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Netilmicin with dexamethasone ocular preservative-free


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

Drugs List

  • NETILDEX 3mg/ml + 1mg/ml eye drops preservative-free 0.3ml unit dose
  • netilmicin 3mg/ml and dexamethasone 1mg/ml eye drops preservative-free 0.3ml unit dose
  • Therapeutic Indications


    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.



    Instil 1 drop into the conjunctival sac 4 times daily in each affected eye, or according to medical prescription.

    Treatment duration can vary from 5 to 14 days.

    Systemic absorption is reduced when using nasolacrimal occlusion or closing the eyelids for 2 minutes. This may result in a decrease of systemic side effects and an increase in local activity.


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

    Precautions and Warnings

    Family history of 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


    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.


    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


    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: 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: Last accessed: 27 September 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.