Sulfate 881 should be avoided in smokers,''''' and high doses of Systematic Reviews; Issue 2. Chichester: John Wiley; 2008 (accessed PhannacopoeialPreparations may have adverse effects. 12 The carotenoids, 09/05/08). USP 36: Veneporfin for Injection. vitamins 29. NICE. Ranibizumab and pegaptanib for the treatment of age-related lutein and zeaxanthin, have been promoted as retinal macular degeneration: Technology Appraisal Guidance ISS (issued protectants, but controlled data are lacking.9•10•14·34·35 August 2008). Available at: http://www.nice.org.uk/nicemedia/pdf/ Sorne recmn1nend that those at risk of AMD should be TA I55guidance.pdf (accessed 01/10/09) IBANM, usAN, rtNNMJ 30. BrownDM, eta!. CLEAR-IT 2 Investigators. Primary endpoint results of a Vinblastine Sulfate encouraged to stop smoking and to consume a diet phase II study of vascular endothelial growth factor trap-eye in wet age­ . Vimblasrina; . Sti fei including vegetables, fish, whole grains, and nuts, and to related macular degeneration. Ophthalmology 2011; 118: 1089-97. 29060-LE; :Nsc:49842; . i o reduce consumption of fats especially vegetable oil.7•12•34 31. Heier JS, et a!. CLEAR·IT 2 Investigators. The 1-year results of CLEAR-IT vinbla>�[na; Vi nblastiinisulf<�atti; Yinblastinde SU.Ifm; _Vinbl�fiO<;de A prospective cohort study found that a high dietary 2, a phase 2 study of vascular endothelial growth factor trap-eye dosed sulfate de; Vinblastine; Sttllate Vinblastine Sulphate; Ophthalmology 118: 1098-- intake of vitamin E and zinc, or an above-median intake as-needed after 12-week fixed dosing. 20ll; Vinblastlni Sulfa$; Vinblastino de;sulfates;c Vinb!asti!JSUl{at; 1106. Correction. ibid.; 1700. of the combination of vitamins C and E, betacarotene, et a!. Nlnbla�tin-sulfat; Vinblasztin-'Qulfat; 'Vin�leukobJaslihe 32. Wong TY, Clinical update: new treatments for age-related macular sui' and zinc were associated with a lower risk of incident degeneration. Lancet 2007; 370: 204-6. phate; VLB {vinbiastlmel;Winbl astyny siaro:ar); s.W.OhactfiHa . AMD, 36 Daily supplementation with folic acid, pyrid­ 33. Liu M, Regillo CD. A review of treatments for macular degeneration: a synopsis of currently approved treatments and ongoing clinical trials. oxine, and cyanocobalamin during an average of 7. 3 CulT Opin Ophthalmo/ 2004; 15: 221-6. C<;:y,6llb$ctT,HssN40,,H2S0,=9®. 1. · years of follow-up reduced the risk of AMD in a large 34. Anonymous. Nutritional supplements for macular degeneration. Drug l43°6i'4(Vinblasrine sulfate}, = . cohort of women at increased risk for vascular disease; Ther Bull 2006; 44: 9-1 1. CAS 865 -2 F4 Mnblasrine); . .. Am .. benefit emerged at about 2 years of follow-up and 3S. Zhao L, Sweet BY. Lutein and zeaxanthin for macular degeneration. \fet J Health-Syst Pharm 2008; 65: 1232-8. ATC-t01CA01: . persisted throughout the study, 37 However, systematic 36. van Leeuwen R, et a!. Dietary intake of antioxidants and risk of age­ ATC N()QW-22Y02B.:;,._:QLOICAOi, reviews38•39 have found no evidence to support the role related macular degeneration. 200S; 294: 3101-7. Description.UNII _; Vinblastine sulfate is the sulfate of an of antoxidant vitamin and mineral supplements in the 37. Christen WG, et al. Folic add,lAMA pyridoxine, and cyanocobalamin primary prevention of AMD. combination treatment and age-related macular degeneration in alkaloid, vincaleukoblastine, extracted from Catharanthus Retinal or macular surgery, and transpupillary thermo­ women: the Women's Antioxidant and Folic Acid Cardiovascular Study. roseus (Vinca rosea) (Apocynaceae), • Arch Intern Med 2009; 169: 3 3 5--41. therapy have been investigated; U0•13·14•33 however, long­ 38. Chong EW-T, et a!. Dietary antioxidants and primary prevention of age Pharmacopoeias, In Chin,, Bur, (see p, vii), Int,, Jpn, US, and term data are lacking for surgery, 12 and use of related macular degeneration: systematic review and meta-analysis. Viet BMJ 335: transpupil!ary thermotherapy is not recommended, 15 2007; 7SS-9. Ph. Eur. 8: (Vinblastine Sulfate), A white or slightly Radiotherapy has also been tried with mixed results 9,13 39. Evans JR, Henshaw K. Antioxidant vitamin and mineral supplements for preventing age-related macular degeneration. Available in The yellowish, very hygroscopic, crystalline powder, It loses not Retinal transplantation is under investigation.6•10•14 Gene Cochrane Database of Systematic Reviews; Issue l. Chichester: John more than 15% of its weight on drying, Freely soluble in silencing with bevasiranib, a short interfering RNA Wiley; 2008 (accessed 09/05/08). water; practically insoluble in alcohol. A 0,15% solution in (siRNA) therapeutic designed to turn off or silence the 40. Arjamaa 0. Gene silencing in wet age-related macular degeneration. Lancet 368: water has a pH of 3.5 to 5.0. Store at a temperature not gene that produces VEGF, is also under investigation for 2006; 630-l. 41. Chappelow AV, Kaiser PK. Neovascular age-related macular degenera­ exceeding -20 degrees in airtight glass containers. Protect wet AMD.I2A0.4I tion: