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Visudyne Side Effects, and Drug Interactions - Verteporfin Inj

Visudyne Side Effects, and Drug Interactions - Verteporfin Inj

SIDE EFFECTS

The most frequently reported adverse events to VISUDYNE are headaches, injection site reactions (including extravasation and rashes) and visual disturbances (including blurred vision, decreased visual acuity and visual field defects). These events occurred in approximately 10-30% of patients. The following events, listed by Body System, were reported more frequently with VISUDYNE therapy than with placebo therapy and occurred in 1-10% of patients:

Ocular Treatment Site:

Blepharitis, cataracts, conjunctivitis/conjunctival injection, dry eyes, ocular itching, severe vision loss with or without subretinal or vitreous hemorrhage

Body as a Whole:

Asthenia, back pain (primarily during infusion), fever, flu syndrome, photosensitivity reactions

Cardiovascular:

Atrial fibrillation, hypertension, peripheral vascular disorder, varicose veins

Dermatologic:

Eczema

Digestive:

Constipation, gastrointestinal cancers, nausea

Hemic and Lymphatic:

Anemia, white blood cell count decreased, white blood cell count increased

Hepatic:

Elevated liver function tests

Metabolic/Nutritional:

Albuminuria, creatinine increased

Musculoskeletal:

Arthralgia, arthrosis, myasthenia

Nervous System:

Hypesthesia, sleep disorder, vertigo

Respiratory:

Cough, pharyngitis, pneumonia

Special Senses:

Cataracts, decreased hearing, diplopia, lacrimation disorder

Urogenital:

Prostatic disorder

Severe vision decrease, equivalent of 4 lines or more, within 7 days after treatment has been reported in 1-5% of patients. Partial recovery of vision was observed in some patients. Photosensitivity reactions usually occurred in the form of skin sunburn following exposure to sunlight. The higher incidence of back pain in the VISUDYNE group occurred primarily during infusion.

The following adverse events have occurred either at low incidence (<1%) during clinical trials or have been reported during the use of VISUDYNE in clinical practice where these events were reported voluntarily from a population of unknown size and frequency of occurrence cannot be determined precisely. They have been chosen for inclusion based on factors such as seriousness, frequency of reporting, possible causal connection to VISUDYNE, or a combination of these factors:

Ocular Treatment Site:

Retinal detachment (nonrhegmatogenous), retinal or choroidal vessel nonperfusion

Non-ocular Events:

Chest pain and other musculoskeletal pain during infusion, hypersensitivity reactions (which can be severe), syncope, severe allergic reactions with dyspnea and flushing, and vaso-vagal reactions.

DRUG INTERACTIONS

Drug interaction studies in humans have not been conducted with VISUDYNE. Verteporfin is rapidly eliminated by the liver, mainly as unchanged drug. Metabolism is limited and occurs by liver and plasma esterases. Microsomal cytochrome P450 does not appear to play a role in verteporfin metabolism.

Based on the mechanism of action of verteporfin, many drugs used concomitantly could influence the effect of VISUDYNE therapy. Possible examples include the following: Calcium channel blockers, polymyxin B or radiation therapy could enhance the rate of VISUDYNE uptake by the vascular endothelium. Other photosensitizing agents (e.g., tetracyclines, sulfonamides, phenothiazines, sulfonylurea hypoglycemic agents, thiazide diuretics and griseofulvin) could increase the potential for skin photosensitivity reactions. Compounds that quench active oxygen species or scavenge radicals, such as dimethyl sulfoxide, b -carotene, ethanol, formate and mannitol, would be expected to decrease VISUDYNE activity. Drugs that decrease clotting, vasoconstriction or platelet aggregation, e.g., thromboxane A2 inhibitors, could also decrease the efficacy of VISUDYNE therapy.

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