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DOSAGE
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Mild Inflammation: 1-2 gtts to 4-6/ Day, then taper to discontinuation as the inflammation subside. If severe, may be used q1hr. Shake prior to use
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Cornea SPK (Moderate/Severe) (1) AT 4-8/day + Gel qHS (2) Mild Topical Steroid (FML 0.1% of Lotemax QID) x 1-4 weeks, then taper (3) Add on Restasis BID to QID as alternative or adjunctive treatment (if steroid responder)
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EKC (Viral) with mild SEI: Mild Topical Steroid/gel BID
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Inflammed Ping/Pterygium (Moderate/Severe): (1) UV protection (2) AT 4/day (3) FML 0.1% or Lotemax 0.2% to 0.5% QID (3) NSAID like ketoralac 0.4% or Mast cell combo Pataday qD to decrease symptoms
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Severe GPC: Short-term use of FML 0.1% or Lotemax 0.2%-0.5% QID (d/c CL wear), addition to topical combo anti-allergies like Pataday 0.2% qD
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GENERIC
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dexamethasone 0.1%
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SIZE
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5mL
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INDICATIONS
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Steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivitis when the inherent hazard of steroid use is accepted to obtain an advisable diminution in edema and inflammation; corneal injury from chemical, radiation, or thermal burns, or penetration of foreign bodies.
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MECHANISM OF ACTION
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Ketone-based steroid
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MICROBIOLOGY
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Dexamethasone suppresses the inflammatory response to a variety of agents and it probably delays or slows healing.
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CONTRAINDICATIONS & WARNINGS
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Contraindicated in acute, untreated bacterial infections; mycobacterial ocular infections; epithelial herpes simplex (dendritic keratitis); vaccinia, varicella, and most other viral diseases of the cornea and conjunctiva; fungal disease of ocular structures; and in those persons who have shown hypersensitivity to any component of this preparation.
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Prolonged use may result in ocular hypertension and/or glaucoma, with damage to the optic nerve, defects in visual acuity and fields of vision, and posterior subcapsular cataract formation. Prolonged use may suppress the host response and thus increase the hazard of secondary ocular infections. In acute purulent conditions or parasitic infections of the eye, corticosteroids may mask infection or enhance existing infection. In those diseases causing thinning of the cornea or sclera, perforations have been known to occur with the use of topical corticosteroids. If these products are used for 10 days or longer, intraocular pressure (IOP) should be routinely monitored even though it may be difficult in children and uncooperative patients.
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PEDIATRIC USE
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The safety and effectiveness of MAXIDEX have been established in the pediatric patients. Use of MAXIDEX in all pediatric age groups is supported by evidence from adequate and well-controlled studies of MAXIDEX in adults with safety data from additional adequate and well controlled trials in pediatric patients.
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PREGNANCY
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Category C. Teratogenic MAXIDEX® (dexamethasone ophthalmic suspension) 0.1% should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the embryo or fetus. There are no adequate or well-controlled studies in pregnant women. However, prolonged or repeated corticoid use during pregnancy has been associated with an increased risk of intra-uterine growth retardation. Infants born of mothers who have received substantial doses of corticosteroids during pregnancy should be observed carefully for signs of hypoadrenalism.
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NOTE
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Employment of corticosteroid medication in the treatment of herpes simplex other than epithelial herpes simplex keratitis, in which it is contraindicated, requires great caution; periodic slit-lamp microscopy is essential.
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BAK preserved (0.01%). Neopolydex has 0.1% dexamethasone and is often listed as a $4 generic.
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