What is Retisert, and how does it work?
Retisert is indicated for the treatment of chronic non-infectious uveitis affecting the posterior segment of the eye. It is a corticosteroid used to treat inflammation within the eye that may be caused by a variety of diseases or infections.
What are the side effects of Retisert?
Clinical Trials Experience – Ocular Events
The available safety data includes exposure to Retisert in patients with chronic
non-infectious uveitis affecting the posterior segment in two multicenter controlled
clinical trials. Patients were randomized to dosage regimens of 0.59 mg or 2.1
mg implants.
The most frequently reported ocular adverse events were
- cataract,
- increased intraocular pressure,
- procedural complication, and
- eye pain.
These events occurred
in approximately 50 – 90% of patients. Cataract includes aggravated cataract,
and posterior capsular opacification. Procedural complications includes post-op
complication, post-op wound complication, post-op wound site
erythema, and wound
dehiscense.
Based on clinical trials with Retisert, during the 3-year post-implantation
period, nearly all phakic eyes are expected to develop cataracts and require
cataract surgery. IOP lowering medications to lower intraocular pressure were
required in approximately 77% of patients; filtering surgeries were required
to control intraocular pressure in 37% of patients.
Ocular adverse events occurring
in approximately 10 – 40% of patients in decreasing order of incidence were
- ocular/conjunctival hyperemia,
- reduced visual acuity,
- glaucoma,
- conjunctival hemorrhage,
- blurred vision,
- abnormal sensation in the eye,
- eye irritation,
- maculopathy,
- vitreous floaters,
- hypotony,
- pruritus,
- ptosis,
- increased tearing,
- vitreous hemorrhage,
- dry eye,
- eyelid
edema, - macula edema and
- visual disturbance.
Ocular adverse events occurring in approximately 5 – 9% of patients in decreasing
order of incidence were
- eye discharge,
- photophobia,
- blepharitis,
- corneal edema,
- iris adhesions,
- choroidal detachment,
- diplopia,
- eye swelling,
- retinal detachment,
- photopsia,
- retinal hemorrhage and
- hyphema.
Clinical Trials Experience – Non-Ocular Events
The most frequently reported non-ocular adverse event was headache (33%). Other
non-ocular adverse events occurring in approximately 5-20% of patients in decreasing
order of incidence were
- nasopharyngitis,
- arthralgia,
- sinusitis,
- dizziness,
- pyrexia,
- upper respiratory tract infection,
- influenza,
- vomiting,
- nausea,
- cough,
- back
pain, - limb pain, and
- rash.
What is the dosage for Retisert?
Dosing Information
- Retisert (fluocinolone acetonide intravitreal implant) 0.59 mg is implanted
into the posterior segment of the affected eye through a pars plana incision. - The implant contains one tablet of 0.59 mg of fluocinolone acetonide.
- Retisert
is designed to release fluocinolone acetonide at a nominal initial rate of 0.6
μg/day, decreasing over the first month to a steady state between 0.3-0.4
μg/day over approximately 30 months. - Following depletion of fluocinolone
acetonide as evidenced by recurrence of uveitis, Retisert may be replaced.
Handling of Implant
- Caution should be exercised in handling Retisert in order to avoid damage to
the implant, which may result in an increased rate of drug release from the
implant. - Thus, Retisert should be handled only by the suture tab.
- Care should
be taken during implantation and explantation to avoid sheer forces on the implant
that could disengage the silicone cup
reservoir (which contains a fluocinolone
acetonide tablet) from the suture tab. - Aseptic technique should be maintained
at all times prior to and during the surgical implantation procedure. - Retisert should not be resterilized by any method.
What drugs interact with Retisert?
- No Information Provided
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Is Retisert safe to use while pregnant or breastfeeding?
- No adequate animal reproduction studies have been conducted with fluocinolone acetonide.
- There are no adequate and well-controlled studies in pregnant women.
- Retisert should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
- It is not known whether ocular administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk.
- Systemic steroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects.
- Caution should be exercised when Retisert is implanted in a nursing woman.