Verteporfin

What is Verteporfin

Verteporfin is a porphyrin derivative present in a 1:1 ratio of regioisomers. As a photosensitizing agent, verterporfin is used as part of photodynamic therapy (PDT).

Photodynamic therapy is a two-stage process requiring administration of the drug photosensitizer followed by an activating light source. With verteporfin, a nonthermal red light (689 nm wavelength laser light) is utilized.

Verteporfin PDT is used as a selective treatment for choroidal neovasularization (CNV) associated with macular degeneration. The verteporfin procedure helps prevent progression of the disease and preserve a patient’s vision. In comparison to conventional laser photocoagulation therapy, verteporfin PDT offers the advantage of selective tissue injury due to localization of verteporfin in the CNV complex and decreased retinal injury due to the use of a non-thermal light source.

A report of two randomized controlled trials of verteporfin PDT in patients with CNV in age-related macular degeneration showed that 61% of eyes assigned to verteporfin compared with 46% of eyes assigned to placebo maintained baseline visual acuity.

In subgroup analysis, verteporfin efficacy was demonstrated when the area of CNV occupied >= 50% of the entire lesion, especially when there was no occult CNV.

Verteporfin is being studied for the treatment of CNV due to other causes including angioid streaks or idiopathic causes.

Verteporfin is also under investigation for the treatment of skin cancer, psoriasis, and rheumatoid arthritis. In April 2000, the FDA approved verteporfin for the treatment of CNV in patients with the wet form of age-related macular degeneration.

The FDA approved verteporfin treatment of CNV associated with macular degeneration due to pathologic myopia or ocular histoplasmosis in September 2001.

Brand Name

Visudyne

Indications

  • central serous chorioretinopathy
  • choroidal neovascularization (CNV)
  • macular degeneration

Side Effects

  1. anemia
  2. arthralgia
  3. asthenia
  4. atrial fibrillation
  5. back pain
  6. blepharitis
  7. blurred vision
  8. cataracts
  9. chest pain (unspecified)
  10. clastogenesis
  11. conjunctivitis
  12. constipation
  13. cough
  14. diaphoresis
  15. diplopia
  16. dizziness
  17. dyspnea
  18. edema
  19. elevated hepatic enzymes
  20. fever
  21. flushing
  22. headache
  23. hearing loss
  24. hypertension
  25. hypoesthesia
  26. influenza
  27. injection site reaction
  28. lacrimation
  29. leukocytosis
  30. leukopenia
  31. malaise
  32. musculoskeletal pain
  33. myasthenia
  34. nausea
  35. ocular hemorrhage
  36. ocular inflammation
  37. ocular pain
  38. ocular pruritus
  39. pharyngitis
  40. photosensitivity
  41. pruritus
  42. rash
  43. retinal detachment
  44. scotomata
  45. syncope
  46. urticaria
  47. vertigo
  48. visual impairment
  49. xerophthalmia

Monitoring Parameters

  • laboratory monitoring not necessary

Contraindications

  • accidental exposure
  • breast-feeding
  • children
  • dental work
  • egg hypersensitivity
  • extravasation
  • geriatric
  • hepatic disease
  • ocular exposure
  • porphyria
  • porphyrin hypersensitivity
  • pregnancy
  • radiation therapy
  • skin photosensitivity disorder
  • sunlight (UV) exposure
  • surgery

