abciximab decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- amlodipine
amlodipine increases levels of verteporfin by pharmacodynamic synergism. Minor/Significance Unknown.
- anagrelide
anagrelide decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- antioxidants
antioxidants decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- antithrombin alfa
antithrombin alfa decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- antithrombin III
antithrombin III decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- argatroban
argatroban decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- bemiparin
bemiparin decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- bendroflumethiazide
bendroflumethiazide, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- bivalirudin
bivalirudin decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- chlorothiazide
chlorothiazide, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- chlorthalidone
chlorthalidone, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- cilostazol
cilostazol decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- clevidipine
clevidipine increases levels of verteporfin by pharmacodynamic synergism. Minor/Significance Unknown.
- clopidogrel
clopidogrel decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- cyclopenthiazide
cyclopenthiazide, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- dabigatran
dabigatran decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- dalteparin
dalteparin decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- demeclocycline
demeclocycline, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- diltiazem
diltiazem increases levels of verteporfin by pharmacodynamic synergism. Minor/Significance Unknown.
- dipyridamole
dipyridamole decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- doxycycline
doxycycline, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- enoxaparin
enoxaparin decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- eptifibatide
eptifibatide decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- ethanol
ethanol decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- felodipine
felodipine increases levels of verteporfin by pharmacodynamic synergism. Minor/Significance Unknown.
- fondaparinux
fondaparinux decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- heparin
heparin decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- hydrochlorothiazide
hydrochlorothiazide, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- indapamide
indapamide, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- isradipine
isradipine increases levels of verteporfin by pharmacodynamic synergism. Minor/Significance Unknown.
- methyclothiazide
methyclothiazide, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- metolazone
metolazone, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- minocycline
minocycline, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- nicardipine
nicardipine increases levels of verteporfin by pharmacodynamic synergism. Minor/Significance Unknown.
- nifedipine
nifedipine increases levels of verteporfin by pharmacodynamic synergism. Minor/Significance Unknown.
- nisoldipine
nisoldipine increases levels of verteporfin by pharmacodynamic synergism. Minor/Significance Unknown.
- oxytetracycline
oxytetracycline, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- phenindione
phenindione decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- polymyxin B
polymyxin B increases levels of verteporfin by pharmacodynamic synergism. Minor/Significance Unknown.
- prasugrel
prasugrel decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- protamine
protamine decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- radiation
radiation increases levels of verteporfin by Other (see comment). Minor/Significance Unknown. Comment: Radiation may enhance tissue uptake of verteporfin.
- sulfadiazine
sulfadiazine, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- sulfamethoxazole
sulfamethoxazole, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- sulfisoxazole
sulfisoxazole, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- tetracycline
tetracycline, verteporfin. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Increased phototoxicity.
- ticlopidine
ticlopidine decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- tirofiban
tirofiban decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- verapamil
verapamil increases levels of verteporfin by pharmacodynamic synergism. Minor/Significance Unknown.
Adverse Effects
Frequency Not Determined
Visual disturbances
Injection site reactions including extravasation and rashes
Edema
Hemorrhage
Inflammation
Flashes of light
Severe vision loss (1-4%)
Photosensitivity
Headache
Conjunctivitis
Dry eyes
Ocular itching
Subconjunctival
Subretinal or vitreous hemorrhage
Back pain during infusion
Asthenia
Fever
Flu-like syndrome
Atrial fibrillation
Hypertension
Peripheral vascular disorder
Varicose veins
Eczema
Constipation
GI cancers
Nausea
Anemia
WBC incr/decr
Elev LFTs
Albuminuria
Leukocyte count increase/decrease
Increased liver function test results
Albuminuria
Increased serum creatinine
Arthralgia
Arthrosis
Myasthenia
Hypesthesia
Sleep disorder
Vertigo
Pharyngitis
Pneumonia
Hearing decrease
Lacrimation disorder
Prostatic disorder
Warnings
Contraindications
Hypersensitivity, porphyria
Cautions
Avoid bright light for 5 days after injection
Moderate/severe hepatic impairment
Chest pain, hypersensitivity, and vasovagal reactions reported (observe patient during infusion); cases of anaphylactic reactions reported in patients receiving therapy; medical supervision recommended during infusion; if an anaphylactic or other serious allergic reaction occurs during or following infusion, administration should be discontinued immediately, and appropriate therapy initiated
Use with caution in patients with biliary obstruction
Patients under anesthesia not studied
Use in both eyes concurrently not studied (if required, apply to the agressive lesion first followed by the second eye a week later; may apply concurrently to both eyes thereafter)
