Nurses Compass
Drug Guide
Idoxuridine
Classification
Therapeutic: Antiviral (Eye infections)
Pharmacological: Nucleoside analog
FDA Approved Indications
- Herpes simplex virus keratitis
Mechanism of Action
Idoxuridine is a nucleoside analog that incorporates into viral DNA, disrupting DNA synthesis and inhibiting viral replication.
Dosage and Administration
Adult: Apply drops to affected eye(s) every 2 hours while awake, then taper as condition improves.
Pediatric: Use as directed by physician; dosing similar to adult, tailored to age and severity.
Geriatric: Monitor for local irritation; dosing generally unchanged.
Renal Impairment: Use cautiously; no specific adjustment recommended.
Hepatic Impairment: No specific guidelines available.
Pharmacokinetics
Absorption: Poor systemic absorption when used ophthalmically.
Distribution: Local tissue distribution in eye tissues.
Metabolism: Metabolized locally in eye tissues.
Excretion: Minimal systemic excretion due to limited absorption.
Half Life: Approximately 1-3 hours in ocular tissues.
Contraindications
- Hypersensitivity to idoxuridine or nucleoside analogs.
Precautions
- Use cautiously in patients with impaired corneal epithelium; avoid prolonged use to prevent toxicity.
Adverse Reactions - Common
- Local irritation, redness, itching (Common)
- Photophobia (Less common)
Adverse Reactions - Serious
- Corneal erosion or ulceration (Rare)
- Allergic reactions, including dermatitis (Rare)
Drug-Drug Interactions
- None well documented
Drug-Food Interactions
- Not applicable
Drug-Herb Interactions
- No known interactions
Nursing Implications
Assessment: Assess ocular condition before and during treatment.
Diagnoses:
- Risk for infection related to ocular herpes.
- Risk for tissue damage due to drug toxicity.
Implementation: Instruct patient on proper eye drop technique; monitor for signs of local irritation or toxicity.
Evaluation: Evaluate improvement in symptoms and ocular health.
Patient/Family Teaching
- Use medication exactly as prescribed.
- Report any increase in pain, redness, or vision changes.
- Avoid touching the tip of the dropper to avoid contamination.
Special Considerations
Black Box Warnings:
- None
Genetic Factors: Not applicable.
Lab Test Interference: May interfere with certain viral assays, but generally used locally with minimal systemic impact.
Overdose Management
Signs/Symptoms: Local eye irritation, potential corneal damage if overused.
Treatment: Discontinue medication, provide symptomatic relief, seek ophthalmologic evaluation.
Storage and Handling
Storage: Store at room temperature, away from light.
Stability: Stable for up to 24 months if unopened; follow specific shelf-life on packaging.