Drugs List

Therapeutic Indications

Uses

Eye - non-infected inflammatory conditions

Treatment of steroid responsive inflammatory conditions of the conjunctiva, cornea and anterior segment of the eye, such as, anterior uveitis, iritis, cyclitis, allergic and vernal conjunctivitis, herpes zoster keratitis, superficial punctate keratitis and non-specific superficial keratitis.

Also for the treatment of corneal injury from chemical, radiation or thermal burns or following penetration by foreign bodies. Indicated for post-operative use to reduce inflammatory reactions and suppress graft reaction.

Contraindications

Wearing of contact lenses
History of herpes simplex keratitis
Mycobacterial eye infection
Ocular infection
Undiagnosed red eye

Precautions and Warnings

Children under 2 years
Family history of diabetes mellitus
Family history of glaucoma
Breastfeeding
Corneal damage
Diabetes mellitus
Glaucoma
Pregnancy

Diabetes mellitus: May increase risk of glaucoma and cataracts
May mask symptoms or signs of infections
Advise patient blurred vision may affect ability to drive/operate machinery
Exclude bacterial infection before treatment
Exclude fungal infection before treatment
Exclude viral infection before treatment
Not all available brands are licensed for all age groups
Treat and control infections prior to commencing therapy
Contains benzalkonium chloride. Not to be used with soft contact lenses
Contains polysorbate
In combined therapy, administer eye products at least five minutes apart
To reduce systemic absorption compress lacrimal sac during administration
Check ocular lens frequently - risk of cataract formation
Monitor intraocular pressure frequently - risk of steroid glaucoma
Perform eye tests in any patient with vision change/ophthalmologic symptoms
Possible systemic absorption of steroid
Prolonged or high dose may lead to adrenal suppression
May cause perforation of eye in disorders that thin the sclera or cornea
Prolonged use may cause raised intraocular pressure
Prolonged use may result in ocular infections
Treatment may adversely affect wound healing
Advise patient to avoid touching the eye/other surfaces with container tip
Contact lenses should not be worn during treatment
Remove contact lenses before use and re-insert 15 minutes after use

Prolonged use may result in ocular hypertension and/or glaucoma with damage to the optic nerve, reduced visual acuity, visual field defects and posterior subcapsular cataract formation.

Pregnancy and Lactation

Pregnancy

Use dexamethasone with caution during pregnancy.

The manufacturer does not recommend using dexamethasone during pregnancy. At the time of writing there is limited data regarding the use of dexamethasone eye drops in pregnant women. Prolonged or repeated corticoid use during pregnancy has been associated with an increased risk of intra-uterine growth retardation. Infants of mothers who have received substantial doses of corticosteroids during pregnancy should be observed carefully for signs of hypoadrenalism. Animal studies have shown reproductive toxicity.

Lactation

Use dexamethasone with caution during breastfeeding.

The manufacturer advises that the patient either discontinues dexamethasone or discontinues breastfeeding. The presence of dexamethasone in human breast milk is unknown. It is unlikely that the amount of dexamethasone in human milk would be capable of producing clinical effects in the infant following maternal use of the product. Effects on exposed infants are unknown.

Side Effects

Abnormal sensation in eye
Adrenal suppression
Blurred vision (transient)
Conjunctivitis
Corneal deposits
Corneal erosion
Corneal perforation
Corneal staining
Corneal thinning
Corneal ulcer
Cushing's syndrome
Dizziness
Dry eyes
Dysgeusia
Eye infection
Glaucoma
Headache
Hypersensitivity reactions
Impaired healing
Increased intra-ocular pressure
Increased lacrimation
Keratitis
Lid margin crusting
Mydriasis
Ocular discomfort
Ocular hyperaemia
Ocular irritation
Ocular pain
Ocular pruritus
Opportunistic infections
Optic nerve damage
Perforation of the ocular globe
Photophobia
Ptosis
Reduced visual acuity
Scleral thinning
Sensation of foreign body in eye
Subcapsular cataract
Systemic effects (on prolonged use)
Ulcerative keratitis
Visual field defects

Presentation

Eye drops containing dexamethasone (preservative containing).

