Photrexa Cross-linking Kit

Photrexa Cross-linking Kit is an FDA-registered drug product whose active ingredient is RIBOFLAVIN 5-PHOSPHATE OPHTHALMIC. It is labelled by Glaukos Corporation and marketed as a human prescription drug product. Identifiers on file: NDC 25357-025, application NDA203324, label effective 20260724. This page reproduces the FDA-approved label text so you can check what a product is, who makes it and how it is supplied before discussing it with a pharmacist or prescriber.

Across FDA labelling, products containing RIBOFLAVIN 5-PHOSPHATE OPHTHALMIC are most often described in connection with: photrexa viscous, corneal collagen, kxl system, progressive keratoconus, ectasia following, refractive surgery, cross-linking combination, photoenhancers indicated. Wording differs between labels, and the full indications section on this page takes precedence when it is present.

1 INDICATIONS AND USAGE PHOTREXA ® VISCOUS and PHOTREXA ® are indicated for use in corneal collagen cross-linking in combination with the KXL ® System for the treatment of PHOTREXA VISCOUS and PHOTREXA are photoenhancers indicated for use with the KXL System in corneal collagen cross-linking for the treatment of progressive keratoconus ( 1.1 ) and corneal ectasia following refractive surgery ( 1.2 ). 1.1 Progressive Keratoconus 1.2 Corneal Ectasia Following Refractive Surgery

2 DOSAGE AND ADMINISTRATION Using topical anesthesia, debride the epithelium to a diameter of approximately 9 mm using standard aseptic technique. Post epithelial debridement, instill 1 drop of PHOTREXA VISCOUS topically on the eye every 2 minutes for 30 minutes. At the end of the 30 minute soaking period, examine the eye under the slit lamp for the presence of a yellow flare in the anterior chamber. If the yellow flare is not detected, instill 1 drop of PHOTREXA VISCOUS every 2 minutes for an additional 2 to 3 drops and recheck for the presence of a yellow flare. This process can be repeated as necessary. Once the yellow flare is observed, perform ultrasound pachymetry. If corneal thickness is less than 400 microns, instill 2 drops of PHOTREXA every 5 to 10 seconds until the corneal thickness increases to at least 400 microns. Irradiation should not be performed unless this 400 micron threshold is met and the yellow flare is seen. Irradiate the eye for 30 continuous minutes at 3mW/cm 2 at a wavelength of 365 nm, centered over the cornea, using the KXL System as per the instructions in the KXL manual. During irradiation, continue topical instillation of PHOTREXA VISCOUS onto the eye every 2 minutes for the 30 minute irradiation period. For topical ophthalmic use. Do not inject. Single use PHOTREXA VISCOUS and PHOTREXA only. Discard syringe(s) after use. PHOTREXA VISCOUS and PHOTREXA are for use with the KXL System only. PLEASE REFER TO THE KXL OPERATOR'S MANUAL FOR SPECIFIC DEVICE INSTRUCTIONS. Debride the epithelium using standard aseptic technique using topical anesthesia ( 2 ). Then instill 1 drop of PHOTREXA VISCOUS topically on the eye every 2 minutes for 30 minutes ( 2 ). After 30 minutes, examine the eye under slit lamp for presence of a yellow flare in the anterior chamber. If flare is not detected, instill 1 drop of PHOTREXA VISCOUS every 2 minutes for an additional 2 to 3 drops and recheck for yellow flare. Repeat as necessary ( 2 ). Once flare is observed, perform ultrasound pachymetry. If corneal thickness is less than 400 microns, instill 2 drops of PHOTREXA every 5 to 10 seconds until the corneal thickness increases to at least 400 microns ( 2 ). Irradiation should not be performed unless this 400 micron threshold is met and the yellow flare is seen ( 2 ). Irradiate the eye for 30 minutes at 3mW/cm 2 using the KXL System as per the instructions in the KXL manual. During irradiation, continue topical instillation of PHOTREXA VISCOUS onto the eye every 2 minutes for the 30 minute irradiation period ( 2 ). Refer to the KXL Operator's manual for specific device instructions ( 2 ).

