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dexamethasone ophthalmic (Rx)Brand and Other Names:Maxidex

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ointment

  • 0.05%

ophthalmic solution/suspension

  • 0.1%
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Inflammatory Ocular Conditions

1-2 gtt q1hr during day and q2hr at night, THEN

Decrease to 1 gtt q4hr, THEN

Decrease to 1 gtt TID-QID

See Also Combo

With tobramycin (TobraDex)

With neomycin

Other Indications & Uses

Potent corticosteroid indicated for many ocular conditions: Iritis, uveitis, keratitis, etc; it is essential for proper monitoring of patients while on steroid eye drops

Safety and efficacy not established

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Adverse Effects

>10%

Raised intraocular pressure (25% )

1-10%

Cataract (4% )

Ocular hypertension

Open-angle glaucoma, optic nerve damage, and defects in visual acuity and field of vision (after prolonged use)

<1%

Transient ocular stinging, burning, local irritation, ocular discharge, ocular discomfort or pain, foreign body sensation, hyperemia, abnormal vision/blurring, pruritus, lid margin crusting, sticky sensation, increased fibrin, dry eye, conjunctival edema, corneal staining, keratitis, tearing, edema, irritation, corneal ulcer, browache, eyelid erythema, corneal edema, infiltrate, corneal erosion, mydriasis, ptosis, epithelial punctate keratitis, and possible corneal or scleral malacia, [posterior subcapsular cataracts] (prolonged use)

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Warnings

Contraindications

Hypersensitivity

Glaucoma, epithelial defect, epithelial herpes simplex keratitis, acute infectious stages of vaccinia, varicella, and other diseases of cornea & conjunctiva

Mycobacterial infection of eye, fungal diseases

Cautions

Short term treatment is best, if possible, because of the ocular side effects of glaucoma, secondary infection (herpes simplex), cataract formations, etc

Reduce to lowest dose, use suspension last, wait 5min between gtts if using multiple drugs

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Pregnancy & Lactation

Pregnancy Category: C

Lactation: excretion in milk unknown/not recommended

Pregnancy Categories

A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA:Information not available.

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Pharmacology

Absorbed: into the aqueous humor and systemic

Excretion: kidney

Mechanism of Action

Inhibits the inflammatory response to mechanical, chemical, or immunologic agents

Corticosteroids inhibit edema, fibrin deposition, capillary dilatation, and migration of leukocytes and phagocytes in the acute inflammatory response

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Images

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Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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