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Riboflavin 5'-Phosphate

Medically reviewed by Drugs.com. Last updated on Sep 16, 2020.

Pronunciation

(RYE boe flay vin five FOS fate)

Index Terms

  • Photrexa
  • Photrexa Viscous

Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution Prefilled Syringe, Ophthalmic:

Photrexa Viscous: 0.146% in Dextran 20% (3 mL)

Photrexa-Photrexa Viscous Kit: Photrexa 0.146%; Photrexa Viscous 0.146% in Dextran 20% (6 mL) [contains dextran]

Brand Names: U.S.

  • Photrexa Viscous
  • Photrexa-Photrexa Viscous Kit

Pharmacologic Category

  • Corneal Collagen Cross-Linking Agent, Ophthalmic
  • Ophthalmic Agent

Pharmacology

Photo enhancer that generates singlet oxygen in corneal collagen cross-linking.

Use: Labeled Indications

Corneal ectasia following refractive surgery: Treatment of corneal ectasia following refractive surgery with the KXL System in corneal collagen cross-linking.

Keratoconus, progressive: Treatment of progressive keratoconus with the KXL System in corneal collagen cross-linking.

Contraindications

There are no contraindications listed in the manufacturer's labeling.

Dosing: Adult

Corneal ectasia following refractive surgery; Keratoconus, progressive: Ophthalmic: Instill 1 drop every 2 minutes for 30 minutes following debridement of the epithelium to a diameter of ~9 mm. After 30 minutes, examine the eye under the slit lamp for the presence of a yellow flare in the anterior chamber. If flare is not detected, instill 1 drop every 2 minutes for an additional 2 to 3 drops and recheck for flare. Repeat as necessary. Once the flare is observed, perform ultrasound pachymetry. If corneal thickness is <400 microns, instill 2 drops every 5 to 10 seconds until the corneal thickness increases to ≥400 microns. Once the 400 micron threshold is met, irradiate the eye for 30 continuous minutes using the KXL System. During irradiation, instill riboflavin 5’-phosphate onto the eye every 2 minutes for the 30 minute irradiation period.

Dosing: Pediatric

Corneal ectasia following refractive surgery; Keratoconus, progressive: Adolescents ≥14 years: Ophthalmic: Instill 1 drop of viscous solution every 2 minutes for 30 minutes following debridement of the epithelium to a diameter of ~9 mm. After 30 minutes, examine the eye under the slit lamp for the presence of a yellow flare in the anterior chamber. If flare is not detected, instill 1 drop of viscous solution every 2 minutes for an additional 2 to 3 drops and recheck for flare. Repeat as necessary. Once the flare is observed, perform ultrasound pachymetry. If corneal thickness is <400 microns, instill 2 drops of nonviscous solution every 5 to 10 seconds until the corneal thickness increases to ≥400 microns. Once the 400 micron threshold is met, irradiate the eye for 30 continuous minutes using the KXL System. During irradiation, instill riboflavin 5’-phosphate viscous solution onto the eye every 2 minutes for the 30-minute irradiation period.

Administration

For topical ophthalmic use; do not inject. For use with the KXL System only.

Storage

Store at 2°C to 8°C (36°F to 46°F); protect from light once removed from packaging.

Drug Interactions

There are no known significant interactions.

Adverse Reactions

>10%:

Central nervous system: Foreign body sensation of eye (14% to 15%)

Ophthalmic: Corneal opacity (haze) (64% to 71%), corneal disease (3% to 28%), eye pain (17% to 26%), punctate keratitis (20% to 25%), corneal edema (in progressive keratoconus patients: 24%; all other patients: 3% to 9%), photophobia (2% to 19%), blurred vision (16% to 17%), ocular hyperemia (8% to 14%), dry eye syndrome (6% to 14%), decreased visual acuity (10% to 11%)

1% to 10%:

Central nervous system: Headache (4% to 8%)

Ophthalmic: Increased lacrimation (5% to 10%), eye discomfort (9%), conjunctival edema (7%), eyelid edema (5% to 6%), anterior chamber inflammation (2% to 6%), visual impairment (3% to 4%), blepharitis (3%), keratitis (1% to 3%), asthenopia (2%), diplopia (2%), eye discharge (2%), eye pruritus (2%), vitreous detachment (2%), eye injury (associated with device; 1% to 2%), visual halos around lights (1% to 2%)

Warnings/Precautions

Concerns related to adverse effects:

• Ulcerative keratitis: May occur; monitor for resolution of epithelial defects.

Monitoring Parameters

Resolution of epithelial defects

Pregnancy Considerations

Animal reproduction studies have not been conducted with riboflavin 5'-phosphate. The manufacturer recommends that the corneal collagen cross-linking procedure not be done during pregnancy. Pregnancy may be a risk factor for the progression of keratoconus (Bilgihan 2011).

Patient Education

What is this drug used for?

• It is used to treat an eye problem called keratoconus.

• It is used to treat certain eye problems after eye surgery.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Seeing floaters

• Dry eyes

• Foreign body sensation

• Tearing

• Headache

• Sensitivity to light

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Vision changes

• Severe eye pain

• Severe eye irritation

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.