Idoxuridine

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Idoxuridine
Idoxuridine - Idoxuridin.svg
Clinical data
Other namesIododeoxyuridine; IUdR
AHFS/Drugs.com Micromedex Detailed Consumer Information
MedlinePlus a601062
Pregnancy
category
  • B1 (topical), B3 (ophthalmologic) [AU]
Routes of
administration
topically
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
  • In general: ℞ (Prescription only)
Identifiers
  • 1-[(2R,4S,5R)-4-hydroxy-5-(hydroxymethyl)oxolan-2-yl]-5-iodo-1,2,3,4-tetrahydropyrimidine-2,4-dione
CAS Number
PubChem CID
DrugBank
ChemSpider
UNII
KEGG
ChEMBL
NIAID ChemDB
CompTox Dashboard (EPA)
ECHA InfoCard 100.000.189 OOjs UI icon edit-ltr-progressive.svg
Chemical and physical data
Formula C9H11IN2O5
Molar mass 354.100 g·mol−1
3D model (JSmol)
  • I\C1=C\N(C(=O)NC1=O)C2C[C@H](O)[C@@H](CO)O2
  • InChI=1S/C9H11IN2O5/c10-4-2-12(9(16)11-8(4)15)7-1-5(14)6(3-13)17-7/h2,5-7,13-14H,1,3H2,(H,11,15,16)/t5-,6+,7?/m0/s1 Yes check.svgY
  • Key:XQFRJNBWHJMXHO-GFCOJPQKSA-N Yes check.svgY
 X mark.svgNYes check.svgY  (what is this?)    (verify)

Idoxuridine is an anti-herpesvirus antiviral drug.

It is a nucleoside analogue, a modified form of deoxyuridine, similar enough to be incorporated into viral DNA replication, but the iodine atom added to the uracil component blocks base pairing. It is used only topically due to cardiotoxicity. It was synthesized by William Prusoff in the late 1950s. [1] Initially developed as an anticancer drug, idoxuridine became the first antiviral agent in 1962. [2]

Contents

Clinical use

Idoxuridine is mainly used topically to treat herpes simplex keratitis. [3] Epithelial lesions, especially initial attacks presenting with a dendritic ulcer, are most responsive to therapy, while infection with stromal involvement are less responsive. [4] Idoxuridine is ineffective against herpes simplex virus type 2 and varicella-zoster. [3]

Side effects

Common side effects of the eye drops include irritation, blurred vision and photophobia. [5] Corneal clouding and damage of the corneal epithelium may also occur.[ citation needed ]

Formulations and dosage

Idoxuridine is available as either a 0.5% ophthalmic ointment or as a 0.1% ophthalmic solution. [3] The dosage of the ointment is every 4 hours during day and once before bedtime. [3] The dosage of the solution is 1 drop in the conjunctival sac hourly during the day and every 2 hours during the night until definitive improvement, then 1 drop every 2 hours during the day and every 4 hours during the night. [3] Therapy is continued for 3–4 days after healing is complete, as demonstrated by fluorescein staining. [3]

Synthesis

Idoxuridine synthesis. Idoxuridine synthesis.svg
Idoxuridine synthesis.

See also

Related Research Articles

<span class="mw-page-title-main">Deoxyuridine</span> Chemical compound

Deoxyuridine (dU) is a compound and a nucleoside.It belongs to a class of compounds known as Pyrimidine 2'-deoxyribonucleosides and closely resembles the chemical composition of uridine but without the presence of the 2' hydroxyl group. Idoxuridine and Trifluridine are variants of deoxyuridine used as antiviral drugs. They are similar enough to be incorporated as part of DNA replication, but they possess side groups on the uracil component (an iodine and a CF3 group, respectively), that prevent base pairing. A known use of dU is as a precursor in the synthesis of Edoxudine.

<span class="mw-page-title-main">Keratitis</span> Medical condition

Keratitis is a condition in which the eye's cornea, the clear dome on the front surface of the eye, becomes inflamed. The condition is often marked by moderate to intense pain and usually involves any of the following symptoms: pain, impaired eyesight, photophobia, red eye and a 'gritty' sensation.

<span class="mw-page-title-main">Aciclovir</span> Antiviral medication used against herpes, chickenpox and shingles

Aciclovir (ACV), also known as acyclovir, is an antiviral medication. It is primarily used for the treatment of herpes simplex virus infections, chickenpox, and shingles. Other uses include prevention of cytomegalovirus infections following transplant and severe complications of Epstein–Barr virus infection. It can be taken by mouth, applied as a cream, or injected.

