verteporfin (Rx)

Brand and Other Names:Visudyne
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Dosing & Uses

AdultPediatric

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

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Interactions

Interaction Checker

and verteporfin

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            All Interactions Sort By:
             activity indicator 

            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

                ranibizumab 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 (51)

              • 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.

              • warfarin

                warfarin decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.

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              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

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              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

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              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.

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              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

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              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

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              Images

              No images available for this drug.
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              Patient Handout

              Patient Education
              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 (e.g., 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. Dosage is based on your body size and response to treatment.Use precautions to keep the drug from leaking out of the vein while it is being given (extravasation). If leaking occurs, the injection should be stopped and a cold pack/compress should be applied to the affected area. Protect the area from light until swelling and discoloration go away.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 (e.g., 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.)Avoid contact of this medication with the eyes and skin during preparation and handling. Wear rubber gloves and eye protection if you handle this medication. Accidental spills should be wiped up with a damp cloth and disposed of properly.

              SIDE EFFECTS: Injection site reactions (e.g., pain, redness, irritation, swelling), headache, tiredness, or blurred vision may occur. If any of these effects persist or worsen, tell your doctor promptly.Remember that your doctor has prescribed this medication because he or she 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, sweating, eye pain, sudden change in vision.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.This medication should not be used if you have certain medical conditions. Before using this medicine, consult your doctor or pharmacist if you have: a certain metabolic disorder (porphyria).Before using this medication, tell your doctor or pharmacist your medical history, especially of: 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 that you are using this medication. It is recommended that you avoid surgery/dental procedures for at least 5 days after receiving a dose of this medication.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. Therefore, breast-feeding while using this drug is not recommended. Consult your doctor before breast-feeding.

              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.Some products that may interact with this drug include: antioxidants (e.g., beta carotene, mannitol, dimethylsulfoxide-DMSO), "blood thinners" (e.g., aspirin, ticlopidine, warfarin), polymyxin B.If your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.Before using this medication, tell your doctor or pharmacist if you take any medicine that may make you more sensitive to light, especially: griseofulvin, phenothiazines (such as chlorpromazine), sulfa drugs (such as sulfamethoxazole, glyburide), tetracycline antibiotics (such as doxycycline, tetracycline), certain "water pills" (including thiazide diuretics such as hydrochlorothiazide).

              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 March 2021. Copyright(c) 2021 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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              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.

              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.
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              Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
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              Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.