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SENSORY ORGANS › OPHTHALMOLOGICALS › ANTIINFLAMMATORY AGENTS AND ANTIINFECTIVES IN COMBINATION › Corticosteroids/antiinfectives/mydriatics in combination
dexamethasone
S01CB01
Forms & Strengths
- Ophthalmic Suspension: 0.1%
- Ophthalmic Ointment: 0.05%
Adult Dosing
- Ophthalmic Suspension: Instill 1 to 2 drops into the conjunctival sac up to 4 to 6 times daily.
- Severe inflammation: Instill 1 to 2 drops hourly, tapering to discontinuation as inflammation subsides.
- Ophthalmic Ointment: Apply a small amount (approx. 0.5 inch ribbon) into the conjunctival sac 3 to 4 times daily.
Pediatric Dosing
- Safety and efficacy in pediatric patients below the age of 18 have not been established.
- Use lowest effective dose and monitor intraocular pressure if used.
Indications
- Steroid-responsive inflammatory conditions of the palpal and bulbar conjunctiva, cornea, and anterior segment of the globe.
- Corneal injury from chemical, radiation, or thermal burns, or penetration of foreign bodies.
Mechanism of Action
- Potent glucocorticoid that depresses the formation, release, and activity of endogenous inflammatory mediators including prostaglandins, kinins, histamine, liposomal enzymes, and leukotrienes.
- Modulates the immune response by inhibiting leukocyte infiltration, phagocytosis, and edema formation.
Contraindications
- Epithelial herpes simplex keratitis (dendritic keratitis)
- Vaccinia, varicella, and other viral diseases of the cornea and conjunctiva
- Mycobacterial infection of the eye
- Fungal diseases of ocular structures
- Hypersensitivity to any component of the formulation
Adverse Reactions
- Elevation of intraocular pressure with possible development of glaucoma
- Posterior subcapsular cataract formation
- Delayed wound healing
- Secondary ocular infection (bacterial, fungal, viral)
- Transient stinging or burning upon instillation
- Blurred vision
Drug Interactions
- Concomitant use of topical ophthalmic NSAIDs and topical corticosteroids may delay corneal healing.
- Prolonged co-administration with CYP3A4 inhibitors (e.g., ritonavir, cobicistat) may theoretically increase systemic exposure, though minimal with ophthalmic drops.
- Anticholinergic agents may lead to increased intraocular pressure when used with ophthalmic corticosteroids.
Curated Content: Needs Vetting Before Put to Clinical Use