<span class="mw-page-title-main">Prednisolone</span> Chemical compound (steroid medication)

Prednisolone is a corticosteroid, a steroid hormone used to treat certain types of allergies, inflammatory conditions, autoimmune disorders, and cancers. Some of these conditions include adrenocortical insufficiency, high blood calcium, rheumatoid arthritis, dermatitis, eye inflammation, asthma, and multiple sclerosis. It can be taken by mouth, injected into a vein, used topically as a skin cream, or as eye drops. It differs from the similarly named prednisone in having a hydroxyl at the 11th carbon instead of a ketone.

<span class="mw-page-title-main">Thygeson's superficial punctate keratopathy</span> Medical condition

Thygeson's superficial punctate keratopathy (TSPK) is a disease of the eyes. The causes of TSPK are not currently known, but details of the disease were first published in the Journal of the American Medical Association in 1950 by renowned American ophthalmologist Phillips Thygeson (1903–2002), after whom it is named.

<span class="mw-page-title-main">Ganciclovir</span> Chemical compound

Ganciclovir, sold under the brand name Cytovene among others, is an antiviral medication used to treat cytomegalovirus (CMV) infections.

<span class="mw-page-title-main">Nucleoside analogue</span> Biochemical compound

Nucleoside analogues are structural analogues of a nucleoside, which normally contain a nucleobase and a sugar. Nucleotide analogues are analogues of a nucleotide, which normally has one to three phosphates linked to a nucleoside. Both types of compounds can deviate from what they mimick in a number of ways, as changes can be made to any of the constituent parts. They are related to nucleic acid analogues.

<span class="mw-page-title-main">Brivudine</span> Chemical compound

Brivudine is an antiviral drug used in the treatment of herpes zoster ("shingles"). Like other antivirals, it acts by inhibiting replication of the target virus.

<span class="mw-page-title-main">Trifluridine</span> Chemical compound

Trifluridine is an anti-herpesvirus antiviral drug, used primarily on the eye. It was sold under the trade name Viroptic by Glaxo Wellcome, now merged into GlaxoSmithKline. The brand is now owned by Monarch Pharmaceuticals, which is wholly owned by King Pharmaceuticals.

<span class="mw-page-title-main">Corneal neovascularization</span> Medical condition

Corneal neovascularization (CNV) is the in-growth of new blood vessels from the pericorneal plexus into avascular corneal tissue as a result of oxygen deprivation. Maintaining avascularity of the corneal stroma is an important aspect of corneal pathophysiology as it is required for corneal transparency and optimal vision. A decrease in corneal transparency causes visual acuity deterioration. Corneal tissue is avascular in nature and the presence of vascularization, which can be deep or superficial, is always pathologically related.

<span class="mw-page-title-main">Corneal ulcer</span> Medical condition of the eye

Corneal ulcer, also called keratitis, is an inflammatory or, more seriously, infective condition of the cornea involving disruption of its epithelial layer with involvement of the corneal stroma. It is a common condition in humans particularly in the tropics and in farming. In developing countries, children afflicted by vitamin A deficiency are at high risk for corneal ulcer and may become blind in both eyes persisting throughout life. In ophthalmology, a corneal ulcer usually refers to having an infection, while the term corneal abrasion refers more to a scratch injury.

<span class="mw-page-title-main">Thymidine kinase from herpesvirus</span>

Thymidine kinase from herpesvirus is a sub-family of thymidine kinases that catalyses the transfer of phospho group of ATP to thymidine to generate thymidine monophosphate, which serves as a substrate during viral DNA replication.

<span class="mw-page-title-main">Herpes</span> Viral disease caused by herpes simplex viruses

Herpes simplex, often known simply as herpes, is a viral infection caused by the herpes simplex virus. Herpes infections are categorized by the area of the body that is infected. The two major types of herpes are oral herpes and genital herpes, though other forms also exist.

<span class="mw-page-title-main">Cold sore</span> Herpes simplex virus infection of the lip

A cold sore is a type of herpes infection caused by the herpes simplex virus that affects primarily the lip. Symptoms typically include a burning pain followed by small blisters or sores. The first attack may also be accompanied by fever, sore throat, and enlarged lymph nodes. The rash usually heals within ten days, but the virus remains dormant in the trigeminal ganglion. The virus may periodically reactivate to create another outbreak of sores in the mouth or lip.

