Drug Class: Ophthalmic steroids with anti-infectives
Usual Adult Dose for Uveitis
Ointment: Apply a small amount (about 1/2 inch) into the conjunctival sac of the affected eye(s) up to 3 or 4 times a day
Suspension: Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times a day; in severe disease, may be used hourly and tapered to discontinuation as inflammation subsides
Comments:
- A maximum of 20 mL of suspension or a maximum of 8 g of ointment should be prescribed initially and should not be refilled without further evaluation of the patient's condition.
- If signs/symptoms fail to improve after 2 days of treatment, the patient should be re-evaluated.
Uses:
- For the treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or risk of bacterial ocular infection exists
- Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation; also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns; or penetration of foreign bodies.
- The anti-infective component of this drug is active against the following common bacterial eye pathogens: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa; this drug does not provide adequate coverage against Serratia marcescens and Streptococci including S pneumoniae
Usual Adult Dose for Ocular Infection
Ointment: Apply a small amount (about 1/2 inch) into the conjunctival sac of the affected eye(s) up to 3 or 4 times a day
Suspension: Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times a day; in severe disease, may be used hourly and tapered to discontinuation as inflammation subsides
Comments:
- A maximum of 20 mL of suspension or a maximum of 8 g of ointment should be prescribed initially and should not be refilled without further evaluation of the patient's condition.
- If signs/symptoms fail to improve after 2 days of treatment, the patient should be re-evaluated.
Uses:
- For the treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or risk of bacterial ocular infection exists
- Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation; also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns; or penetration of foreign bodies.
- The anti-infective component of this drug is active against the following common bacterial eye pathogens: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa; this drug does not provide adequate coverage against Serratia marcescens and Streptococci including S pneumoniae
Usual Adult Dose for Bacterial Conjunctivitis
Ointment: Apply a small amount (about 1/2 inch) into the conjunctival sac of the affected eye(s) up to 3 or 4 times a day
Suspension: Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times a day; in severe disease, may be used hourly and tapered to discontinuation as inflammation subsides
Comments:
- A maximum of 20 mL of suspension or a maximum of 8 g of ointment should be prescribed initially and should not be refilled without further evaluation of the patient's condition.
- If signs/symptoms fail to improve after 2 days of treatment, the patient should be re-evaluated.
Uses:
- For the treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or risk of bacterial ocular infection exists
- Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation; also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns; or penetration of foreign bodies.
- The anti-infective component of this drug is active against the following common bacterial eye pathogens: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa; this drug does not provide adequate coverage against Serratia marcescens and Streptococci including S pneumoniae
Usual Adult Dose for Keratitis
Ointment: Apply a small amount (about 1/2 inch) into the conjunctival sac of the affected eye(s) up to 3 or 4 times a day
Suspension: Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times a day; in severe disease, may be used hourly and tapered to discontinuation as inflammation subsides
Comments:
- A maximum of 20 mL of suspension or a maximum of 8 g of ointment should be prescribed initially and should not be refilled without further evaluation of the patient's condition.
- If signs/symptoms fail to improve after 2 days of treatment, the patient should be re-evaluated.
Uses:
- For the treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or risk of bacterial ocular infection exists
- Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation; also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns; or penetration of foreign bodies.
- The anti-infective component of this drug is active against the following common bacterial eye pathogens: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa; this drug does not provide adequate coverage against Serratia marcescens and Streptococci including S pneumoniae
Usual Adult Dose for Keratoconjunctivitis
Ointment: Apply a small amount (about 1/2 inch) into the conjunctival sac of the affected eye(s) up to 3 or 4 times a day
Suspension: Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times a day; in severe disease, may be used hourly and tapered to discontinuation as inflammation subsides
Comments:
- A maximum of 20 mL of suspension or a maximum of 8 g of ointment should be prescribed initially and should not be refilled without further evaluation of the patient's condition.
- If signs/symptoms fail to improve after 2 days of treatment, the patient should be re-evaluated.
Uses:
- For the treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or risk of bacterial ocular infection exists
- Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation; also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns; or penetration of foreign bodies.
- The anti-infective component of this drug is active against the following common bacterial eye pathogens: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa; this drug does not provide adequate coverage against Serratia marcescens and Streptococci including S pneumoniae
Usual Adult Dose for Blepharitis
Ointment: Apply a small amount (about 1/2 inch) into the conjunctival sac of the affected eye(s) up to 3 or 4 times a day
Suspension: Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times a day; in severe disease, may be used hourly and tapered to discontinuation as inflammation subsides
Comments:
- A maximum of 20 mL of suspension or a maximum of 8 g of ointment should be prescribed initially and should not be refilled without further evaluation of the patient's condition.
- If signs/symptoms fail to improve after 2 days of treatment, the patient should be re-evaluated.
Uses:
- For the treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or risk of bacterial ocular infection exists
- Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation; also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns; or penetration of foreign bodies.
- The anti-infective component of this drug is active against the following common bacterial eye pathogens: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa; this drug does not provide adequate coverage against Serratia marcescens and Streptococci including S pneumoniae
Usual Pediatric Dose for Uveitis
2 years or older:
- Suspension: Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times a day; in severe disease, may be used hourly and tapered to discontinuation as inflammation subsides
Comments:
- A maximum of 20 mL of suspension should be prescribed initially and should not be refilled without further evaluation of the patient's condition.
