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Zovirax eye ointment discontinued by manufacturer after 5 years; FDA: ophthalmologic benefits [see Warnings and Precautions (5.1) for additional information ]. Postmarketing experience with Viread and other Osp A-IV drugs for treatment of recurrent prophthamies has been reported. Osp A virus is the source of these infections. Cases have been reported in patients having had surgery for retinal detachment or perforation (such as cataract surgery) well in patients suspected of having had exposure to a family member or acquaintance with a venereal disease. While it is unlikely that therapy with IV ointment containing Osp A virus would lead to permanent treatment problems in HIV-positive patients, caution should be taken when treating patients with exposure histories that should be considered abnormal to the virus. Adverse reactions drug have included: mild pruritus, including erythema and itching. Other clinically significant effects such as headache and increased intracranial pressure have been reported. VIRUSES AND OTHER INFECTIOUS AGENTS; PREPARATION OF OSP A-IV The use of Viread has been associated with cross-neutralizing antibody responses to all human and animal viruses encountered in clinical postmarketing experience. During Phase III clinical trials, approximately 10% of patients receiving Viread had a neutralizing antibody response (defined as a change in neutralizing activity level of greater than 200 units/mL after neutralization) to at least an equivalent number of Osp A virus-specific or B-specific antigens. Studies to determine what percentage of patients respond to Viread-containing monotherapy in patients with a high risk for acquiring VZV during pregnancy have not been completed. Osp A-IV was reported to be associated with the following rare but serious ocular injuries after the drug received regulatory approval: severe inflammation, intracranial injury, optic nerve damage, and abnormalities. Other reported events are listed below. Acute bacterial/viral infections Ocular injuries such as uveitis, keratitis, visual disturbances, and retinal detachment have been reported after administration of Viread in patients with exposure histories of ophthalmologic infections. The majority patients who have these ocular injuries did zovirax patches uk so within 24 hours after Viread discontinuing treatment on primary ophthalmic examination. Other severe infections such as bacteremia, bacterial meningitis, respiratory tract infection, meningeal ophthalmia, and otitis media are also reported rarely. These conditions should be reported to the FDA directly. There has been a single report of Guillain-Barré syndrome associated with intravenous ointment containing Osp A-IV. The following factors seem to contribute the increased chance of serious ocular events in the setting of Osp A-IV drug exposure: Ocular signs and symptoms that are similar to or develop quickly after treatment. Initial ocular signs that include rash, pain, itching, and burning usually resolve within 24 hours after discontinuation of treatment. Subsequently, however, signs such as ocular surface hyperextensibility and photophobia often may persist for 2-4 days. Signs and symptoms are more likely to occur within three days after the injection of first dose Viread than within 24 hours after it. Signs or symptoms that are more likely to persist include retinal detachment and/or the formation of pseudovalveolar perivascular infiltrates in the cornea; it is probable that a higher proportion of patients exposed to Osp A-IV have such signs than those not exposed. The severity and duration of signs vary by patients. Prolonged ocular infections. Patients exposed to the drug may have protracted episodes of ocular pain and inflammation similar to a viral meningitis. Infection of the epithelial barrier system The possibility of a systemic reaction to virus or toxin should be considered in the differential diagnosis of immune-mediated eye disorders. Immune globulins and cytokines can cause systemic toxicity in the absence of ocular symptoms. Immune-mediated eye disorders may cause pain, swelling, fever, fever with rash, headache, conjunctivitis, or altered mental status without ocular signs or symptoms. The following factors seem to contribute the increased chance of serious eye impairment in the setting of Osp A-IV drug exposure: Symptoms of ocular inflammation that may be delayed for several hours, in particular conjunctivitis with or without fever. The presence of a systemic reaction such as fever, neutropenia, increased white cell count, and/or leukopenia in susceptible immunocompromised patients the minutes or hours following initial contact with the vaccine. Fever after exposure may last into 6 hours. Exposure to viral antigens or toxins that the immune system attacks;

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