Nurses Compass
Drug Guide
Riboflavin 5'-phosphate
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.