Drugs List

Therapeutic Indications

Uses

Eye - non-infected inflammatory conditions

Treatment of steroid responsive inflammatory conditions of the conjunctiva, cornea and anterior segment of the eye, such as, anterior uveitis, iritis, cyclitis, allergic and vernal conjunctivitis, herpes zoster keratitis, superficial punctate keratitis and non-specific superficial keratitis.

Also for the treatment of corneal injury from chemical, radiation or thermal burns or following penetration by foreign bodies. Indicated for post-operative use to reduce inflammatory reactions and suppress graft reaction.

Dosage

Frequency of instillation of drops and the duration of treatment will vary upon the severity of the underlying condition and the response to treatment.

Adults

Children

Contraindications

Wearing of contact lenses
History of herpes simplex keratitis
Mycobacterial eye infection
Ocular infection
Undiagnosed red eye

Precautions and Warnings

Children under 2 years
Family history of diabetes mellitus
Family history of glaucoma
Breastfeeding
Corneal damage
Diabetes mellitus
Glaucoma
Pregnancy

Diabetes mellitus: May increase risk of glaucoma and cataracts
May mask symptoms or signs of infections
Advise patient blurred vision may affect ability to drive/operate machinery
Exclude bacterial infection before treatment
Exclude fungal infection before treatment
Exclude viral infection before treatment
Not all available brands are licensed for all age groups
Treat and control infections prior to commencing therapy
Contains benzalkonium chloride. Not to be used with soft contact lenses
Contains polysorbate
In combined therapy, administer eye products at least five minutes apart
To reduce systemic absorption compress lacrimal sac during administration
Check ocular lens frequently - risk of cataract formation
Monitor intraocular pressure frequently - risk of steroid glaucoma
Perform eye tests in any patient with vision change/ophthalmologic symptoms
Possible systemic absorption of steroid
Prolonged or high dose may lead to adrenal suppression
May cause perforation of eye in disorders that thin the sclera or cornea
Prolonged use may cause raised intraocular pressure
Prolonged use may result in ocular infections
Treatment may adversely affect wound healing
Advise patient to avoid touching the eye/other surfaces with container tip
Contact lenses should not be worn during treatment
Remove contact lenses before use and re-insert 15 minutes after use

Prolonged use may result in ocular hypertension and/or glaucoma with damage to the optic nerve, reduced visual acuity, visual field defects and posterior subcapsular cataract formation.

Pregnancy and Lactation

Pregnancy

Use dexamethasone with caution during pregnancy.

The manufacturer does not recommend using dexamethasone during pregnancy. At the time of writing there is limited data regarding the use of dexamethasone eye drops in pregnant women. Prolonged or repeated corticoid use during pregnancy has been associated with an increased risk of intra-uterine growth retardation. Infants of mothers who have received substantial doses of corticosteroids during pregnancy should be observed carefully for signs of hypoadrenalism. Animal studies have shown reproductive toxicity.

Lactation

Use dexamethasone with caution during breastfeeding.

The manufacturer advises that the patient either discontinues dexamethasone or discontinues breastfeeding. The presence of dexamethasone in human breast milk is unknown. It is unlikely that the amount of dexamethasone in human milk would be capable of producing clinical effects in the infant following maternal use of the product. Effects on exposed infants are unknown.

Side Effects

Abnormal sensation in eye
Adrenal suppression
Blurred vision (transient)
Conjunctivitis
Corneal deposits
Corneal erosion
Corneal perforation
Corneal staining
Corneal thinning
Corneal ulcer
Cushing's syndrome
Dizziness
Dry eyes
Dysgeusia
Eye infection
Glaucoma
Headache
Hypersensitivity reactions
Impaired healing
Increased intra-ocular pressure
Increased lacrimation
Keratitis
Lid margin crusting
Mydriasis
Ocular discomfort
Ocular hyperaemia
Ocular irritation
Ocular pain
Ocular pruritus
Opportunistic infections
Optic nerve damage
Perforation of the ocular globe
Photophobia
Ptosis
Reduced visual acuity
Scleral thinning
Sensation of foreign body in eye
Subcapsular cataract
Systemic effects (on prolonged use)
Ulcerative keratitis
Visual field defects

Overdosage

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 ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: October 2022

Reference Sources

Summary of Product Characteristics: Maxidex 0.1% eye drops. Novartis Pharmaceuticals UK Ltd. Revised October 2022.

NICE Evidence Services Available at: www.nice.org.uk Last accessed: 12 October 2022