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Dexamethasone implant intravitreal


Intravitreal implant in applicator containing dexamethasone.

Drugs List

  • dexamethasone 700microgram intravitreal implant in applicator
  • OZURDEX 700microgram intravitreal implant in applicator
  • Therapeutic Indications


    Macular oedema following branch or central retinal vein occlusion
    Posterior segment non-infectious uveitis
    Treatment of visual impairment due to diabetic macular oedema


    A broad spectrum topical antimicrobial should be given for 3 days prior to and for 3 days after procedure. Adequate local anaesthesia should be administered.


    One implant to be administered intra-vitreally to the affected eye.

    Patients treated with this medication who have experienced an initial response and in the physician's opinion may benefit from retreatment without being exposed to significant risk should be considered for retreatment.

    Retreatment may be performed after approximately 6 months if the patient experiences decreased vision and/or an increase in retinal thickness, secondary to recurrent or worsening diabetic macular oedema.

    There is currently no experience of the efficacy or safety of repeat administrations in DME beyond 7 implants.

    RVO and Uveitis
    Repeat doses for macular oedema should be considered when a patient experiences a response to treatment followed subsequently by a loss in visual acuity and who may benefit from retreatment without being exposed to significant risk.

    Patients who experience and retain improved vision should not be retreated.

    Patients who experience a deterioration in vision, which is not slowed by this medication, should not be retreated.

    There is only very limited information on repeat dosing intervals less than 6 months. There is currently no experience of repeat administrations beyond 2 implants in Retinal Vein Occlusion and no experience of repeat administration in posterior segment non-infectious uveitis.


    Single use intravitreal implant in applicator for intravitreal use only.

    Each applicator can only be used for the treatment of a single eye; administration to both eyes concurrently is not recommended.


    Anterior chamber intraocular lens with posterior lens capsule rupture
    Aphakia with posterior lens capsule rupture
    Herpes simplex keratitis
    Iris fixated intraocular lens with posterior lens capsule rupture
    Ocular infection
    Periocular infection
    Transscleral fixated intraocular lens with posterior lens capsule rupture
    Uncontrolled glaucoma

    Precautions and Warnings

    Recent anticoagulant therapy
    History of herpes simplex keratitis

    Advise patient blurred vision may affect ability to drive/operate machinery
    Premedication with antimicrobial eye drops required 3 days pre & post dose
    Treatment of second eye is not recommended within 7 days
    Treatment to be administered under the supervision of a specialist
    If visual disturbances occur, perform ophthalmic evaluation
    Monitor intra-ocular pressure post injection and manage appropriately
    Advise patient to report any symptoms of endophthalmitis immediately

    Monitoring may consist of a check for perfusion of the optic nerve head immediately after the injection, tonometry within 30 minutes following the injection, and biomicroscopy between 2 and 7 days following the injection.

    Where the posterior capsule of the lens is absent or has a tear, (for example, after cataract surgery) or there is an iris defect (for example, due to iridectomy) there is a risk of implant migration to the anterior chamber. The implant should be used with caution in such patients who should be monitored for any signs of migration.

    Increases in intra-ocular pressure may occur which peaks about 60 days after the injection and returns to baseline within 180 days. Regular monitoring is required and treatment prescribed as appropriate. This is more common in patients less than 45 years of age.

    Pregnancy and Lactation


    Use dexamethasone intravitreal implants with caution during pregnancy.

    The manufacturer notes that this medication should only be used during pregnancy if the potential benefit justifies the potential risk to the foetus.

    There is no adequate data from the use of intravitreally administered dexamethasone in pregnant women. Studies in animals have shown teratogenic effects following topical ophthalmic administration. The systemic exposure of dexamethasone would be expected to be very low after intravitreal implant treatment. One study showed the majority of subjects had plasma levels of dexamethasone that were unquantifiably low. The highest concentration achieved in any subject was 0.094 nanogram/ml. Long-term systemic treatment with glucocorticoids during pregnancy increases the risk for intra-uterine growth retardation and adrenal insufficiency of the newborn child. Dexamethasone crosses the placenta to the foetus.


    Use dexamethasone intravitreal implants with caution during breastfeeding.

    The manufacturer notes that this medication should only be considered if the expected benefit to the mother is greater than any risk to the breastfed infant.

    Dexamethasone is excreted in breast milk but no effects on the child are anticipated due to the route of administration and the resulting minimal systemic levels.

    Side Effects

    Abnormal sensation in eye
    Anterior chamber flare
    Anterior chamber inflammation
    Cells in anterior chamber of eye
    Conjunctival haemorrhage
    Conjunctival hyperaemia
    Conjunctival oedema
    Eyelid pruritus
    Increased intra-ocular pressure
    Necrotising retinitis
    Ocular hypertension
    Ocular hypotony
    Ocular pain
    Reddened sclera
    Reduced visual acuity
    Retinal detachment
    Retinal tear
    Subcapsular cataract
    Visual disturbances
    Vitreous detachment
    Vitreous haemorrhage
    Vitreous opacities


    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: September 2014

    Reference Sources

    Drugs in Pregnancy and Lactation: A Reference Guide to Fetal and Neonatal Risk, 9th edition (2011) ed. Briggs, G., Freeman, R. and Yaffe, S. Lippincott Williams & Wilkins, Philadelphia.

    Summary of Product Characteristics: Ozurdex. Allergan Ltd. Revised March 2019.

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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.