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riboflavin ophthalmic

Generic Name: riboflavin ophthalmic (RYE boe flay vin off THAL mik)
Brand Name: Photrexa, Photrexa Viscous

What is riboflavin ophthalmic?

Riboflavin (vitamin B2) is important in the maintenance of many tissues of the body.

Riboflavin ophthalmic (for the eyes) is a "photosensitive" solution used during a procedure to treat progressive keratoconus in adults and adolescents who are at least 14 years old.

Keratoconus (KER-a-toe-KOE-nus) is a degenerative eye disease that affects the cornea, the outermost layer on the surface of your eye. The cornea works by directing light toward the back of your eye to help you focus your vision. In people with keratoconus, the cornea becomes thin and weak, and then bulges outward. This causes incoming light to be channeled in too many directions, causing distorted vision. Progressive keratoconus can cause vision problems that may eventually lead to vision loss or a corneal transplant.

Riboflavin ophthalmic is used together with ultraviolet (UV) light as part of a procedure called corneal collagen crosslinking.

Corneal collagen crosslinking is a method of applying riboflavin eye drops and UV light to the cornea. In this procedure, riboflavin eye drops are placed into the eyes over several minutes. Then a UV light is directed over the cornea. The riboflavin enhances the light, causing a reaction in collagen fibers inside the cornea. This procedure helps stiffen and strengthen your cornea to slow or stop the progression of keratoconus.

Riboflavin ophthalmic may also be used for purposes not listed in this medication guide.

What is the most important information I should know about riboflavin ophthalmic?

Avoid rubbing your eyes for at least 5 days after your corneal procedure.

What should I discuss with my healthcare provider before receiving riboflavin ophthalmic?

To make sure riboflavin ophthalmic is safe for you, tell your doctor about all your medical conditions or allergies, and all the medicines you are using.

Also tell your doctor if you are pregnant or breast-feeding a baby.

How is riboflavin ophthalmic used?

A surgeon or other healthcare provider will give you this medicine as part of your corneal collagen crosslinking procedure.

You will be given numbing eyedrops to prepare you for the procedure. You may also be given a sedative or anesthesia to help you relax. Although you will most likely be awake during the procedure, you should feel little or no discomfort. A special device will be placed around your eyelids to keep them open during the procedure.

Your eye surgeon will place riboflavin ophthalmic drops into your eyes about every 2 minutes during the procedure.

After the procedure, the surgeon will place a contact lens on the treated eye to protect it for a short time.

Call your doctor right away if the contact lens falls out or feels like it is out of place inside your eye.

You may also need to use antibiotic or steroid eyedrops to prevent infection and reduce swelling after your procedure. Carefully follow all after-care instructions and do not miss any follow-up appointments.

What happens if I miss a dose?

Because riboflavin ophthalmic is given as part of a medical procedure, this medicine has no daily dosing schedule.

What happens if I overdose?

Since this medicine is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after being treated with riboflavin ophthalmic?

Avoid rubbing your eyes for at least 5 days after your procedure.

Your eyes may be more sensitive to light after your procedure. Wear sunglasses when you are exposed to bright light.

Riboflavin ophthalmic side effects

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have:

  • eye redness or watering;

  • severe eye pain; or

  • sudden change in your vision.

Common side effects may include:

  • feeling like something is in your eye;

  • increased tearing;

  • blurred vision, hazy vision;

  • increased glare in your vision; or

  • headache.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Riboflavin ophthalmic dosing information

Usual Adult Dose for Corneal Refractive Surgery:

-After epithelial debridement: Apply 1 drop of the viscous solution to the affected eye every 2 minutes for 30 minutes, then, using a slit lamp, examine the eye for a yellow flare in the anterior chamber
-If the yellow flare is not present: Apply 1 drop of viscous solution to the affected eye every 2 minutes for an additional 2 to 3 drops and check for a yellow flare; repeat as necessary
-If the yellow flare is present AND the corneal thickness is less than 400 microns on ultrasound pachymetry: Apply 2 drops of the solution into the affected eye every 5 to 10 seconds until corneal thickness is at least 400 microns
-During irradiation: Apply 1 drop of viscous solution into the affected eye every 2 minutes for the duration of irradiation (e.g., 30 minutes)

Comments:
-This drug should be used at an irradiation level of 3 mW/cm2 at a wavelength of 365 nm.
-The KXL System manufacturer product information should be referred to for patient positioning.

Uses:
-Treatment of progressive keratoconus
-Treatment of corneal ectasia after refractive surgery

Usual Pediatric Dose for Corneal Refractive Surgery:

14 years and older:
-After epithelial debridement: Apply 1 drop of the viscous solution to the affected eye every 2 minutes for 30 minutes, then, using a slit lamp, examine the eye for a yellow flare in the anterior chamber
-If the yellow flare is not present: Apply 1 drop of viscous solution to the affected eye every 2 minutes for an additional 2 to 3 drops and check for a yellow flare; repeat as necessary
-If the yellow flare is present AND the corneal thickness is less than 400 microns on ultrasound pachymetry: Apply 2 drops of the solution into the affected eye every 5 to 10 seconds until corneal thickness is at least 400 microns
-During irradiation: Apply 1 drop of viscous solution into the affected eye every 2 minutes for the duration of irradiation (e.g., 30 minutes)

Comments:
-This drug should be used at an irradiation level of 3 mW/cm2 at a wavelength of 365 nm.
-The KXL System manufacturer product information should be referred to for patient positioning.

Uses:
-Treatment of progressive keratoconus
-Treatment of corneal ectasia after refractive surgery

What other drugs will affect riboflavin ophthalmic?

It is not likely that other drugs you take orally or inject will have an effect on riboflavin used in the eyes. But many drugs can interact with each other. Tell each of your healthcare providers about all medicines you use, including prescription and over-the-counter medicines, vitamins, and herbal products.

Where can I get more information?

  • Your pharmacist can provide more information about riboflavin ophthalmic.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.02.

Date modified: July 02, 2017
Last reviewed: March 23, 2017

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