Nurses Compass
Drug Guide
Fomivirsen Sodium
Classification
Therapeutic: Antiviral agent
Pharmacological: Antisense oligonucleotide
FDA Approved Indications
- Treatment of cytomegalovirus (CMV) retinitis in patients with AIDS
Mechanism of Action
Fomivirsen is an antisense oligonucleotide that binds to CMV mRNA, inhibiting viral gene expression and replication.
Dosage and Administration
Adult: Repeated intravitreal injections of 230 mcg weekly until disease stabilization or relapse.
Pediatric: Not approved/established.
Geriatric: Use with caution; no specific dosing adjustments.
Renal Impairment: No specific guidance, but caution advised.
Hepatic Impairment: Not applicable.
Pharmacokinetics
Absorption: Administered directly into the vitreous humor, bypassing systemic absorption.
Distribution: Localized to the eye; systemic distribution is minimal.
Metabolism: Degraded by nucleases in ocular tissues.
Excretion: Excreted within ocular tissues; systemic excretion is negligible.
Half Life: Approximately 55 days in ocular tissues.
Contraindications
- Known hypersensitivity to fomivirsen or any component of the formulation.
Precautions
- Use with caution in patients with active intraocular inflammation, or history of retinal detachment. Regular eye exams required.
Adverse Reactions - Common
- Conjunctivitis (Frequent)
- Inflammation or intraocular infection (Infrequent)
Adverse Reactions - Serious
- Retinal detachment (Rare)
- Increased intraocular pressure (Rare)
- Endophthalmitis (Rare)
Drug-Drug Interactions
- No significant interactions reported.
Drug-Food Interactions
N/ADrug-Herb Interactions
N/ANursing Implications
Assessment: Monitor visual acuity, intraocular pressure, and signs of ocular inflammation.
Diagnoses:
- Risk for infection
- Impaired visual sensory planning
Implementation: Administer injections under sterile conditions; monitor ocular health post-injection.
Evaluation: Assess for improvements in vision or stabilization of retinitis, and monitor for adverse effects.
Patient/Family Teaching
- Report any vision changes, eye pain, or excessive redness.
- Attend scheduled follow-up appointments.
- Avoid rubbing or applying pressure to the eyes after injections.
Special Considerations
Black Box Warnings:
- Potential for eye inflammation, retinal detachment, increased intraocular pressure.
Genetic Factors: Not applicable.
Lab Test Interference: None reported.
Overdose Management
Signs/Symptoms: Local ocular toxicity, increased inflammation, or injury.
Treatment: Supportive care, ocular evaluation, and management of complications.
Storage and Handling
Storage: Store at 2°C to 8°C (36°F to 46°F). Do not freeze.
Stability: Stable until the expiration date printed on the label when stored as directed.