Trifluridine (Viroptic) is a fluorinated pyrimidine nucleoside that is used as a topical ophthalmic antiviral solution used in the treatment of infections of the eyes caused by herpes simplex types 1 and 2.

Trifluridine Uses:

• Herpes keratoconjunctivitis and keratitis:

  • It is used to treat infections of the eye (primary keratoconjunctivitis and recurrent epithelial keratitis) caused by herpes simplex virus types 1 and 2.

Trifluridine Dose in Adults

Trifluridine Dose in the treatment of Herpes keratoconjunctivitis and keratitis:

• Ophthalmic:
  • Instill one drop into the infected eye every two-hourly while awake to a maximum of nine drops per day.
  • The treatment is continued until the re-epithelization of the corneal ulcer occurs.
  • After re-epithelization, instill one drop every four-hourly for the next seven days (a minimum daily dose of 5 drops are recommended.
  • If there is no improvement within 7 to 21 days of the treatment, other treatments should be considered.
  • The total duration of the treatment should be limited to 21 days.

Trifluridine Dose in Childrens

Trifluridine Dose in the treatment of Herpes keratoconjunctivitis or keratitis:

• Children ≥6 years and Adolescents:

  • Ophthalmic:
    • Instill one drop into the infected eye every two-hourly while awake to a maximum of nine drops per day.
    • The treatment is continued until the re-epithelization of the corneal ulcer occurs.
    • After re-epithelization, instill one drop every four-hourly for the next seven days (a minimum daily dose of 5 drops are recommended.
    • If there is no improvement within 7 to 21 days of the treatment, other treatments should be considered.
    • The total duration of the treatment should be limited to 21 days.

Pregnancy Risk Category: C

• It has not yet been tested in humans.
• Negative fetal events were not observed in animal reproduction studies.

Trifluridine use during breastfeeding:

• This drug can only be used for ophthalmic purposes. 
• Lactating women can use the drug if they are unable to absorb it systemically.

Dose in Kidney Disease:

The manufacturer has not recommended any adjustments in the dose in patients with kidney disease.

Dose in Liver disease:

The manufacturer has not recommended any adjustments in the dose in patients with liver disease.

Side Effects of Trifluridine:

• Ophthalmic:

  • Burning Sensation Of Eyes
  • Stinging Of Eyes
  • Eyelid Edema
  • Epithelial Keratopathy
  • Eye Irritation
  • Hyperemia
  • Increased Intraocular Pressure
  • Keratoconjunctivitis Sicca
  • Ocular Stromal Edema
  • Superficial Punctate Keratitis

• Hypersensitivity:

  • Local Ocular Hypersensitivity Reaction

Contraindications to Trifluridine:

Allergy reactions to any component of the drug or the drug itself

Warnings and precautions

• Irritation

  • Instilled in the eyes, it can cause temporary irritation of the cornea and conjunctiva. These effects are typically mild.

Monitoring parameters:

Monitor the response to treatment.

How to administer Trifluridine?

It is available for ophthalmic use only. Wash hands before and after instilling the medicine and avoid touching the tip of the applicator to eyes or other surfaces.

Mechanism of action of Trifluridine:

It inhibits the enzyme Thymidylate Synthetase, and substitutes for thymidine within the DNA of viruses, inviting them to reproduce.

Absorption:

• When administered to the eyes, it has very little systemic absorption. It is well-suited for corneal and ophthalmic penetration.

Half-life elimination:

• About twelve minutes

International Brands of Trifluridine:

• Viroptic
• APO-Trifluridine
• SANDOZ Trifluridine
• Bephen
• Fludin
• Keravir
• Ocufridine
• Optiridin
• TFT
• TFT Ophtiole
• TFT Thilo
• Thilol
• Tri Fluoro Timidina Poen
• Triflumann
• Trifluridin Thilo
• Triherpine
• Trivirina
• Unitf
• Viridin
• Virophta

Trifluridine Brand Names in Pakistan:

No Brands Available in Pakistan.