dexamethasone ophthalmic (Rx)

Brand and Other Names:Maxidex

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic suspension

  • 0.1% (Maxidex)

ophthalmic solution

  • 0.1% (various generics)

Inflammatory Ocular Conditions

Mild disease: Instill 1-2 gtt in conjunctival sac(s) q4-6hr; taper frequency as symptoms subside

Severe disease: Instill 1-2 gtt(s) in conjunctival sac(s); may use hourly, and then tapered to discontinue as the inflammation subsides

Indications

  • Steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe (eg, allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivitides when the inherent hazard of steroid use is accepted to obtain an advisable diminution in edema and inflammation)
  • Corneal injury from chemical, radiation, thermal burns, or foreign body penetration

Dosage Forms & Strengths

ophthalmic suspension

  • 0.1% (Maxidex)

ophthalmic solution

  • 0.1% (various generics)

Inflammatory Ocular Conditions

Mild disease: Instill 1-2 gtt in conjunctival sac(s) q4-6hr; taper frequency as symptoms subside

Severe disease: Instill 1-2 gtt(s) in conjunctival sac(s); may use hourly, and then tapered to discontinue as the inflammation subsides

Indications

  • Steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe (eg, allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivitides when the inherent hazard of steroid use is accepted to obtain an advisable diminution in edema and inflammation)
  • Corneal injury from chemical, radiation, thermal burns, or foreign body penetration
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Adverse Effects

Frequency Not Defined

Cataract

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)

Postmarketing Reports

Cushing’s syndrome and adrenal suppression (after use in excess of listed dosing instructions in predisposed patients, including children and patients treated with CYP3A4 inhibitors)

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Warnings

Contraindications

Hypersensitivity

Viral diseases including epithelial herpes simplex keratitis, acute infectious stages of vaccinia, varicella, and most other viral diseases of the cornea and conjunctiva

Mycobacterial infection of eye

Fungal disease of ocular structures

Cautions

Prolonged use may result in ocular hypertension and/or glaucoma, with damage to the optic nerve, defects in visual acuity and fields of vision, and posterior subcapsular cataract formation; prolonged use may suppress the host response and thus increase the hazard of secondary ocular infections

In acute purulent conditions or parasitic infections of the eye, corticosteroids may make infection or enhance existing infections; in those diseases causing thinning of the cornea or sclera, perforations have been known to occur with the use of topical corticosteroids

If these products are used for 10 days or longer, intraocular pressure (IOP) should be routinely monitored even though it may be difficult in children and uncooperative patients; employment of corticosteroid medication in the treatment of herpes simplex other than epithelial herpes simplex keratitis, in which it is contraindicated, requires great caution; periodic slit-lamp microscopy is essential

The possibility of persistent fungal infections of cornea should be considered after prolonged corticosteroid dosing

The initial prescription and renewal of the medication order should be made by a physician only after examination of the patient with aid of magnification, such as slit-lamp biomicroscopy and, where appropriate, fluorescein staining; if signs and symptoms fail to improve after 2 days, the patient should be re-evaluated

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Pregnancy & Lactation

Pregnancy

There are no adequate or well-controlled studies in pregnant women; should be used during pregnancy only if the potential benefit to the mother justifies the potential risk to the embryo or fetus

However, prolonged or repeated corticoid use during pregnancy has been associated with an increased risk of intra-uterine growth retardation

Animal studies

  • Dexamethasone has been shown to be teratogenic in mice and rabbits following topical ophthalmic application in multiples of the therapeutic dose In mice, corticosteroids produce fetal resorptions and a specific abnormality, cleft palate
  • In rabbits, corticosteroids have produced fetal resorptions and multiple abnormalities involving the head, ears, limbs, and palate

Lactation

Systemically administered corticosteroids appear in human milk and could suppress growth, interfere with endogenous corticosteroid production, or cause other untoward effects

Unknown whether topical administration of corticosteroids could result in sufficient systemic absorption to produce detectable quantities in human milk

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

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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Administration

