Fomivirsen sodium
Fomivirsen sodium (Vitravene)
Fomivirsen sodium
( foh-mah- VEER-sin)
Pregnancy Category: C Vitravene (Rx)

Classification: Antiviral drug

See Also: See also Antiviral Drugs.

Action/Kinetics: A phosphorothioate oligonucleotide that inhibits cytomegalovirus (CMV) replication through an antisense mechanism. Binding of fomivirsen to the target mRNA causes inhibition of IE2 protein synthesis, thus inhibiting replication. CMV isolates that are resistant to fomivirsen may be sensitive to ganciclovir, foscarnet, or cidofovir. Levels of fomivirsen are highest in the retina and iris.

Uses: Local treatment of CMV retinitis in AIDS clients who are intolerant of or have a contraindiction to other treatments of CMV retinitis, or who did not respond to other treatments.

Contraindications: Use in those who have been treated with either IV or ophthalmic cidofovir in the past 2- 4-weeks, due to the risk of exaggerated ocular inflammation. Lactation.

Special Concerns: For ophthalmic (intravitreal injection) use only; does not provide treatment for systemic CMV disease. Safety and efficacy have not been determined in children.

Side Effects: Ophthalmic: Ocular inflammation, including iritis and vitritis; abnormal vision, anterior chamber inflammation, blurred vision, cataract, conjunctival hemorrhage, decreased visual acuity, desaturation of color vision, eye pain, floaters, increased IOP, photophobia, retinal detachment, retinal edema, retinal hemorrhage, retinal pigment changes, application site reaction, conjunctival hyperemia, conjunctivitis, corneal edema, decreased peripheral vision, eye irritation, hypotony, keratic precipitates, optic neuritis, photopsia, retinal vascular disease, visual field defect, vitreous hemorrhage, vitreous opacity.
Systemic. GI: Abdominal pain, diarrhea, nausea, vomiting, abnormal liver function, anorexia, oral monilia, pancreatitis. CNS: Headache, abnormal thinking, depression, dizziness. Respiratory: Pneumonia, sinusitis, bronchitis, dyspnea, increased cough. Hematologic: Anemia, neutropenia, thrombocytopenia. Whole body: Asthenia, fever, infection, rash, sepsis systemic CMV, allergic reactions, cachexia, decreased weight, dehydration, flu syndrome, lymphoma-like reaction, neuropathy, pain, sweating. Miscellaneous: Back pain, catheter infection, chest pain, kidney failure.

How Supplied: Injection (as sodium): 6.6 mg/mL

Dosage
?Ophthalmic injection Treat ophthalmic CMV.
Induction dose: 330 mcg (0.05 mL) as a single intravitreal injection every other week for 2 doses; maintenance: 330 mcg (0.05 mL) once q 4 weeks.