4 CONTRAINDICATIONS None. None ( 4 )

6 ADVERSE REACTIONS The following clinically significant adverse reactions are described elsewhere in the labeling: Ulcerative keratitis [ Warnings and Precautions (Section 5) ] In progressive keratoconus patients, the most common ocular adverse reactions in any CXL-treated eye were corneal opacity (haze), punctate keratitis, corneal striae, corneal epithelium defect, eye pain, reduced visual acuity, and blurred vision ( 6.1 ). In corneal ectasia patients, the most common ocular adverse reactions were corneal opacity (haze), corneal epithelium defect, corneal striae, dry eye, eye pain, punctate keratitis, photophobia, reduced visual acuity, and blurred vision ( 6.1 ). To report SUSPECTED ADVERSE REACTIONS, contact Avedro at 1-844-528-3376 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch . 6.1 Clinical Trials Experience Because clinical trials are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. The safety of the corneal collagen cross-linking procedure was evaluated in 3 randomized, parallel-group, open-label, sham-controlled trials; patients were followed up for 12 months. Study 1 enrolled patients with progressive keratoconus or corneal ectasia following refractive surgery. Study 2 enrolled only patients with progressive keratoconus, and Study 3 enrolled only patients with corneal ectasia following refractive surgery. In each study, only one eye of each patient was designated as the study eye. Study eyes were randomized to receive one of the two study treatments (CXL or sham) at the baseline visit and were followed up at Day 1, Week 1, and Months 1, 3, 6, and 12. At Month 3 or later, sham study eyes and non-study eyes had the option of receiving CXL treatment, and were followed-up for 12 months from the time of receiving CXL treatment. Each CXL treated eye received a single course of CXL treatment only. Safety data were obtained from: 193 randomized CXL study eyes (102 keratoconus, 91 corneal ectasia), 191 control eyes, and 319 nonrandomized CXL non-study eyes (191 keratoconus, 128 corneal ectasia). Overall, 512 eyes (293 keratoconus, 219 corneal ectasia) in 364 patients received CXL treatment. In progressive keratoconus patients, the most common ocular adverse reactions in any CXL-treated eye were corneal opacity (haze), punctate keratitis, corneal striae, corneal epithelium defect, eye pain, reduced visual acuity, and blurred vision ( Table 1 ). In corneal ectasia patients, the most common ocular adverse reactions were corneal opacity (haze), corneal epithelium defect, corneal striae, dry eye, eye pain, punctate keratitis, photophobia, reduced visual acuity, and blurred vision. These events are expected sequelae following epithelial corneal debridement and occurred at a higher incidence than observed in control patients, who did not undergo debridement or exposure to UVA light ( Table 1 ). Adverse events reported in non-study, non-randomized CXL treated were similar in terms of preferred terms and frequency to those seen in randomized study eyes. The majority of adverse events reported resolved during the first month, while events such as corneal epithelium defect, corneal striae, punctate keratitis, photophobia, dry eye and eye pain, and decreased visual acuity took up to 6 months to resolve and corneal opacity or haze took up to 12 months to resolve. In 1-2% of patients, corneal epithelium defect, corneal edema, corneal opacity and corneal scar continued to be observed at 12 months. In 6% of corneal ectasia patients, corneal opacity continued to be observed at 12 months. Table 1: Most Common (≥1%) Ocular Adverse Reactions in CXL-Treated Study Eye in the Pooled Randomized Safety Population – N (%) 1) Results are presented as the number (%) of patients with an event from baseline to Month 3. 2) Almost all cases of corneal opacity were reported as haze. Progressive Keratoconus Studies Corneal Ectasia Studies Preferred Term CXL Group (N=102) 1 Control Group (N=103) 1 CXL Group (N=91) 1 Control Group (N=88) 1 Anterior chamber cell 2 (2) 0 2 (2) 1 (1) Anterior chamber flare 4 (4) 0 5 (6) 2 (2) Asthenopia 1 (1) 1 (1) 2 (2) 0 Blepharitis 0 0 0 1 (1) Corneal disorder 3 (3) 1 (1) 3 (3) 0 Corneal epithelium defect 24 (24) 1 (1) 26 (28) 3 (3) Corneal oedema 3 (3) 0 3 (3) 0 Corneal opacity 2 65 (64) 9 (9) 65 (71) 8 (9) Corneal striae 24 (24) 12 (12) 8 (9) 6 (7) Corneal thinning 1 (1) 2 (2) 0 0 Diplopia 2 (2) 1 (1) 1 (1) 0 Dry eye 6 (6) 2 (2) 13 (14) 4 (5) Eye complication associated with device 2 (2) 0 1 (1) 0 Eye discharge 2 (2) 1 (1) 0 0 Eye oedema 7 (7) 0 0 0 Eye pain 17 (17) 3 (3) 24 (26) 0 Eye pruritus 2 (2) 0 0 0 Eyelid oedema 5 (5) 0 5 (6) 1 (1) Foreign body sensation in eyes 15 (15) 1 (1) 13 (14) 2 (2) Glare 4 (4) 1 (1) 2 (2) 0 Halo vision 1 (1) 0 2 (2) 0 Keratitis 1 (1) 0 3 (3) 0 Lacrimation increased 5 (5) 0 9 (10) 1 (1) Meibomian gland dysfunction 1 (1) 1 (1) 3 (3) 2 (2) Ocular discomfort 0 0 8 (9) 0 Ocular hyperaemia 14 (14) 2 (2) 7 (8) 4 (5) Photophobia 11 (11) 0 17 (19) 0 Punctate keratitis 25 (25) 8 (8) 18 (20) 3 (3) Vision blurred 16 (16) 2 (2) 15 (17) 4 (5) Visual acuity reduced 10 (10) 9 (9) 10 (11) 1 (1) Visual impairment 3 (3) 2 (2) 4 (4) 1 (1) Vitreous detachment 2 (2) 0 0 0 Headache was reported in between 4 to 8% of treated patients.

What is Photrexa Cross-linking Kit used for?
1 INDICATIONS AND USAGE PHOTREXA ® VISCOUS and PHOTREXA ® are indicated for use in corneal collagen cross-linking in combination with the KXL ® System for the treatment of PHOTREXA VISCOUS and PHOTREXA are photoenhancers indicated for use with the KXL System in corneal collagen cross-linking for the treatment of progressive keratoconus ( 1.1 ) and corneal ectasia following refractive surgery ( …

Who makes Photrexa Cross-linking Kit?
Glaukos Corporation is the labeler of record for Photrexa Cross-linking Kit.

Is Photrexa Cross-linking Kit prescription or over-the-counter?
The FDA label for this product is recorded as human prescription drug. Marketing status can differ between strengths and countries, so check the dispensing rules where you live.

Has Photrexa Cross-linking Kit been recalled?
No FDA recall record in our database matches this product name or manufacturer. Recall data is updated periodically, so a very recent notice may not appear here yet.

Where does this information come from?
All content is reproduced from FDA Structured Product Labelling data via openFDA. It is provided for identification and reference only and is not medical advice.