Ophthalmic Administration

Suspension: Shake well before using

Instill 1-2 gtt in conjunctival sac(s)

Storage

Store upright at 8-25°C (46-77°F)

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Images

BRAND FORM. UNIT PRICE PILL IMAGE
Dexamethasone Intensol oral
-
1 mg/mL drops
Maxidex ophthalmic (eye)
-
0.1 % drops
dexamethasone oral
-
4 mg tablet
dexamethasone oral
-
0.75 mg tablet
dexamethasone oral
-
4 mg tablet
dexamethasone oral
-
2 mg tablet
dexamethasone oral
-
1.5 mg (51 tabs) tablet
dexamethasone oral
-
1.5 mg (35 tabs) tablet
dexamethasone oral
-
1.5 mg tablet
dexamethasone oral
-
1.5 mg tablet
dexamethasone oral
-
4 mg tablet
dexamethasone oral
-
0.5 mg/5 mL elixir
dexamethasone oral
-
0.5 mg/5 mL elixir
dexamethasone oral
-
6 mg tablet
dexamethasone oral
-
0.75 mg tablet
dexamethasone oral
-
2 mg tablet
dexamethasone oral
-
4 mg tablet
dexamethasone oral
-
2 mg tablet
dexamethasone oral
-
6 mg tablet
dexamethasone oral
-
1 mg tablet
dexamethasone oral
-
4 mg tablet
dexamethasone oral
-
0.5 mg tablet
dexamethasone oral
-
2 mg tablet
dexamethasone oral
-
0.5 mg/5 mL elixir
dexamethasone oral
-
0.5 mg tablet
dexamethasone oral
-
4 mg tablet
dexamethasone oral
-
4 mg tablet
dexamethasone oral
-
1.5 mg (21 tabs) tablet
dexamethasone oral
-
0.5 mg/5 mL solution
dexamethasone oral
-
0.5 mg/5 mL solution
TaperDex oral
-
1.5 mg (21 tabs) tablet
TaperDex oral
-
1.5 mg (49 tabs) tablet
TaperDex oral
-
1.5 mg (27 tabs) tablet
ZCort oral
-
1.5 mg (25 tabs) tablet
Dexabliss oral
-
1.5 mg (39 tabs) tablet

Copyright © 2010 First DataBank, Inc.

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Patient Handout

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Patient Education
dexamethasone oral

DEXAMETHASONE CONCENTRATE SOLUTION - ORAL

(dex-uh-METH-uh-sown)

COMMON BRAND NAME(S): Dexamethasone Intensol

USES: Dexamethasone is used to treat conditions such as arthritis, blood/hormone disorders, allergic reactions, skin diseases, eye problems, breathing problems, bowel disorders, cancer, and immune system disorders. It is also used as a test for an adrenal gland disorder (Cushing's syndrome).Dexamethasone belongs to a class of drugs known as corticosteroids. It decreases your immune system's response to various diseases to reduce symptoms such as swelling and allergic-type reactions.

HOW TO USE: Take this medication by mouth as directed by your doctor. Take with food or milk to prevent stomach upset.Before using this medication, check the liquid for particles. Do not use this medication if it contains any particles.Use only the dropper provided with the product. Draw the prescribed amount of the medication into the dropper, and then squeeze into liquid (such as water, juice, soda) or semi-solid food (such as applesauce, pudding). Stir the liquid or food gently for a few seconds. Take the entire amount of the drug and liquid/food mixture by mouth right away. Do not save for later.If you take this medication once daily, take it in the morning before 9 AM. If you are taking this medication every other day or on another schedule besides a daily one, it may help to mark your calendar with a reminder.The dosage and length of treatment are based on your medical condition and response to treatment. Take this medication exactly as prescribed. Follow the dosing schedule carefully. Your doctor may attempt to reduce your dose slowly from time to time to minimize side effects.Do not stop taking this medication without consulting your doctor. Some conditions may become worse when this drug is suddenly stopped. Also, you may experience symptoms such as nausea, dizziness, weakness, or muscle/joint pain. To prevent these symptoms while you are stopping treatment with this drug, your doctor may reduce your dose gradually. Consult your doctor or pharmacist for more details. Report any new or worsening symptoms right away.Tell your doctor if your condition does not improve or if it worsens.

