IDOXURIDINE (IDU)

IDOXURIDINE (IDU)
(eye-dox-yoor'i-deen)
Dendrid, Herplex Liquifilm
Classifications: antiviral;
Therapeutic: antiviral

Prototype: Acyclovir
Pregnancy Category: C

Availability

0.1% ophthalmic solution

Action

Topical antiviral agent. Pyrimidine nucleoside structurally related to thymidine, a nucleic acid essential for synthesis of viral DNA. Antiviral activity is primarily due to inhibition of viral replication.

Therapeutic Effect

Inhibits growth of herpes simplex types I and II, varicella-zoster, vaccinia, cytomegalovirus, and small animal viruses containing DNA.

Uses

Herpes simplex keratitis as single agent or conjunctively with a corticosteroid.

Unlabeled Uses

Cutaneous herpes simplex.

Contraindications

Hypersensitivity to idoxuridine, iodine or iodine-containing preparations, or any components in the formulation, pregnancy (category C), lactation.

Cautious Use

Corticosteroid therapy.

Route & Dosage

Herpes Simplex Keratitis
Adult/Child: Topical 1 drop in conjunctival sac hourly during the day and q2h at night until improvement occurs, then decrease to q2h during the day and q4h at night

Administration

Topical
  • Prevent the possibility of systemic absorption by applying light finger pressure to head of lacrimal duct for 1 min when eyedrop is instilled.
  • Follow manufacturer's directions regarding storage. Decomposed idoxuridine not only has reduced antiviral activity but also may be toxic.
  • Store ophthalmic solution refrigerated at 2°–8° C (36°–46° F) in a tight, light-resistant container unless otherwise directed.

Adverse Effects (≥1%)

Body as a Whole: Sensitization, systemic absorption (stomatitis, anorexia, nausea, vomiting, alopecia, leukopenia, thrombocytopenia, iodism, hepatotoxicity). Special Senses: Local irritation, pain, burning, lacrimation, pruritus, inflammation, or edema of eyes, lids, and surrounding face; follicular conjunctivitis, photophobia; corneal ulceration and swelling; delayed healing, small defects in corneal epithelium (local overdosage).

Interactions

Drug: Boric acid-containing solutions may cause precipitation.

Pharmacokinetics

Absorption: Poorly absorbed from eye tissues. Distribution: Crosses placenta. Metabolism: In liver.

Nursing Implications

Assessment & Drug Effects

  • Monitor for therapeutic effectiveness. Epithelial infections usually improve within 7–8 d. If patient continues to improve, therapy is generally continued ≤21 d.
  • Supervise patients closely by ophthalmologist.

Patient & Family Education

  • Learn proper technique for eye drop instillation.
  • Do not exceed the recommended frequency and duration of therapy.
  • Wear sunglasses if photosensitivity is troublesome.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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