Fluocinolone (intraocular)

Fluocinolone acetonide intravitreal implants are used in the treatment of diabetics who have the condition, diabetic macular edema.

Overview

In the US, fluocinolone acetonide intravitreal implants are better known under the brand names, Iluvien and Retisert. The drug is only available in a hospital or clinic environment and is always administered by an appropriately trained medical professional.

Fluocinolone acetonide intravitreal implants are used to treat a condition called diabetic macular edema (DME), which is sometimes a symptom of diabetes. The condition can cause swelling in the posterior area of the eye, ultimately causing visual impairment or even total loss of vision. The drug is typically used to treat patients who have already used certain steroid medications without notable improvement in their condition or an increase in intraocular pressure.

Conditions treated

  • Diabetic macular edema (DME)

Type of medicine

  • Intravitreal implant

Side effects

Many drugs cause unwanted effects, as well as bringing benefits in the treatment of patients. You may not experience any ill-effects at all while you are being treated with fluocinolone acetonide intravitreal implants, but if you do, it may be necessary for you to seek further medical assistance.

If you notice any of the side effects mentioned in the list below, tell your nurse or doctor right away:

  • Seeing floating spots in front of your eyes, or a curtain-link veil obscuring all or part of your vision
  • Seeing sparks or flashes of light
  • Reddening, swelling, or pain, in the eye, inner eyelid lining or eyelid
  • Increased sensitivity of your eyes to direct sunlight
  • Discharge or excessive tearing from your eyes
  • Unusually poor or decrease in night vision
  • Decreased daytime vision
  • Changes in color vision
  • Dry, burning or itching eyes
  • Blurred vision
  • Bloody eye
  • Blindness

Fluocinolone acetonide may cause some effects that do not need medical assistance. These side effects usually vanish during the course of your treatment, when your body gets used to the new medication. Your treating physician may be able to give you some information and guidance on how to reduce or prevent some or all of these effects. If any of the effects listed below prove to be especially bothersome or long-lasting, you should mention them to your doctor:

  • The constant feeling that you have something in your eye

The side effects mentioned here may not be an exhaustive list. If you notice any effects that are not referred to in this guide, check with your treating physician.

Dosage

This medication is not for home use. The fluocinolone acetonide intravitreal implants will be given to you in a clinic or hospital setting by a trained medical professional.

The drug is an implant that your doctor will place into your eye. While the implant is in place, the medicine will be gradually released, effectively treating the condition from which you are suffering. The implant will remain in your eye without the need for a replacement for a period of up to three years.

If you do not think that your condition is showing signs of improvement following your implant, or if you think that you are actually becoming worse, you must arrange to see your specialist doctor immediately.

Interactions

Some groups of drugs must never be used together under any circumstances, as doing so could cause a serious interaction between them. However, in some cases, it may be appropriate to use two different drugs, even though there may be an interaction. If this is the case for your treatment, your treating physician may decide to change one or both of the medicines.

It is not generally recommended to use the following medications at the same time as you are using fluocinolone acetonide intravitreal implants. If you are prescribed both drugs together, your medic may change the frequency of use or adjust the dose of one of the medicines that you are taking:

  • Pixantrone
  • Nadroparin
  • Bemiparin

You should not take some medications at the same time as using tobacco, drinking alcohol, or eating particular food groups, as this could cause an interaction. You should be sure to discuss this aspect of your treatment and drug therapy with your doctor before you have your implants.

Medical interactions

Some existing medical conditions can affect how fluocinolone acetonide intravitreal implants work. It is therefore very important that you discuss your medical history in detail with your doctor before you start your treatment with this drug.

Fluocinolone acetonide intravitreal implants must be used with caution in patients with any of the following conditions, as the drug can make these conditions worse:

This medication must not be used in patients who have any of the following health problems affecting their eyes:

Warnings

When you decide to have treatment with any form of medication, you should take into account the risks as well as the benefits of doing so. Before electing to have fluocinolone acetonide intravitreal implants, be sure to discuss the pros and cons of doing so with your treating physician.

You must tell your GP if you have ever suffered any odd or allergic reactions to fluocinolone acetonide or to any other form of prescription drug. You should also mention any bad reactions that you have noted when using over-the-counter medicines, vitamin supplements, herbal remedies, animal by-products, food colors or preservatives.

Pregnancy and breastfeeding

Studies carried out to date have not shown any adverse effects on the unborn baby. However, if you are pregnant, or if you are planning on becoming pregnant while you are receiving treatment with this medicine, you should tell your doctor.

Similarly, there is no evidence to suggest that fluocinolone acetonide passes into breast milk. However, you may wish to discuss the risks and benefits of doing so with your GP or with your midwife.

Medical complications

You will be required to attend your specialist eye doctor throughout the course of your treatment for assessments. These visits are important to ensure that your treatment is working correctly, especially in the first few weeks following treatment.

Some patients do experience serious eye problems, following treatment with this drug. If you notice that your vision has changed or if your eyes become red, painful or very sensitive to the light, you must consult your doctor.

This medication can cause cataracts to occur. If your vision becomes blurred, decreased or is lost altogether, you must check with your doctor straight away.

Fluocinolone acetonide can initially cause a temporary visual disturbance. If you are affected in this way, you should not drive, operate machinery or undertake any other activity that may be dangerous if you cannot see properly.

In rare cases, the implant can move within the structure of your eye, especially if the posterior area of the lens is torn or missing. If you have any concerns in this regard, check with your doctor.

Storage

Fluocinolone acetonide intravitreal implants are generally only ever used in a hospital or other suitable medical environment where they will be stored in accordance with the manufacturer's guidelines. However, if you are ever asked to store this drug at home, you should discuss the correct procedure for doing so with your doctor or pharmacist.

Keep this medication well out of the reach of pets and children. If a pet does consume the drug, check with your vet right away.

Summary

Fluocinolone acetonide intravitreal implants are generally used in diabetic patients who have the complication, diabetic macular edema (DME). This painful condition causes the area around the rear of the eye to become swollen, placing pressure on the optic nerve, resulting in visual disturbance and impairment. The medication is usually used in patients who have already received treatment with steroid drugs, where an improvement has not been seen or where an increase in the pressure within the eye has resulted.

There are a few drugs that should not be used while you are being treated with fluocinolone acetonide. There are also a number of eye conditions that could prevent the use of this medication as a treatment option in your case. For these reasons, you must discuss your medical history in detail with your doctor before you begin your treatment with this drug. Throughout the course of your treatment, you will need to attend regular check-up appointments with your eye specialist. These appointments are essential to make sure that the drug is working properly and to discuss any adverse effects that it may be causing.

One common side effect of fluocinolone acetonide that affects some patients is problems and interference with vision. If you need to use a car or operate machinery in your line of work, or if you take part in any other activities where clear vision is important, you must first be sure that your vision has not been adversely affected by this medication.