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(EYE-dox-YOU-rih-deen)
Herplex,  Herplex-D
Class: Ophthalmic/Antiviral

 Action Blocks reproduction of herpes simplex virus by irreversibly inhibiting incorporation of thymidine into viral DNA.

 Indications Treatment of herpes simplex keratitis.

 Contraindications Standard considerations.

 Route/Dosage

ADULTS: OPHTHALMIC SOLUTION: Instill 1 gtt into infected eye(s) q hr during day and q 2 hr during night. Alternate schedule: Instill 1 gtt q 1 min for 5 min; repeat q 4 hr night and day. OINTMENT: Apply ointment to infected conjunctival sac q 4 hr (5 applications daily).

 Interactions Boric acid-containing solution: May cause irritation; do not coadminister.

 Lab Test Interferences None well documented.

 Adverse Reactions

EENT: Ocular irritation, pain, pruritus, inflammation or edema; photophobia; corneal clouding; stippling; punctate defects in corneal epithelium; follicular conjunctivitis; puncta occlusion; conjunctival scarring.

 Precautions

Pregnancy: Category C. Lactation: Undetermined. Children: Safety and efficacy not established. Carcinogenesis: Based on animal studies, may be carcinogenic. Recurrence: Continue medication for 5 to 7 days after epithelial healing to avoid recurrence.

PATIENT CARE CONSIDERATIONS

 Administration/Storage

  • For patient convenience, drops may be prescribed for waking hours and ointment for nighttime.
  • Wash hands before and after instillation of solution or ointment.
  • Do not mix with other topical eye medications.
  • Store at room temperature and protect from light.

 Assessment/Interventions

  • Obtain complete patient history, including drug history and any known allergies.
  • Assess for allergy, itching, lacrimation, redness, or swelling.
  • Withhold drug and contact physician if unusual changes or inflammation of eye occurs.

 Patient/Family Education

  • Demonstrate proper technique for instillation of drops or ointment, emphasizing importance of hand-washing and of not touching cap or tip of tube to eye, conjunctiva, fingers, or any unsterile object.
  • Inform patient that vision may be hazy for short time after instillation.
  • Explain importance of continuing medication for prescribed time even after healing has occurred, to avoid recurrence.
  • Advise patient to wear sunglasses and to avoid prolonged exposure to bright light.
  • Instruct patient to notify physician if condition worsens or if no improvement is noted in 2 wk. Physician should also be contacted if burning or stinging occur.
  • Caution patient not to use any other medications on eye such as boric acid.
  • Warn patient not to use other persons’ eye makeup, towels, washcloths, or eye medications; reinfection may occur.
  • Instruct patient to report the following symptoms to physician: Visual changes, pain, itching or swelling of eye.

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