Idoxuridine
Idoxuridine (Herplex) is a water-soluble iodinated
deriv-ative of deoxyuridine that inhibits several DNA viruses including HSV,
VZV, vaccinia, and polyoma virus. The triphosphorylated metabolite of
idoxuridine inhibits both viral and cellular DNA synthesis and is also
incor-porated into DNA. Such modified DNA is susceptible to strand breakage and
causes aberrant viral protein syn-thesis. Because
of its significant host cytotoxicity, idoxuri-dine cannot be used to treat
systemic viral infections. The development
of resistance to this drug is common.
Idoxuridine is marketed
strictly for topical ophthalmic use, and systemic exposure is insignificant.
However, af-ter oral dosing, the drug is rapidly metabolized and ex-creted. It
tends not to accumulate in body tissues.
The only FDA-approved use of
idoxuridine is in the treatment of herpes simplex infections of the eyelid,
con- junctiva, and cornea. It is most effective against surface infections
because it has little ability to penetrate the tis-sues of the eye. intravenous
idoxuridine was designated an orphan drug for the treatment of soft tissue
sarcoma.
Idoxuridine may cause local
irritation, mild edema, itch-ing, and photophobia. Corneal clouding and small
punc-tate defects in the corneal epithelium have been re-ported. Allergic
reactions are rare.
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