<span class="mw-page-title-main">Edoxudine</span> Chemical compound

Edoxudine is an antiviral drug. It is an analog of thymidine, a nucleoside.

<span class="mw-page-title-main">Herpes simplex keratitis</span> Medical condition

Herpetic simplex keratitis is a form of keratitis caused by recurrent herpes simplex virus (HSV) infection in the cornea.

<span class="mw-page-title-main">Herpes zoster ophthalmicus</span> Shingles in the human eye

Herpes zoster ophthalmicus (HZO), also known as ophthalmic zoster, is shingles involving the eye or the surrounding area. Common signs include a rash of the forehead with swelling of the eyelid. There may also be eye pain and redness, inflammation of the conjunctiva, cornea or uvea, and sensitivity to light. Fever and tingling of the skin and allodynia near the eye may precede the rash. Complications may include visual impairment, increased pressure within the eye, chronic pain, and stroke.

Neurotrophic keratitis (NK) is a degenerative disease of the cornea caused by damage of the trigeminal nerve, which results in impairment of corneal sensitivity, spontaneous corneal epithelium breakdown, poor corneal healing and development of corneal ulceration, melting and perforation. This is because, in addition to the primary sensory role, the nerve also plays a role maintaining the integrity of the cornea by supplying it with trophic factors and regulating tissue metabolism.

Cochrane Eyes and Vision (CEV) is a collaboration of researchers and healthcare professionals who prepare systematic reviews to study interventions pertaining to the treatment of eye disease and visual impairment. Though many of the systematic reviews focus on common eye diseases, reviews have been prepared for varied eye topics, including screening prevention and rarer eye diseases.

Herbert Edward Kaufman is an American ophthalmologist who discovered idoxuridine, the first clinically useful antiviral agent; co-developed with William Bourne the clinical specular microscope to view the live corneal endothelium, co-developed timolol with Thomas Zimmerman, a new class of medications to treat glaucoma; corneal storage media for eye banks; natamycin, the first commercially available medication to treat fungal infections of the eye; co-developed with Tony Gasset the use of bandage contact lenses; and was involved in the first laser vision photorefractive keratectomy of the eye with Marguarite McDonald.

References

  1. 1 2 Prusoff WH (March 1959). "Synthesis and biological activities of iododeoxyuridine, an analog of thymidine". Biochimica et Biophysica Acta. 32 (1): 295–296. doi: 10.1016/0006-3002(59)90597-9 . PMID   13628760.
  2. Wilhelmus KR (January 2015). "Antiviral treatment and other therapeutic interventions for herpes simplex virus epithelial keratitis". The Cochrane Database of Systematic Reviews. 1: CD002898. doi:10.1002/14651858.CD002898.pub5. PMC   4443501 . PMID   25879115.
  3. 1 2 3 4 5 6 Goodman and Gilman's The Pharmacological Basis of Therapeutics. Edited by Gilman AG, Rall TW, Nies AS, Taylor P. McGraw-Hill. 8th ed. 1990.
  4. Maxwell E (October 1963). "Treatment of herpes keratitis with 5-iodo-2-deoxyuridine (IDU): a clinical evaluation of 1500 cases". American Journal of Ophthalmology. 56: 571–573. doi:10.1016/0002-9394(63)90006-0. PMID   14070708.
  5. Drugs.com: Idoxuridine ophthalmic
  6. FR 1336866,Gaston A, Vesperto T,"Nouveau procédé de préparation d'un dérivé de l'uridine et produits utilisés dans ce procédé [New process for preparing a derivative of uridine and products used in this process]",published 1963-09-06, assigned to Roussel-Uclaf
  7. GB 1024156,"Process for the preparation of 5-iodo-2'-desoxy-uridine",published 1966-03-30, assigned to Roussel-Uclaf
  8. Cheong L, Rich MA, Eidinoff ML (May 1960). "Introduction of the 5-halogenated uracil moiety into deoxyribonucleic acid of mammalian cells in culture". The Journal of Biological Chemistry. 235 (5): 1441–1447. doi: 10.1016/S0021-9258(18)69427-X . PMID   13809628.
  9. Chang PK, Welch AD (July 1963). "Iodination of 2'-Deoxycytidine and Related Substances". Journal of Medicinal Chemistry. 6 (4): 428–430. doi:10.1021/jm00340a019. PMID   14184899.

Further reading