pegaptanib sodium injection

pegaptanib sodium injection

Macugen

Pharmacologic class: Selective vascular endothelial growth factor (VEGF) antagonist

Therapeutic class: Ophthalmic agent

Pregnancy risk category B

Action

Binds to extracellular VEGF, which contributes to progression of neovascular age-related macular degeneration; this action suppresses pathologic neovascularization and macular degeneration progression.

Availability

Solution for ophthalmic injection: 0.3 mg/90-microliter single-dose syringe

Indications and dosages

Neovascular (wet) age-related macular degeneration

Adults: 0.3 mg by intravitreous injection into affected eye once every 6 weeks

Contraindications

• Hypersensitivity to drug or its components
• Ocular or periocular infection

Precautions

Use cautiously in:
• pregnant or breastfeeding patients
• children (safety and efficacy not established).

Administration

• Administer only by ophthalmic intravitreous injection under controlled aseptic conditions.
• Inspect drug for particulates and discoloration before administering.
• Attach threaded plastic plunger rod to rubber stopper inside syringe barrel. Don't pull back on plunger.

Adverse reactions

CNS: dizziness, headache, vertigo

CV: hypertension, carotid artery occlusion, chest pain, transient ischemic attack, cerebrovascular accident

EENT: anterior chamber inflammation, blurred vision, cataract, conjunctival hemorrhage, corneal edema, eye discharge, eye inflammation or swelling, eye irritation or pain, increased intraocular pressure, ocular discomfort, punctate keratitis, reduced visual acuity, visual disturbance, vitreous disorder or hemorrhage, vitreous floaters or opacities, blepharitis, conjunctivitis, photop-sia, allergic conjunctivitis, conjunctival edema, corneal abrasion, corneal deposits, corneal epithelial disorder, endophthalmitis, eyelid irritation, mei-bomianitis, mydriasis, periorbital hematoma, retinal edema, hearing loss

GI: diarrhea, nausea, vomiting, dyspepsia

GU: urinary tract infection, urinary retention

Metabolic: diabetes mellitus

Musculoskeletal: arthritis, bone spur

Respiratory: bronchitis, pleural effusion

Skin: contact dermatitis, contusion

Other: anaphylaxis, including angioedema (rare)

Interactions

None

Patient monitoring

• Watch for increased intraocular pressure, especially within 30 minutes of injection. Be prepared to intervene appropriately.
• Monitor patient for endophthalmitis during week after injection to promote early detection and treatment.

Patient teaching

Instruct patient to contact ophthalmologist immediately if treated eye becomes red, light-sensitive, or painful or if vision change occurs.
• As appropriate, review all other significant and life-threatening adverse reactions.