ce CONTINUING EDUCATION concomitant medications resulting in serious adverse reactions were calcineurin inhibitors (e.g., tacrolimus, cyclosporine) and calcium channel blockers.
Safety: The most common side effects of nirmatrel- vir-ritonavir are headache, abdominal pain, vomiting, high blood pressure, nausea, and malaise. The combination is not recommended for use in patients with severe renal or hepatic impairment. There is a black box warning for the potential of serious or life-threatening drug interactions due to ritonavir being a strong CYP3A inhibitor; a thorough review of a patient’s medication history is essential prior to starting treatment, and the benefit of nirmatrelvir-ri- tonavir to reduce hospitalization and death should be assessed if drug interactions can be appro- priately managed. The most commonly reported
Additional Notes: It is important to note that the FDA has also authorized the emergency use of nirmatrelvir-ritonavir for the treatment of mild-to-moderate COVID-19 in children 12 years of age and older weighing at least 40 kg who are at high risk for progression to severe COVID-19, including hospitalization or death, under an emer- gency use authorization (EUA).
OPHTHALMOLOGY
Izervay (avacincaptad pegol) Indication and Mechanism of Action: Avacincaptad pegol is an intravitreal injection approved to treat geographic atrophy secondary to age-related mac- ular degeneration (AMD). Geographic atrophy is an advanced form of dry AMD. Avacincaptad pegol is an RNA aptamer, a pegylated oligonucleotide that binds to and inhibits comple- ment protein C5. By inhibiting C5, avacincaptad pegol may prevent its cleavage to C5a and C5b thus decreasing membrane attack complex (MAC) for- mation. Increased geographic atrophy area growth is reflective of loss of photoreceptors and AMD dis- ease progression. Reductions in the rate geographic atrophy growth (up to 35%) were observed from baseline through the first year of treatment across avacincaptad pegol treatment groups in studies GATHER1 and GATHER2. Administration: The recommended dose of avacin- captad pegol is 2 mg (0.1 mL of 20 mg/mL solution) administered by intravitreal injection to each affected eye once monthly (approximately 28 ± 7 days) for up to 12 months. It must be administered by a trained eye care professional. Safety: The most common adverse reactions observed in the GATHER1 and GATHER2 clinical trials were conjunctival hemorrhage, increased intra- ocular pressure, blurred vision, and neovascular
age-related macular degeneration. Avacincaptad pegol is contraindicated in patients with ocular or periocular infections and active intraocular inflammation. Storage and Handling: Avacincaptad pegol is available as an intravitreal solution: 20 mg/mL in a single-dose vial. It should be stored in the refriger- ator between 2°C to 8°C (36°F to 46°F). Keep the vial in the original carton to protect from light. Do not freeze or shake. Prior to use, the unopened glass vial of avacincaptad pegol may be kept at controlled room temperature for up to 24 hours. Ensure that the injection is given immediately after preparation of the dose.
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