Use precaution to avoid extravasation (stop infusion immediately if it occurs); extravasation, especially if the affected area is exposed to light, can cause severe pain, inflammation, swelling or discoloration at the injection site; localized (skin) necrosis at injection site following extravasation also reported
Safety and efficacy of use >2 years not established
Patients who experience severe decrease of vision of 4 lines or more within 1 week, following treatment, should not be retreated, at least until vision completely recovers to pretreatment levels and potential benefits and risks of subsequent treatment are carefully considered by treating physician
Pregnancy & Lactation
Pregnancy
There are no data with use in pregnant women to inform a drug-associated risk; there are no adequate and well-controlled studies in pregnant women; drug should be used during pregnancy only if benefit justifies potential risk to fetus
Animal data
- Intravenous administration of drug to pregnant rats during period of organogenesis produced an increase in the incidence of anophthalmia/microphthalmia and wavy ribs at exposures approximately 40-fold the human exposure at recommended clinical dose; drug did not produce adverse fetal effect in rats or rabbits at exposures 6- to 20-fold human exposure at recommended clinical dose;
Lactation
The drug and its diacid metabolite have been found in human breast milk following an intravenous infusion at the recommended human dose of 6 mg/m2; the drug was present in breast milk at levels up to 66% of the corresponding plasma levels and declined below the limit of quantification (2 ng/mL) within 24 hours
The diacid metabolite had lower peak concentrations but persisted up to at least 48 hours
Because of potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or postpone treatment, taking into account the importance of the drug to the mother
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
Mechanism of Action
Produces oxygen free radicals in presence of light that damage neovascular endothelium, which in turn leads to temporary vessel occlusion
Pharmacokinetics
Half-Life: 5-6 hr
Metabolism: To a small extent by liver and plasma esterases to a diacid metabolite that exhibits pharmacologic activity similar to that of verteporfin
Excretion: Feces
Administration
IV Preparation
Reconstitute 15 mg drug with 7 mL SWI to obtain a 2 mg/mL opaque dark-green solution
Protect from light & use within 4 hr
Further dilute in D5W to match 6 mg/sq.meter dose and infusion volume of 30 mL
After dilution protect from light & use within 4 hr
IV Administration
Infuse the 30 mL solution at rate of 3 mL/min over 10 min
Large antecubital veins are preferred to avoid extravasation
Extravasation Management
Stop infusion immediately & apply cold compresses
Protect extravasation site from light
Images
Patient Handout
verteporfin intravenous
VERTEPORFIN - INJECTION
(VER-te-POR-fin)
COMMON BRAND NAME(S): Visudyne
USES: Verteporfin is used along with laser light treatment to treat certain serious eye conditions (such as macular degeneration, pathologic myopia, ocular histoplasmosis). It is used to help prevent decreased vision and blindness. After you have received the injection of verteporfin, your doctor will use laser light treatment on the affected eye(s). The laser light will change the drug to a form that works by damaging only those cells that cause the serious eye problem.
HOW TO USE: This medication is given by injection into a vein by a health care professional as directed by your doctor. The dosage is based on your body size and response to treatment.Your doctor will treat your affected eye with laser light about 15 minutes after you receive this medication. If you have any questions about the treatment, consult your doctor.Wear a wristband for 5 days after receiving this drug to notify other health care professionals that you have received this drug and to remind you to avoid bright lights (such as halogen lights) and direct sunlight. However, do not stay in totally dark areas after treatment. You should expose your skin to regular indoor/indirect light because doing so will help stop any drug in your skin from causing damage to skin cells. If any of the information is unclear, consult your doctor. (See also Precautions section.)
SIDE EFFECTS: Injection site reactions (such as pain, redness, irritation, swelling), headache, tiredness, or blurred vision may occur. If any of these effects last or get worse, tell your doctor promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: chest pain, fainting, eye pain, sudden change in vision, severe pain/swelling at injection site.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), flushing, severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Before using this medication, tell your doctor or pharmacist if you are allergic to verteporfin; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: a certain metabolic disorder (porphyria), liver disease.This medication will make you more sensitive to the sun and to bright indoor lights. Avoid sun exposure, halogen lights, high-powered indoor lighting used in operating rooms/dental offices, tanning booths, and sunlamps for at least 5 days after receiving this medication. Wear protective clothing and dark sunglasses when outdoors. Sunscreens will not provide protection.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products). It is recommended that you avoid surgery/dental procedures for at least 5 days after receiving a dose of verteporfin.During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.This medication passes into breast milk and may have undesirable effects on a nursing infant. Breastfeeding is not recommended while using this medication. Consult your doctor before breastfeeding.
DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: Your doctor will schedule periodic eye exams to monitor your progress or check for side effects.
MISSED DOSE: Not applicable.
STORAGE: Not applicable. This medication is given in a clinic and will not be stored at home.
Information last revised October 2023. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
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