|Systematic (IUPAC) name|
|ATC code||D06 J05, S01|
|Molecular mass||354.099 g/mol|
|(what is this?)|
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. Initially developed as an anticancer drug, idoxuridine became the first antiviral agent in 1962.
Idoxuridine is mainly used topically to treat herpes simplex keratitis. Epithelial lesions, especially initial attacks presenting with a dendritic ulcer, are most responsive to therapy, while infection with stromal involvement are less responsive. Idoxuridine is ineffective against herpes simplex virus type 2 and varicella-zoster.
Formulations and dosage
Idoxuridine is available as either a 0.5% ophthalmic ointment or as a 0.1% ophthalmic solution. The dosage of the ointment is every 4 hours during day and once before bedtime. 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. Therapy is continued for 3-4 days after healing is complete, as demonstrated by fluorescein staining.
- Prusoff, W.H. (1959) Synthesis and biological activities of iododeoxyuridine, an analog of thymidine. Biochim Biophys Acta. March; 32(1): 295–296.
- Wilhelmus KR (2010). "Antiviral treatment and other therapeutic interventions for herpes simplex virus epithelial keratitis". Cochrane Database Syst Rev 12: CD002898. doi:10.1002/14651858.CD002898.pub4. PMID 21154352.
- Goodman and Gilman's The Pharmacological Basis of Therapeutics. Edited by Gilman AG, Rall TW, Nies AS, Taylor P. McGraw-Hill. 8th ed. 1990.
- Maxwell E. Treatment of herpes keratitis with 5-iodo-2-deoxyuridine (IDU): a clinical evaluation of 1500 cases. Am. J. Ophthalmol., 1963, 56, 571-573.
- Drugs.com: Idoxuridine ophthalmic
- Prusoff, W. H. (1959). "Synthesis and biological activities of iododeoxyuridine, an analog of thymidine". Biochimica et Biophysica Acta 32 (1): 295–6. doi:10.1016/0006-3002(59)90597-9. PMID 13628760.
- Introduction of the 5-Halogenated Uracil Moiety into Deoxyribonucleic Acid of Mammalian Cells in Culture. L. Cheong, M. A. Rich, and M. L. Eidinoff J. Biol. Chem. 1960 235: 1441-1447.
- Chang, P. K.; Welch, A. D. (1963). "Iodination of 2'-Deoxycytidine and Related Substances1". Journal of Medicinal Chemistry 6 (4): 428. doi:10.1021/jm00340a019.
- Seth A, Misra A, Umrigar D (2004). "Topical liposomal gel of idoxuridine for the treatment of herpes simplex: pharmaceutical and clinical implications". Pharm Dev Technol 9 (3): 277–289. doi:10.1081/PDT-200031432. PMID 15458233.
- Otto S (1998). "Radiopharmaceuticals (Strontium 89) and radiosensitizers (idoxuridine)". J Intraven Nurs 21 (6): 335–7. PMID 10392098.
- Fauth E, Zankl H (1999). "Comparison of spontaneous and idoxuridine-induced micronuclei by chromosome painting". Mutat Res 440 (2): 147–56. doi:10.1016/s1383-5718(99)00021-2. PMID 10209337.