potential therapies. Drugs 2008; 68: 1029-36. from light, 1. Soubrane G, Bressler NM. Treatment of subfoveal choroidal neovascularisation in age related macular degeneration: focus on USP 36; (Vinblastine Sulfate), A white or slightly yellow, clinical application of verteporfin photodynamic therapy. Br J Adverse Effects and Precautions odourless, hygroscopic, amorphous or crystalline powder. It Ophthalmol 2001; 85: 483-9S. loses not more than 15% of its weight on drying. Freely 2. NICE. Guidance on the use of photodynamic therapy for age-related Photosensitivity will occur in all patients treated with macular degeneration: Technology Appraisal 68 (issued September soluble in water, A 0,15% solution in water has a pH of 3.5 verteporfin and patients should not be exposed to direct -l 2003). Available at: http://www.nice.org.uk/nicemedia/pdf/68_ to 5,0, Store at a temperature between -25 degrees and 0 PDTGuidance.pdf (accessed 01110/09) sunlight for 2 to 5 days after treatment. However, exposure degrees in airtight containers. Protect from light. 3. El-Arnir AN, et a!. Age-related macular degeneration. Br J Hosp Med to ambient indoor light is encouraged, as it allows gradual 66: 200S; 677-81. inactivation of any remaining drug. Headaches, injection Stability. Between about 5 and 20% of active drug was 4. Messmer KJ,Abel SR. Verteporfin for age-related macular degeneration. site reactions, and visual disturbances occur frequently. Ann Pharmacother 2001; 35: 1S93-8. lost from solution when a solution of vinblastine sulfate S. Wormald R, et a!. Photodynamic therapy for neovascular age-related Extravasation at the injection site may produce severe pain 3 micrograms/mL in glucose 5% injection was stored for macular degeneration. Available in The Cochrane Database of and inflammation and requires interruption of therapy. 48 hours in a range of intravenous burette giving sets, the Systematic Reviews; Issue 3. Chichester: John Wiley; 2007 (accessed Patients who have a severe decrease in vision should not be highest loss being from cellulose propionate sets and the 01/08/08). re-treated until their vision recovers. Other reported 6. Cook HL, et al. Age-related macular degeneration: diagnosis and lowest from one made from methacrylate butadiene styr­ management. Br Med Bull 2008; 85: 127--49. adverse effects include hypersensitivity, infusion-related ene.1 Similarly, storage in PVC tubing led to a 42 to 44% 7. Constable IJ. Age-related macular degeneration and its possible pain (mainly presenting as back pain), chest pain, loss from solution whereas only about 6% was lost over Med J Aust 2004; 181: 471-2. prevention. gastrointestinal disturbances, atrial fibrillation, hyper­ the 48 hours in polybutadiene tubing, The losses appeared 8. Yang YC. Preserving vision with veneporfin photodynamic therapy. tension, decreased hearing, and anaemia. Verteporfin Hosp Med 2004; 65: 39--43. 1 to be due to drug sorption, and were therefore greater 9. Comer GM, et al. Current and future treatment options for nonexudative should be used with care in patients with hepatic from the tubing which had a greater surface-area-to­ and exudative age-related macular degeneration. Drugs Aging 2004; 21: impairment and may be contra-indicated if impairment is volume ratio than the burettes, 967-92. severe. 1. McElnay JC, et al. Stability of methotrexate and vinblastine in burette 10. Bylsma GW, Guymer RH. Treatment of age-related macular administration sets. Int J Pharmaceutics 1988; 47: 239--47. degeneration. Clin Exp Optom 2005; 88: 322-34. ll. Treatment of age-related macular degeneration with photodynamic Porphyria. Licensed product information states that the therapy (TAP) Study Group. Photodynamic therapy of subfoveal use of verteporfin is contra-indicated in patients with por­ Uses and Administration choroidal neovascularization in age-related macular degeneration with phyria, However, the Drug Database for Acute Porphyria, veneporfin: one-year results of 2 randomized clinical trials-TAP report Vinblastine sulfate is an antineoplastic vinca alkaloid that Arch Ophthalmol 1999; 117: compiled by the Norwegian Porphyria Centre (NAPOS) 1. l329--4S. apparently acts by binding to the microtubular proteins of 12. Jager RD, et a!. Age-related macular degeneration. N Eng! J Med 2008; and the Porphyria Centre Sweden, classifies verteporfin as 358: 2606-17. not porphyrinogenic; it may be used as a drug of first the spindle and arresting mitosis at the metaphase; it is thus 13. Sun JK, Miller JW. Medical treatment of choroidal neovascularization choice and no precautions are needed. 1 specific for the M phase of the cell cycle. It also interferes secondary to age-related macular degeneration. Int Ophthalmol Clin with amino acid metabolism and possibly nucleic acid 200S; 45: I. The Drug Database for Acute Porphyria. Available at: http://www. llS-32. synthesis, and has some immunosuppressant activity. 14. Lois N. Neovascular age-related macular degeneration. Compr drugs-porphyria.org (accessed 11111111) Ophthalmol Update 2004; 5: 143-61.