Many drugs used concomiitantly influence the effect of the drug

Summary of Interactions

Cal Chanl blckrs, polymix B or radiation therapy
could increase rate of vertoporfin uptake

Photosensitive agents eg tetracycline,sulfonamides, phenothiazides, sulfonylurea,
hypoglycemic agents , thiazide diuretics, griesofluvin -
increase the potential for skin photosenstivity  reaction

Compounds that quench active oxygen species or scavenge radicals such as
dimethyl sulfonate,beta carotene, ethanol, formate and mannitol -
decrease verteporfin activity

Age related macular degeneration

Most frequently reported advese reactions are-
site reactions, ( extravasation, rashes ) visual disturbances, blurred vision, decreased visual acuity and visual field defect  ( approx 10 to 20% ) of cases

Cardiovacular -
Aatrial fibrillation, hypertension, prripheral vascular disorder, varicose veins

CNS -
Hypertension, sleep disoder, vertigo

Dermatologic-
Eczema

GI-
Constipation, gastrointestinal cancers, nausea

GU-
Prostatic disorder

Hemotological /lymphoatic -
Albuminuria, creatinine increased

Musculoskeletal -
Artlagia, arthrosis, myasthenia gravis

Ophthalmic -
Blepharitis, conjunctivitis/ conjuntivial injection, dry eyes, ocular itching,
severe vision loss with or without subretinal or vitrous hemorrhage

Porphyria or a known hypersensitivity to any component

Special Precautions/Warning -

Light exposure - if emergency surgery is necessary within 48 hours after treatment as
much of the internal tissue as possible should be protected from internal light.

Decrease in vision- patients who experience severe decrease of vision of 4 lines or more
within 1 week after treatment should not be retreated, at least until their vision completely
to pretreatment level.

Hepatic function impairment - vertoporfin therapy should be considered carefully  in patients with moderate to severe hepatic impairment.

Pregnancy- only use verteporfin only if  needed

Lactation- excercise caution when vertoporfin is adminstered to a woman who is nursing.

Children- safety and efectiveness in pediatric patients have not been established

Indication-

Age related macular degeneration

Dosage-
Course of vvertoprfin is a two step process requiring adminstration of both drug and light.

First step - intravenous IV infusion of vertiporfin. The second step is the activation of both drug light.

The physician should evaluate the patient every 3 months and if choroidal neovascular leakage is detected on fluoresin angiography, therpy should be repeated

Store - vertoporfin between 20 and 25C ( 68 to 77F)

1. Patients who receive verteporfin will become temporarily photosensitive to light after the infusion

2. Patients adviced to wear a wrist band to remind them to avoid direct sunlight for 5 days.

3. During that period patients should avoid exposure of unprotected skin, eyes, or other  body organs to direct sunlight or bright indoor light

4. If treated patients are required to go outdoors in day light, during the first 5 days of treatment, they should ptect all parts of their skin and eyes by weraing protective clothing and sunglasses

5. Patients should not stay in the dark and should be encouraged to exposure their skin to ambient  indoor light, as it  will help inactivate the drug in the skin through  process called photobleaching

Pregnancy-
Only use verteporfin only if  needed

Lactation-
Excercise caution when vertoporfin is adminstered to a woman who is nursing.

Children-
Safety and efectiveness in pediatric patients have not been established