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Dexamethasone and levofloxacin ocular


Eye drops containing dexamethasone and levofloxacin.

Drugs List

  • dexamethasone 1mg/ml and levofloxacin 5mg/ml eye drops
  • DUCRESSA 1mg/ml + 5mg/ml eye drops
  • Therapeutic Indications


    Prophylaxis of infection following cataract surgery
    Topical prophylaxis and treatment of inflammation after cataract surgery



    Instil 1 drop into the conjunctival sac (lateral canthus) after surgery every 6 hours.

    Treatment duration is 7 days. Care should be taken to not discontinue therapy prematurely.

    Re-evaluation of the patient to assess the need to continue the administration of corticosteroid eye drops as monotherapy is recommended after the completion of one week of therapy with dexamethasone and levofloxacin eye drops. The length of treatment can depend on the patient's risk factors and outcome of surgery and must be determined by the doctor according to slip-lamp microscopic findings and depending on the severity of the clinical picture. A follow-up treatment with steroid eye drops should not exceed 2 weeks.

    Additional Dosage Information

    Missed dose
    If one dose is missed, treatment should continue with the next dose as planned.


    For ocular use only.


    Children under 18 years
    Herpes simplex keratitis
    Mycobacterial eye infection
    Ocular herpes simplex infection
    Ocular infection

    Precautions and Warnings

    Hepatic impairment
    Renal impairment

    Advise patient blurred vision may affect ability to drive/operate machinery
    Consult national/regional policy on the use of anti-infectives
    Exclude fungal infection before treatment
    Exclude tubercular infection before treatment
    Exclude viral infection before treatment
    Contains benzalkonium chloride
    Administer other ophthalmic products at least 15 minutes apart
    To reduce systemic absorption compress lacrimal sac during administration
    If visual disturbances occur, perform ophthalmic evaluation
    Monitor intra-ocular pressure
    Contains phosphate: Risk of calcification in existing notable cornea damage
    Discontinue at the first sign of tendon inflammation
    Discontinue if active infection develops
    Prolonged use may result in ocular infections
    Prolonged use may result in superinfection with non-susceptible organisms
    Discontinue if hypersensitivity reactions occur
    Advise patient to avoid touching the eye/other surfaces with container tip
    Advise patient to wash hands before and after use
    Contact lenses should not be worn during treatment

    Prolonged use of topical ophthalmic corticosteroids may result in ocular hypertension/glaucoma but this is unlikely when dexamethasone and levofloxacin is used for the recommended treatment period.

    Topical ocular corticosteroids may promote, aggravate or mask signs and symptoms of eye infections caused by opportunistic microorganisms. Occurrence of these conditions is limited in case of short term corticosteroid treatment such as the one suggested for dexamethasone and levofloxacin.

    Treatment should be progressively discontinued if Cushing's syndrome and/or adrenal suppression associated with systemic absorption of ocular dexamethasone occur after intensive or continuous use in predisposed patients. These patients include children and patients treated with CYP3A4 inhibitors.

    Pregnancy and Lactation


    Dexamethasone and levofloxacin is contraindicated during pregnancy.

    The manufacturer advises that dexamethasone and levofloxacin is not recommended during pregnancy and especially during the first three months. Animal studies of corticosteroids have shown reproductive toxicity and teratogenic effects. At the time of writing there are no or limited data from the use of dexamethasone and levofloxacin in pregnant women. Corticosteroids cross the placenta. Prolonged or repeated corticosteroid use during pregnancy has been associated with an increased risk of intra-uterine growth retardation, lower birth weight and risk for high blood pressure, vascular disorders and insulin resistance in the adulthood. Infants should be carefully observed for signs of hypoadrenalism.


    Dexamethasone and levofloxacin is contraindicated during breastfeeding.

    The manufacturer recommends a decision must be made whether to discontinue breastfeeding or to discontinue dexamethasone and levofloxacin treatment taking into account the benefit of breastfeeding for the child and the benefit of therapy for the women. Systemic corticosteroids and levofloxacin are excreted into human milk. No data is available, to indicate whether relevant amounts of dexamethasone are transferred into human breast milk and which are capable of producing clinical effects in the infant. A risk to the suckling child cannot be excluded.

    Side Effects

    Abnormal sensation in eye
    Adrenal suppression
    Blurred vision
    Burning and stinging of the eyes
    Conjunctival chemosis
    Conjunctival follicles
    Conjunctival hyperaemia
    Conjunctival papillae
    Corneal changes
    Corneal deposits
    Corneal oedema
    Corneal perforation
    Corneal ulcer
    Cushing's syndrome
    Dryness of eyes
    Eye irritation
    Eyelid erythema
    Eyelid oedema
    Facial oedema
    Hypersensitivity reactions
    Impaired vision
    Increased intra-ocular pressure
    Laryngeal oedema
    Mucous strand
    Ocular allergy
    Ocular burning
    Ocular discomfort
    Ocular hypertension
    Ocular itching
    Ocular pain
    Opportunistic infections
    Posterior subcapsular cataracts
    Sticky eyelid
    Tendon inflammation
    Tendon rupture
    Wound healing retarded


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: August 2022

    Reference Sources

    Summary of Product Characteristics: Ducressa 1mg/ml and 5mg/ml eye drops. Santen UK Limited. Revised February 2022.

    NICE Evidence Services Available at: Last accessed: 22 August 2022

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    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

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    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.