Trifluridine
Anti-infective · Rx
Trade namesViroptic
Drug classAntiviral, nucleoside analog (topical)
Strength1% solution
AvailabilityRx
Mechanism of actionThymidine analog incorporated into viral DNA, halting replication; also inhibits thymidylate synthetase. Not cell-selective, hence surface toxicity.
Indication / reason for usePrimary keratoconjunctivitis and recurrent epithelial keratitis due to HSV types 1 and 2; vaccinia keratitis.
Usual adult dosing1 drop onto the cornea q2h while awake (max 9 drops/day) until re-epithelialization, then 1 drop q4h (min 5/day) for 7 more days. Do not exceed 21 days.
PreservativeThimerosal 0.001%
Contact lensesNo lens wear during herpetic keratitis.
Common / important adverse effectsPunctate keratopathy, stromal edema, follicular conjunctivitis, punctal occlusion, delayed healing with prolonged use.
Contraindications & cautionsHypersensitivity. Do not exceed 21 days of continuous use.
Pregnancy / lactationAvoid; teratogenic in animals.
Practice notesStore refrigerated. Ganciclovir gel or oral aciclovir/valaciclovir are usually better tolerated first-line.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.