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Visudyne (verteporfin)

2014-10-08 11:24:20 来源: 作者: 【大中小】浏览:964次评论:0条

Main use	Active ingredient	Manufacturer
Age-related macular degeneration	Verteporfin	Novartis

How does it work?

Visudyne infusion contains the active ingredient verteporfin, which is a medicine that is activated by light. Verteporfin has no effect on its own, but in the presence of light and oxygen, it reacts with oxygen to produce a cell-killing (cytotoxic) effect.

Verteporfin is used in the photodynamic treatment of eye disorders involving abnormal growth of blood vessels in the back of the eye. The treatment involves activating the medicine in a localised area of the eye, by using a laser.

The first condition it is used for is called age-related macular degeneration (ARMD). There are two main types of macular degeneration, known as wet and dry. Verteporfin is used to treat the wet type. In this type, blood vessels from the back of the eye grow in an abnormal fashion into an area called the macula at the back of the eye. (This is called subfoveal choroidal neovascularisation. Specialists use verteporfin to treat patients with wet ARMD who have what they refer to as ‘predominantly classic subfoveal choroidal neovascularisation’.)

The macula is the part of the retina that is responsible for seeing fine detail, such as reading, seeing facial features and interpreting different colours. The blood vessels that grow abnormally into the macula in wet ARMD may leak or bleed into this area, causing a rapid and significant reduction in central vision.

Verteporfin is used to reverse some of these changes that occur in wet ARMD. The medicine is given by a drip into a vein (intravenous infusion) over 10 minutes, and a laser light is then directed at the critical area of the back of the eye. The laser activates the verteporfin that has been taken up by the rapidly growing blood vessel cells in that area. The activated drug destroys the abnormal blood vessels and stops them leaking.

This method is also used to treat abnormal blood vessel growth in the back of the eye secondary to a condition called pathological myopia, which is a form of progressive short-sightedness.

What is it used for?

Abnormal growth of blood vessels in the back of the eye (predominantly classical subfoveal choroidal neovascularisation) due to wet age-related macular degeneration (ARMD).
Abnormal growth of blood vessels in the back of the eye (subfoveal choroidal neovascularisation) secondary to progessive short-sightedness (pathological myopia).

Warning!

When you receive verteporfin you will be sensitive to light for 48 hours after the treatment. During this period you should avoid exposure of your skin and eyes to direct sunlight or bright indoor light (eg tanning salons, bright halogen lighting or high power lighting such as used by surgeons or dentists). You should wear protective clothing and dark glasses if you need to go outside during this period (sunscreens are not effective for this). Normal indoor light is safe, and you should not stay in the dark, as indoor light will help to remove the medicine more quickly through the skin.
Following treatment with this medicine you may develop temporary visual disturbances that may affect your ability to drive and operate machinary. If affected you should not drive or use machines until your vision improves.
If you experience a severe decrease in your vision within the week following treatment with this medicine, you should not be retreated with verteporfin until your vision completely recovers to its pre-treatment level; and then only if your doctor feels the potential benefits outweigh the risks.
After having this treatment your eyes should be re-eva luated every three months by your eye specialist.

Use with caution in

Blockage of the bile duct (biliary obstruction).
Moderately decreased liver function.
History of heart disease.

Not to be used in

Hereditary blood disorders called porphyrias.
Severely decreased liver function.
Breastfeeding.

This medicine should not be used if you are allergic to one or any of its ingredients. Please inform your doctor or pharmacist if you have previously experienced such an allergy.If you feel you have experienced an allergic reaction, stop using this medicine and inform your doctor or pharmacist immediately.

Pregnancy and breastfeeding

Certain medicines should not be used during pregnancy or breastfeeding. However, other medicines may be safely used in pregnancy or breastfeeding providing the benefits to the mother outweigh the risks to the unborn baby. Always inform your doctor if you are pregnant or planning a pregnancy, before using any medicine.

The safety of this medicine for use in pregnancy has not been established. It should not be used during pregnancy unless considered essential by your doctor, and only if the benefits to the mother outweigh any risks to the foetus. Seek medical advice from your doctor.
It is not known if this medicine passes into breast milk. For this reason, it should not be administered to nursing mothers, or if it is, they should not breastfeed for 48 hours after treatment. Seek further medical advice from your doctor.

Side effects

Medicines and their possible side effects can affect individual people in different ways. The following are some of the side effects that are known to be associated with this medicine. Just because a side effect is stated here does not mean that all people using this medicine will experience that or any side effect.

Common (affect between 1 in 10 and 1 in 100 people)

Abnormal vision such as blurry, hazy or fuzzy vision, dark haloes, flashes of light, black spots, decreased vision.
Severe decrease in vision.
Pain and swelling at the site of the injection.
Leakage of the injection fluid into the tissues surrounding the vein (extravasation).
Abnormal reaction of the skin to light, usually a rash (photosensitivity - see warning section above).
Nausea.
Back pain.
Weakness or loss of strength (asthenia).
Raised cholesterol levels.
Heart attack, particularly in people with heart disease, sometimes within 48 hours after treatment with Visudyne.

Uncommon (affect between 1 in 100 and 1 in 1000 people)

Retinal detachment.
Bleeding beneath the retina (sub-retinal haemorrhage).
Bleeding into the chamber behind the lens of the eye (vitreous haemorrhage).
Bleeding or discolouration at the injection site.
Increased blood pressure (hypertension).
Fever.

Rare (affect less than 1 in 1000 people)

Blistering at the injection site.
Sweating.
Dizziness.
Flushing.
Fainting.
Shortness of breath.
Infusion-related back and chest pain that may spread to the shoulder, rib cage or pelvis.
Rash, itching or hives.
Lack of blood circulation to the retina or choroid.

The side effects listed above may not include all of the side effects reported by the medicine's manufacturer.For more information about any other possible risks associated with this medicine, please read the information provided with the medicine or consult your doctor or pharmacist.

How can this medicine affect other medicines?

It is important to tell your doctor or pharmacist what medicines you are already taking, including those bought without a prescription and herbal medicines, before you have treatment with this medicine. Similarly, check with your doctor or pharmacist before taking any new medicines after having treatment with this one, to make sure that the combination is safe.

If you are taking other medicines that can cause increased sensitivity to light (photosensitivity), there is a possibility that you may have an increased risk of photosensitivity reactions following treatment with verteporfin. Other photosensitising medicines include the following: