Drugs List

Therapeutic Indications

Uses

Bacterial ocular infection: topical treatment

For the treatment of inflammatory ocular conditions of the anterior segment of the eye, including post-operative cases, where bacterial infection or risk of bacterial infection with netilmicin-susceptible microorganisms exists.

Contraindications

Children under 18 years
Breastfeeding
Herpetic keratitis
Intraocular hypertension
Mycobacterial eye infection
Ocular herpes simplex infection
Pregnancy

Precautions and Warnings

Family history of glaucoma
Glaucoma

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 viral infection before treatment
Administer other ophthalmic products at least 10 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
May cause perforation of eye in disorders that thin the sclera or cornea
May cause posterior subcapsular cataracts and glaucoma in long term use
Prolonged use may result in ocular infections
Treatment may adversely affect wound healing
Discontinue if hypersensitivity reactions occur
Advise patient to avoid touching the eye/other surfaces with container tip
Advise patient to consult physician if condition worsens / does not improve
Contact lenses should not be worn during treatment

Prolonged use may result in ocular hypertension/glaucoma with resultant damage to the optic nerve and defects in visual acuity and visual fields.

Routinely monitor intraocular pressure if treatment lasts longer than 15 days.

This product contains phosphates which may lead to corneal deposits or corneal opacity when topically administered. It should be used with caution in patients presenting with compromised cornea and in instances where the patient is receiving polypharmacy with other phosphate containing eye medications.

Pregnancy and Lactation

Pregnancy

Netilmicin with dexamethasone is contraindicated during pregnancy.

The manufacturer advises that it is preferable to avoid the use of netilmicin with dexamethasone during pregnancy. At the time of writing there is no clinical data regarding the use of netilmicin with dexamethasone in pregnant women. Animal studies have shown teratogen activity for dexamethasone.

Lactation

Netilmicin with dexamethasone is contraindicated during breastfeeding.

The manufacturer advises that netilmicin with dexamethasone should not be used during breastfeeding. There is insufficient information regarding the excretion of dexamethasone or netilmicin or their metabolites in human milk following ocular use. Effects on exposed infants are unknown. A risk to newborns/infants cannot be excluded.

Side Effects

Adrenal suppression
Blurred vision
Conjunctival hyperaemia
Corneal deposits
Cushing's syndrome
Impaired healing
Increased intra-ocular pressure
Ocular burning
Ocular itching
Ophthalmic herpes simplex
Posterior subcapsular cataracts

Presentation

Eye drops containing netilmicin and dexamethasone (preservative-free).

Drugs List

Therapeutic Indications

Uses

Bacterial ocular infection: topical treatment

For the treatment of inflammatory ocular conditions of the anterior segment of the eye, including post-operative cases, where bacterial infection or risk of bacterial infection with netilmicin-susceptible microorganisms exists.

Dosage

Adults

Contraindications

Children under 18 years
Breastfeeding
Herpetic keratitis
Intraocular hypertension
Mycobacterial eye infection
Ocular herpes simplex infection
Pregnancy

Precautions and Warnings

Family history of glaucoma
Glaucoma

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 viral infection before treatment
Administer other ophthalmic products at least 10 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
May cause perforation of eye in disorders that thin the sclera or cornea
May cause posterior subcapsular cataracts and glaucoma in long term use
Prolonged use may result in ocular infections
Treatment may adversely affect wound healing
Discontinue if hypersensitivity reactions occur
Advise patient to avoid touching the eye/other surfaces with container tip
Advise patient to consult physician if condition worsens / does not improve
Contact lenses should not be worn during treatment

Prolonged use may result in ocular hypertension/glaucoma with resultant damage to the optic nerve and defects in visual acuity and visual fields.

Routinely monitor intraocular pressure if treatment lasts longer than 15 days.

This product contains phosphates which may lead to corneal deposits or corneal opacity when topically administered. It should be used with caution in patients presenting with compromised cornea and in instances where the patient is receiving polypharmacy with other phosphate containing eye medications.

Pregnancy and Lactation

Pregnancy

Netilmicin with dexamethasone is contraindicated during pregnancy.

The manufacturer advises that it is preferable to avoid the use of netilmicin with dexamethasone during pregnancy. At the time of writing there is no clinical data regarding the use of netilmicin with dexamethasone in pregnant women. Animal studies have shown teratogen activity for dexamethasone.

Lactation

Netilmicin with dexamethasone is contraindicated during breastfeeding.

The manufacturer advises that netilmicin with dexamethasone should not be used during breastfeeding. There is insufficient information regarding the excretion of dexamethasone or netilmicin or their metabolites in human milk following ocular use. Effects on exposed infants are unknown. A risk to newborns/infants cannot be excluded.

Side Effects

Adrenal suppression
Blurred vision
Conjunctival hyperaemia
Corneal deposits
Cushing's syndrome
Impaired healing
Increased intra-ocular pressure
Ocular burning
Ocular itching
Ophthalmic herpes simplex
Posterior subcapsular cataracts

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: June 2022

Reference Sources

Summary of Product Characteristics: Netildex 3mg/ml and 1mg/ml eye drops. ParaPharm Development Limited. Revised March 2021.

NICE Evidence Services Available at: www.nice.org.uk Last accessed: 27 September 2022