Home Drug Guide Riboflavin 5'-phosphate

Drug Guide

Generic Name

Riboflavin 5'-phosphate

Brand Names Photrexa, Photrexa Viscous In Dextran 20%

Classification

Therapeutic: Vitamins, Nutritional supplements

Pharmacological: Riboflavin (Vitamin B2) derivative, Photosensitizer

FDA Approved Indications

  • Corneal collagen cross-linking for keratoconus and corneal ectasia

Mechanism of Action

Riboflavin 5'-phosphate acts as a photosensitizer that, when activated by UV-A light, stimulates collagen cross-linking in the cornea, strengthening corneal tissue.

Dosage and Administration

Adult: Administered topically as eye drops prior to and during UV-A irradiation in corneal cross-linking procedures.

Pediatric: Usage similar to adults under ophthalmologic supervision.

Geriatric: No specific dosage adjustments, but monitor for ocular health.

Renal Impairment: topical use; systemic considerations are minimal.

Hepatic Impairment: topical use; systemic considerations are minimal.

Pharmacokinetics

Absorption: Minimal systemic absorption; primarily acts locally in the cornea.

Distribution: Local tissue distribution in the cornea.

Metabolism: Not significantly metabolized systemically.

Excretion: Not applicable, as it acts locally in the eye.

Half Life: Not specified; activity localized to corneal tissue.

Contraindications

  • Hypersensitivity to riboflavin or dextran-containing formulations.

Precautions

  • Use with caution in patients with corneal epithelial defects or active ocular infections.

Adverse Reactions - Common

  • Mild ocular irritation (frequent)
  • Transient corneal haze (occasional)

Adverse Reactions - Serious

  • Corneal scarring or perforation (rare) (rare)
  • Increased intraocular pressure (rare)

Drug-Drug Interactions

  • None specifically reported.

Drug-Food Interactions

  • Topical ocular drugs do not interact significantly with food.

Drug-Herb Interactions

  • No known interactions.

Nursing Implications

Assessment: Assess visual acuity, corneal health, and contraindications.

Diagnoses:

  • Risk for infection or injury related to ocular procedure.
  • Impaired comfort related to ocular irritation.

Implementation: Ensure correct preparation and application of riboflavin during cross-linking. Maintain sterile technique.

Evaluation: Monitor for improvements in corneal stability, absence of adverse reactions.

Patient/Family Teaching

  • Explain the procedure and purpose of riboflavin application.
  • Report any increased pain, vision changes, or adverse reactions.
  • Follow post-procedure care instructions, including eye protection.

Special Considerations

Black Box Warnings:

  • None.

Genetic Factors: Not applicable.

Lab Test Interference: No known interference.

Overdose Management

Signs/Symptoms: Not typical, as used topically.

Treatment: Supportive; discontinue use and evaluate ocular health.

Storage and Handling

Storage: Store in a cool, dry place, protected from light.

Stability: Stable until the expiration date when stored properly.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.