Herpes keratoconjunctivitis, keratitis: Ophthalmic: Instill 1 drop into affected eye(s) every 2 hours while awake, to a maximum of 9 drops/day, until re-epithelialization of corneal ulcer occurs; then use 1 drop every 4 hours while awake for another 7 days (minimum daily dosage of 5 drops is recommended). Do not exceed 21 days of treatment; if improvement has not taken place in 7 to 14 days, consider another form of therapy.
Herpes simplex virus infection, mucocutaneous (acyclovir resistant) (alternative agent) (off-label use): Patients with HIV: Topical: Apply 3 times daily for ≥21 to 28 days, based on clinical response (HHS [OI adult 2020]).
There are no dosage adjustments provided in the manufacturer’s labeling.
There are no dosage adjustments provided in the manufacturer’s labeling.
(For additional information see "Trifluridine: Pediatric drug information")
Herpes keratoconjunctivitis, keratitis: Children ≥6 years and Adolescents: Ophthalmic: Instill 1 drop into affected eye every 2 hours while awake, to a maximum of 9 drops/day, until re-epithelialization of corneal ulcer occurs; then use 1 drop every 4 hours for another 7 days (minimum daily dosage of 5 drops is recommended). Do not exceed 21 days of treatment; if improvement has not taken place in 7 to 14 days, consider another form of therapy.
There are no dosage adjustments provided in the manufacturer's labeling, however, dosage adjustment unlikely needed due to low systemic absorption.
There are no dosage adjustments provided in the manufacturer's labeling, however, dosage adjustment unlikely needed due to low systemic absorption.
Refer to adult dosing.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Solution, Ophthalmic:
Viroptic: 1% (7.5 mL [DSC]) [contains thimerosal (thiomersal)]
Generic: 1% (7.5 mL)
Yes
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Ophthalmic:
Viroptic: 1% (7.5 mL) [contains benzalkonium chloride]
Generic: 1% (7.5 mL)
For ophthalmic use only; avoid touching tip of applicator to eye or other surfaces. Wash hands before and after instillation.
Ophthalmic: Wash hands before and after instillation. Avoid contact of bottle tip with skin or eye; instill drops onto the cornea of the affected eye(s). Apply gentle pressure to lacrimal sac during and immediately following instillation (1 minute) or instruct patient to gently close eyelid after administration, to decrease systemic absorption of ophthalmic drops (Urtti 1993; Zimmerman 1984).
Herpes keratoconjunctivitis, keratitis: Treatment of primary keratoconjunctivitis and recurrent epithelial keratitis due to herpes simplex virus, types 1 and 2
Herpes simplex virus infection, mucocutaneous (acyclovir resistant)
Viroptic may be confused with Timoptic.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified.
1% to 10%:
Ophthalmic: Burning sensation of eyes (≤5%), stinging of eyes (≤5%), eyelid edema (3%)
Frequency not defined:
Hypersensitivity: Local ocular hypersensitivity reaction
Ophthalmic: Dry eye syndrome, epithelial keratopathy, eye irritation, hyperemia, increased intraocular pressure, ocular stromal edema, superficial punctate keratitis
Known hypersensitivity to trifluridine or any component of the formulation
Concerns related to adverse effects:
• Irritation: Mild local irritation of conjunctival and cornea may occur when instilled; effects are usually transient.
None known.
There are no known significant interactions.
Adverse effects have not been observed during animal reproduction studies of the ophthalmic solution. Systemic absorption following ophthalmic application is limited. If ophthalmic agents are needed during pregnancy, the minimum effective dose should be used in combination with punctal occlusion to decrease potential exposure to the fetus (Samples 1988).
The amount of trifluridine available systemically following topical application of the ophthalmic drops is negligible.
Interferes with viral replication by inhibiting thymidylate synthetase and incorporating into viral DNA in place of thymidine (Carmine 1982).
Absorption: Ophthalmic: Systemic absorption negligible, corneal penetration adequate
Half-life elimination: ~12 minutes
Solution (Trifluridine Ophthalmic)
1% (per mL): $29.73
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