TRIFLURIDINE

TRIFLURIDINe
(trye-flure'i-deen)
Viroptic
Classifications: antiviral;
Therapeutic: antiviral

Pregnancy Category: C

Availability

1% ophthalmic solution

Action

Pyrimidine nucleoside whose mechanism of antiviral action is not completely known but appears to involve inhibition of viral DNA synthesis and viral replication.

Therapeutic Effect

Active against herpes simplex virus (HSV) types 1 and 2, vaccinia virus, and certain strains of adenovirus.

Uses

Topically to eyes for treatment of primary keratoconjunctivitis and recurring epithelial keratitis caused by herpes simplex virus types 1 and 2. Also for other herpetic ophthalmic infections including stromal keratitis, uveitis, and for infections caused by vaccinia and Adenovirus, but clinical effectiveness has not been established.

Contraindications

Pregnancy (category C), lactation; children <6 y.

Cautious Use

Dry eye syndrome.

Route & Dosage

Viral Infections of Eye
Adult: Ophthalmic 1 drop 1% ophthalmic solution into affected eye q2h during waking hours until healing (reepithelialization) has occurred (max: 9 drops/d); when healing appears to be complete, dosage reduced to 1 drop q4h during waking hours for an additional 7 d (max: 5 drops/d); continuous administration beyond 21 d not recommended

Administration

Instillation
  • Wait several minutes between applications when used concurrently with other eye drops.
  • Store refrigerated at 2°–8° C (36°–46° F) unless otherwise directed.

Adverse Effects (≥1%)

Special Senses: Mild transient burning or stinging, mild irritation of conjunctiva or cornea, photophobia, edema of eyelids and cornea, punctal occlusion, superficial punctate keratopathy, epithelial keratopathy, stromal edema, keratitis sicca, hyperemia, increased intraocular pressure.

Interactions

Drug: No clinically significant interactions established.

Pharmacokinetics

Absorption: Following topical application to eye, trifluridine penetrates cornea and aqueous humor (inflammation enhances penetration). Systemic absorption does not appear to be significant.

Nursing Implications

Assessment & Drug Effects

  • Expect epithelial eye infections to respond to therapy within 2–7 d, with complete healing occurring in 1–2 wk.

Patient & Family Education

  • Inform physician of progress and keep follow-up appointments. Herpetic eye infections have a tendency to recur and can lead to corneal damage if not adequately treated.

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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