Interactions

  • Abciximab
  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetohexamide
  • Acitretin
  • Adapalene
  • Adapalene; Benzoyl Peroxide
  • Alectinib
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Alteplase
  • Amiloride; Hydrochlorothiazide, HCTZ
  • Aminolevulinic Acid
  • Amiodarone
  • Amitriptyline
  • Amitriptyline; Chlordiazepoxide
  • Amlodipine
  • Amlodipine; Atorvastatin
  • Amlodipine; Benazepril
  • Amlodipine; Celecoxib
  • Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
  • Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
  • Amlodipine; Olmesartan
  • Amlodipine; Telmisartan
  • Amlodipine; Valsartan
  • Anagrelide
  • Anticoagulants
  • Antithrombin III
  • Apixaban
  • Argatroban
  • Aspirin, ASA
  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atenolol; Chlorthalidone
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Azilsartan; Chlorthalidone
  • Benazepril; Hydrochlorothiazide, HCTZ
  • Bendroflumethiazide; Nadolol
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzoyl Peroxide
  • Benzoyl Peroxide; Clindamycin
  • Benzoyl Peroxide; Erythromycin
  • Benzoyl Peroxide; Sulfur
  • Betamethasone; Calcipotriene
  • Betrixaban
  • Bexarotene
  • Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Bisoprolol; Hydrochlorothiazide, HCTZ
  • Bivalirudin
  • Calcipotriene
  • Calcitriol
  • Calcium-channel blockers
  • Candesartan; Hydrochlorothiazide, HCTZ
  • Captopril; Hydrochlorothiazide, HCTZ
  • Carbamazepine
  • Celecoxib
  • Chlorothiazide
  • Chlorpromazine
  • Chlorpropamide
  • Chlorthalidone
  • Chlorthalidone; Clonidine
  • Cilostazol
  • Ciprofloxacin
  • Clevidipine
  • Clomipramine
  • Clopidogrel
  • Cobimetinib
  • Codeine; Phenylephrine; Promethazine
  • Codeine; Promethazine
  • Dabigatran
  • Dalteparin
  • Danaparoid
  • Dantrolene
  • Delafloxacin
  • Demeclocycline
  • Desipramine
  • Desirudin
  • Dextromethorphan; Promethazine
  • Diclofenac
  • Diclofenac; Misoprostol
  • Diflunisal
  • Diltiazem
  • Dimethyl Sulfoxide, DMSO
  • Diphenhydramine; Ibuprofen
  • Diphenhydramine; Naproxen
  • Dipyridamole
  • Doxepin
  • Doxycycline
  • Edoxaban
  • Enalapril; Felodipine
  • Enalapril; Hydrochlorothiazide, HCTZ
  • Enoxaparin
  • Eprosartan; Hydrochlorothiazide, HCTZ
  • Eptifibatide
  • Eravacycline
  • Erythromycin; Sulfisoxazole
  • Esomeprazole; Naproxen
  • Ethanol
  • Etodolac
  • Famotidine; Ibuprofen
  • Felodipine
  • Fenoprofen
  • Flucytosine
  • Fluphenazine
  • Flurbiprofen
  • Fondaparinux
  • Fosinopril; Hydrochlorothiazide, HCTZ
  • Furosemide
  • Gallium Ga 68 Dotatate
  • Gemifloxacin
  • Glimepiride
  • Glimepiride; Pioglitazone
  • Glimepiride; Rosiglitazone
  • Glipizide
  • Glipizide; Metformin
  • Glyburide
  • Glyburide; Metformin
  • Griseofulvin
  • Heparin
  • Hydralazine; Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ
  • Hydrochlorothiazide, HCTZ; Irbesartan
  • Hydrochlorothiazide, HCTZ; Lisinopril
  • Hydrochlorothiazide, HCTZ; Losartan
  • Hydrochlorothiazide, HCTZ; Methyldopa
  • Hydrochlorothiazide, HCTZ; Metoprolol
  • Hydrochlorothiazide, HCTZ; Moexipril
  • Hydrochlorothiazide, HCTZ; Olmesartan
  • Hydrochlorothiazide, HCTZ; Propranolol
  • Hydrochlorothiazide, HCTZ; Quinapril
  • Hydrochlorothiazide, HCTZ; Spironolactone
  • Hydrochlorothiazide, HCTZ; Telmisartan
  • Hydrochlorothiazide, HCTZ; Triamterene
  • Hydrochlorothiazide, HCTZ; Valsartan
  • Hydrocodone; Ibuprofen
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen
  • Ibuprofen; Oxycodone
  • Ibuprofen; Pseudoephedrine
  • Imatinib
  • Imipramine
  • Indomethacin
  • Isotretinoin
  • Isradipine
  • Ketoconazole
  • Ketoprofen
  • Ketorolac
  • Lansoprazole; Naproxen
  • Lepirudin
  • Levofloxacin
  • Mannitol
  • Maprotiline
  • Meclofenamate Sodium
  • Mefenamic Acid
  • Meloxicam
  • Meperidine; Promethazine
  • Mercaptopurine, 6-MP
  • Mesalamine, 5-ASA
  • Mesoridazine
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Methotrexate
  • Methoxsalen
  • Methyclothiazide
  • Methylene Blue
  • Metolazone
  • Minocycline
  • Moxifloxacin
  • Nabumetone
  • Naproxen
  • Naproxen; Pseudoephedrine
  • Naproxen; Sumatriptan
  • Nicardipine
  • Nifedipine
  • Nimodipine
  • Nisoldipine
  • Nonsteroidal antiinflammatory drugs
  • Norfloxacin
  • Nortriptyline
  • Ofloxacin
  • Omadacycline
  • Oxaprozin
  • Pentosan
  • Perindopril; Amlodipine
  • Perphenazine
  • Perphenazine; Amitriptyline
  • Phenothiazines
  • Phenylephrine; Promethazine
  • Photosensitizing agents (topical)
  • Pirfenidone
  • Piroxicam
  • Platelet Inhibitors
  • Polymyxin B
  • Prasugrel
  • Prochlorperazine
  • Promethazine
  • Protriptyline
  • Pyrimethamine; Sulfadoxine
  • Quinolones
  • Reteplase, r-PA
  • Retinoids
  • Rivaroxaban
  • Rofecoxib
  • Rucaparib
  • Sarecycline
  • Simeprevir
  • St. John’s Wort, Hypericum perforatum
  • Streptokinase
  • Sulfadiazine
  • Sulfamethoxazole; Trimethoprim, SMX-TMP, Cotrimoxazole
  • Sulfasalazine
  • Sulfisoxazole
  • Sulfonamides
  • Sulfonylureas
  • Sulindac
  • Tenecteplase
  • Tetracycline
  • Tetracyclines
  • Thiazide diuretics
  • Thiethylperazine
  • Thioridazine
  • Thrombolytic Agents
  • Ticagrelor
  • Ticlopidine
  • Tinzaparin
  • Tirofiban
  • Tolazamide
  • Tolbutamide
  • Tolmetin
  • Trandolapril; Verapamil
  • Tretinoin, ATRA
  • Tricyclic antidepressants
  • Trifarotene
  • Trifluoperazine
  • Trimipramine
  • Urokinase
  • Valdecoxib
  • Vandetanib
  • Vemurafenib
  • Verapamil
  • Vitamin A
  • Vorapaxar
  • Voriconazole
  • Warfarin
  • Ziprasidone
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