Drug Detail:Dexamethasone (intraocular) (Dexamethasone (intraocular) [ dex-a-meth-a-sone ])
Drug Class: Ophthalmic steroids
Usual Adult Dose for Iritis
Suspension: Instill one or two drops topically in the conjunctival sac(s).
Comments:
- In severe disease, drops may be used hourly, being tapered to discontinuation as the inflammation decreases.
- In mild disease, drops may be used up to four to six times a day, being tapered to discontinuation as the inflammation decreases.
Ointment: Apply a one-half to one inch ribbon of ointment into the conjunctival sac(s) up to four times a day
Comments:
- When improvement is observed, use may be reduced gradually to once a day application for several days.
- Ointment may be used in conjunction with suspension.
Uses:
- Steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe (including allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivities, corneal injury from chemical or thermal burns, or penetration of foreign bodies)
Usual Adult Dose for Keratitis
Suspension: Instill one or two drops topically in the conjunctival sac(s).
Comments:
- In severe disease, drops may be used hourly, being tapered to discontinuation as the inflammation decreases.
- In mild disease, drops may be used up to four to six times a day, being tapered to discontinuation as the inflammation decreases.
Ointment: Apply a one-half to one inch ribbon of ointment into the conjunctival sac(s) up to four times a day
Comments:
- When improvement is observed, use may be reduced gradually to once a day application for several days.
- Ointment may be used in conjunction with suspension.
Uses:
- Steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe (including allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivities, corneal injury from chemical or thermal burns, or penetration of foreign bodies)
Usual Adult Dose for Conjunctivitis
Suspension: Instill one or two drops topically in the conjunctival sac(s).
Comments:
- In severe disease, drops may be used hourly, being tapered to discontinuation as the inflammation decreases.
- In mild disease, drops may be used up to four to six times a day, being tapered to discontinuation as the inflammation decreases.
Ointment: Apply a one-half to one inch ribbon of ointment into the conjunctival sac(s) up to four times a day
Comments:
- When improvement is observed, use may be reduced gradually to once a day application for several days.
- Ointment may be used in conjunction with suspension.
Uses:
- Steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe (including allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivities, corneal injury from chemical or thermal burns, or penetration of foreign bodies)
Usual Adult Dose for Cyclitis
Suspension: Instill one or two drops topically in the conjunctival sac(s).
Comments:
- In severe disease, drops may be used hourly, being tapered to discontinuation as the inflammation decreases.
- In mild disease, drops may be used up to four to six times a day, being tapered to discontinuation as the inflammation decreases.
Ointment: Apply a one-half to one inch ribbon of ointment into the conjunctival sac(s) up to four times a day
Comments:
- When improvement is observed, use may be reduced gradually to once a day application for several days.
- Ointment may be used in conjunction with suspension.
Uses:
- Steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe (including allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivities, corneal injury from chemical or thermal burns, or penetration of foreign bodies)
Usual Adult Dose for Uveitis
One implant, containing 0.7 mg of dexamethasone, to be surgically injected into the vitreous cavity of the affected eye
Comments:
- Following the intravitreal injection, patients should be monitored for elevation in intraocular pressure and for endophthalmitis.
Uses: Treatment of macular edema following branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO), non-infectious uveitis affecting the posterior segment of the eye, and diabetic macular edema
Usual Adult Dose for Macular Edema
One implant, containing 0.7 mg of dexamethasone, to be surgically injected into the vitreous cavity of the affected eye
Comments:
- Following the intravitreal injection, patients should be monitored for elevation in intraocular pressure and for endophthalmitis.
Uses: Treatment of macular edema following branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO), non-infectious uveitis affecting the posterior segment of the eye, and diabetic macular edema
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Precautions
Safety and efficacy have not been established in patients younger than 18 years.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- The manufacturer product information should be consulted.
Monitoring:
- Ocular: Elevation in intraocular pressure and endophthalmitis following intravitreal injection by checking for perfusion of the optic nerve head immediately after injection, tonometry within 30 minutes following injection, and biomicroscopy between two and seven days following injection.
Patient advice:
- Patients may experience temporary visual burning after receiving an intravitreal injection and should not drive or use machinery until symptoms have been resolved.
- Patients should be instructed to report any symptoms suggestive of endophthalmitis without delay.
- Patients should be instructed not to touch the tip of the dropper or ointment directly to the eye.