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Severe chest pain, vaso-vagal and hypersensitivity reactions have been reported. Vaso-vagal and hypersensitivity reactions on rare occasions can be severe. These reactions may include syncope, sweating, dizziness, rash, dyspnea, flushing and changes in blood pressure and heart rate. General symptoms can include headache, malaise, urticaria, and pruritus.
The most frequently reported adverse events to VISUDYNE (verteporfin for injection) are injection site reactions (including pain, edema, inflammation, extravasation, rashes, hemorrhage and discoloration) and visual disturbances (including blurred vision, flashes of light, decreased visual acuity and visual field defects, including scotoma). 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 decrease with or without subretinal/retinal or vitreous hemorrhage|
|Body as a Whole:||Asthenia, fever, flu syndrome, infusion related pain primarily presenting as back pain, photosensitivity reactions|
|Cardiovascular:||Atrial fibrillation, hypertension, peripheral vascular disorder, varicose veins|
|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|
Severe vision decrease, equivalent of 4 lines or more, within 7 days after treatment has been reported in l%-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, retinal pigment epithelial tear|
|Non-ocular Events:||Chest pain and other musculoskeletal pain during infusion|
Read the Visudyne (verteporfin injection) Side Effects Center for a complete guide to possible side effects
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, β-carotene, ethanol, formate and mannitol, would be expected to decrease VISUDYNE activity. Drugs that decrease clotting, vasoconstriction or platelet aggregation, e.g., thromboxane AI inhibitors, could also decrease the efficacy of Visudyne therapy.
Read the Visudyne Drug Interactions Center for a complete guide to possible interactions
Last reviewed on RxList: 7/9/2012
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