← Search & browse all drugs
SENSORY ORGANS › OPHTHALMOLOGICALS › ANTIINFLAMMATORY AGENTS › Corticosteroids and mydriatics in combination
betamethasone and mydriatics
S01BB04
Forms & Strengths
- Ophthalmic suspension/drops containing a corticosteroid and a mydriatic/cycloplegic combination
Adult Dosing
- Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times daily as directed by the physician
- Taper dose gradually upon clinical improvement to avoid relapse
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been firmly established
- Use lowest possible effective dose if prescribed by an ophthalmologist
Indications
- Short-term management of inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where concurrent mydriasis/cycloplegia is indicated
- Post-operative ocular inflammation following eye surgery
Mechanism of Action
- Betamethasone is a potent corticosteroid that inhibits the inflammatory response to a variety of agents, delaying or easing healing
- Mydriatic/cycloplegic agent (typically scopolamine, homatropine, or cyclopentolate depending on the specific combination) blocks responses of the sphincter muscle of the iris and the ciliary muscle to cholinergic stimulation, inducing pupillary dilation and paralysis of accommodation
Contraindications
- Most viral diseases of the cornea and conjunctiva including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella
- Mycobacterial infection of the eye
- Fungal diseases of ocular structures
- Hypersensitivity to any component of the medication
- Angle-closure glaucoma or risk thereof due to the mydriatic component
Adverse Reactions
- Elevation of intraocular pressure (IOP) with possible development of glaucoma
- Posterior subcapsular cataract formation
- Delayed wound healing
- Secondary ocular infection (bacterial, fungal, and viral)
- Transient stinging, burning, or blurred vision upon instillation
- Systemic anticholinergic effects from the mydriatic component (e.g., dry mouth, tachycardia, blurred near vision, photophobia)
Drug Interactions
- Other topical ophthalmic drugs (allow at least a 5-minute interval between applications)
- Anticholinergic drugs may have additive systemic effects when combined with the mydriatic component
- CYP3A4 inhibitors (long-term systemic absorption concerns, though minimal with ophthalmic use)
Curated Content: Needs Vetting Before Put to Clinical Use