Dexamethasone ocular preservative-free
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Eye drops containing dexamethasone (preservative-free).
Drugs List
Therapeutic Indications
Uses
Eye - non-infected inflammatory conditions
Dosage
Dose regimens vary according to brand.
Adults
Moderate inflammation
Instil 1 drop every four to six hours.
Severe inflammation
Instil 1 to 2 drops every 60 minutes until a satisfactory response occurs. When this is obtained, reduce the dose towards 1 drop every four hours.
Consider subconjunctival or systemic steroid therapy if there is no response.
Children
Children 2-18 years
Moderate inflammation
Instil 1 drop every four to six hours.
Severe inflammation
Instil 1 to 2 drops every 60 minutes until a satisfactory response occurs. When this is obtained, reduce the dose towards 1 drop every four hours.
Consider subconjunctival or systemic steroid therapy if there is no response.
Children under 2 years (unlicensed)
Moderate inflammation
Instil 1 drop every four to six hours.
Severe inflammation
Instil 1 drop every 60 minutes until a satisfactory response occurs. When this is obtained, reduce the dose towards 1 drop every four hours.
Consider subconjunctival or systemic steroid therapy if there is no response.
Contraindications
Wearing of contact lenses
History of herpes simplex keratitis
Ocular infection
Undiagnosed red eye
Precautions and Warnings
Children under 18 years
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 tubercular 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
Some formulations may contain traces of silver - risk of hypersensitivity
Administer other ophthalmic products at least 15 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
Contains phosphate: Risk of calcification in existing notable cornea damage
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
Pregnancy and Lactation
Pregnancy
Use dexamethasone eye drops with caution during pregnancy.
The manufacturers note that it is preferable to avoid the use of these eye drops during pregnancy.
There is limited data from the use of these eye drops in pregnant women. Most information available relates to use of systemically administered corticosteroids. Dexamethasone crosses the placenta to the foetus but toxicity in the foetus and newborn following its use is rare.
Lactation
Use dexamethasone eye drops with caution during breastfeeding.
The manufacturer recommends avoiding the use of dexamethasone eye drops during breastfeeding. Little data is available on the transfer of dexamethasone into human milk but it is likely to be extremely low when instilled topically. Effects on exposed infants are unknown.
Side Effects
Adrenal suppression
Allergic reaction
Blurred vision (transient)
Burning and stinging of the eyes
Conjunctivitis
Corneal deposits
Corneal oedema
Corneal opacities
Corneal perforation
Corneal thinning
Corneal ulcer
Crystalline keratopathy
Cushing's syndrome
Dysgeusia
Eye infection
Eyelid oedema
Facial oedema
Glaucoma
Hypersensitivity reactions
Impaired healing
Increased intra-ocular pressure
Increased lacrimation
Keratitis
Mydriasis
Ocular discomfort
Ocular irritation
Ocular itching
Ocular pain
Ocular pruritus
Opportunistic infections
Optic nerve damage
Perforation of the ocular globe
Photophobia
Ptosis
Reddening of eyes
Reduced visual acuity
Scleral thinning
Subcapsular cataract
Systemic effects (on prolonged use)
Uveitis
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: Dexamethasone phosphate 1mg/ml, eye drops, solution in single-dose container. Kent Pharma (UK) Ltd. Revised June 2020.
Summary of Product Characteristics: Dexafree 1mg/ml, eye drops, solution in single-dose container. Thea Pharmaceuticals Ltd. Revised August 2018.
Summary of Product Characteristics: Dropodex 0.1% w/v Eye Drops, solution. Rayner Pharmaceuticals Ltd. Revised August 2022.
Summary of Product Characteristics: Eythalm 1mg/ml eye drops, solution. Aspire Pharma Ltd. Revised September 2021.
Summary of Product Characteristics: Minims Dexamethasone sodium phosphate 0.1% w/v eye drops. Bausch & Lomb U.K. Ltd. Revised October 2022.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 21 October 2022
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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.