- If signs/symptoms fail to improve after 2 days of treatment, the patient should be re-evaluated.
Uses:
- For the treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or risk of bacterial ocular infection exists
- Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation; also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns; or penetration of foreign bodies
- The anti-infective component of this drug is active against the following common bacterial eye pathogens: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa; this drug does not provide adequate coverage against Serratia marcescens and Streptococci including S pneumoniae
Usual Pediatric Dose for Ocular Infection
2 years or older:
- Suspension: Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times a day; in severe disease, may be used hourly and tapered to discontinuation as inflammation subsides
Comments:
- A maximum of 20 mL of suspension should be prescribed initially and should not be refilled without further evaluation of the patient's condition.
- If signs/symptoms fail to improve after 2 days of treatment, the patient should be re-evaluated.
Uses:
- For the treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or risk of bacterial ocular infection exists
- Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation; also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns; or penetration of foreign bodies
- The anti-infective component of this drug is active against the following common bacterial eye pathogens: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa; this drug does not provide adequate coverage against Serratia marcescens and Streptococci including S pneumoniae
Usual Pediatric Dose for Bacterial Conjunctivitis
2 years or older:
- Suspension: Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times a day; in severe disease, may be used hourly and tapered to discontinuation as inflammation subsides
Comments:
- A maximum of 20 mL of suspension should be prescribed initially and should not be refilled without further evaluation of the patient's condition.
- If signs/symptoms fail to improve after 2 days of treatment, the patient should be re-evaluated.
Uses:
- For the treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or risk of bacterial ocular infection exists
- Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation; also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns; or penetration of foreign bodies
- The anti-infective component of this drug is active against the following common bacterial eye pathogens: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa; this drug does not provide adequate coverage against Serratia marcescens and Streptococci including S pneumoniae
Usual Pediatric Dose for Keratitis
2 years or older:
- Suspension: Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times a day; in severe disease, may be used hourly and tapered to discontinuation as inflammation subsides
Comments:
- A maximum of 20 mL of suspension should be prescribed initially and should not be refilled without further evaluation of the patient's condition.
- If signs/symptoms fail to improve after 2 days of treatment, the patient should be re-evaluated.
Uses:
- For the treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or risk of bacterial ocular infection exists
- Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation; also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns; or penetration of foreign bodies
- The anti-infective component of this drug is active against the following common bacterial eye pathogens: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa; this drug does not provide adequate coverage against Serratia marcescens and Streptococci including S pneumoniae
Usual Pediatric Dose for Keratoconjunctivitis
2 years or older:
- Suspension: Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times a day; in severe disease, may be used hourly and tapered to discontinuation as inflammation subsides
Comments:
- A maximum of 20 mL of suspension should be prescribed initially and should not be refilled without further evaluation of the patient's condition.
- If signs/symptoms fail to improve after 2 days of treatment, the patient should be re-evaluated.
Uses:
- For the treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or risk of bacterial ocular infection exists
- Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation; also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns; or penetration of foreign bodies
- The anti-infective component of this drug is active against the following common bacterial eye pathogens: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa; this drug does not provide adequate coverage against Serratia marcescens and Streptococci including S pneumoniae
Usual Pediatric Dose for Blepharitis
2 years or older:
- Suspension: Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times a day; in severe disease, may be used hourly and tapered to discontinuation as inflammation subsides
Comments:
- A maximum of 20 mL of suspension should be prescribed initially and should not be refilled without further evaluation of the patient's condition.
- If signs/symptoms fail to improve after 2 days of treatment, the patient should be re-evaluated.
Uses:
- For the treatment of steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where bacterial infection or risk of bacterial ocular infection exists
- Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain a diminution in edema and inflammation; also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns; or penetration of foreign bodies
- The anti-infective component of this drug is active against the following common bacterial eye pathogens: Staphylococcus aureus, Escherichia coli, Haemophilus influenzae, Klebsiella/Enterobacter species, Neisseria species, and Pseudomonas aeruginosa; this drug does not provide adequate coverage against Serratia marcescens and Streptococci including S pneumoniae
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Precautions
Ophthalmic ointment: Safety and efficacy have not been established in patients younger than 18 years.
Ophthalmic suspension: Safety and efficacy have not been established in patients younger than 2 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- For topical ophthalmic use only.
- Suspension: Shake well before use.
Storage requirements:
- Ophthalmic suspension: Store upright; keep tightly closed.
Monitoring:
- Ocular: Monitor intraocular pressure frequently or routinely, especially if used for longer than 10 days.
Patient advice:
- Discontinue use and contact your physician if inflammation or pain persists for longer than 48 hours or becomes aggravated.
- Care should be taken to avoid touching the tip of the bottle to the eyelids or to any other surface.
- Use of the bottle by more than 1 person may spread infection and should be avoided.
- Vision may be temporarily blurred following administration and therefore care should be taken when operating heavy machinery, including driving a motor vehicle.
- To apply the ointment: Tilt your head back, place a finger on your cheek just under your eye and gently pull down until a "V" pocket is formed between your eyeball and your lower lid; place a small amount (about 1/2 inch) of ointment in the "V" pocket without letting the tip of the tube touch your eye and look downward before closing your eye.