SIDE EFFECTS: Stomach upset, heartburn, headache, trouble sleeping, or increased appetite may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly.Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.Tell your doctor right away if you have any serious side effects, including: signs of infection (such as sore throat that doesn't go away, fever), bone/joint pain, fast/slow/irregular heartbeat, eye pain/pressure, vision problems, unusual weight gain, puffy face, swelling of the ankles/feet, symptoms of stomach/intestinal bleeding (such as stomach/abdominal pain, black/tarry stools, vomit that looks like coffee grounds), mental/mood changes (such as depression, mood swings, agitation), menstrual period changes, muscle pain/cramps, weakness, easy bruising/bleeding, slow wound healing, thinning skin, seizures.This medication may rarely make your blood sugar rise, which can cause or worsen diabetes. Tell your doctor right away if you have symptoms of high blood sugar such as increased thirst/urination. If you already have diabetes, check your blood sugar regularly as directed and share the results with your doctor. Your doctor may need to adjust your diabetes medication, exercise program, or diet.A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including: rash, itching/swelling (especially of the face/tongue/throat), severe dizziness, trouble breathing.This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

PRECAUTIONS: Before taking dexamethasone, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.Before using this medication, tell your doctor or pharmacist your medical history, especially of: infections (such as tuberculosis, herpes, fungal infection), kidney disease, liver disease, mental/mood disorders (such as psychosis, anxiety, depression), mineral imbalance (such as low level of potassium/calcium in the blood), thyroid disease, stomach/intestinal problems (such as ulcer, ulcerative colitis, diverticulitis, unexplained diarrhea), high blood pressure, heart problems (such as heart failure, recent heart attack), diabetes, eye diseases (such as cataracts, glaucoma), bone loss (osteoporosis), blood clots.Using corticosteroid medications for a long time can make it more difficult for your body to respond to physical stress. Before having surgery or emergency treatment, or if you get a serious illness/injury, tell your doctor or dentist that you are using this medication or have used this medication within the past 12 months. Tell your doctor right away if you develop unusual/extreme tiredness or weight loss. If you will be using this medication for a long time, carry a warning card or medical ID bracelet that identifies your use of this medication.This medication may mask signs of infection. It can make you more likely to get infections or may make current infections worse. Stay away from anyone who has an infection that may easily spread (such as chickenpox, COVID-19, measles, flu). Talk to your doctor if you have been exposed to an infection or for more details.This medicine may cause stomach bleeding. Daily use of alcohol while using this medicine may increase your risk for stomach bleeding. Limit alcoholic beverages. Consult your doctor or pharmacist for more information.Tell your health care professional that you are using dexamethasone before having any immunizations/vaccinations. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).This product contains alcohol. Caution is advised if you have alcohol dependence, liver disease, or any other condition that requires you to limit/avoid alcohol in your diet. Ask your doctor or pharmacist about using this product safely.Older adults may be more sensitive to the side effects of this drug, especially bone loss/pain, stomach/intestinal bleeding, and mental/mood changes (such as confusion).This medication may slow down a child's growth if used for a long time. Consult the doctor or pharmacist for more details. See the doctor regularly so your child's height and growth can be checked.During pregnancy, this medication should be used only when clearly needed. It may rarely harm an unborn baby. Discuss the risks and benefits with your doctor. Infants born to mothers who have been using this medication for an extended time may have hormone problems. Tell your doctor right away if you notice symptoms such as nausea/vomiting that doesn't stop, severe diarrhea, or weakness in your newborn.It is unknown if this medication passes into breast milk. Consult your doctor before breast- feeding.

DRUG INTERACTIONS: Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.Some products that may interact with this drug include: aldesleukin, drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, "blood thinners" such as dabigatran/warfarin, NSAIDs such as aspirin/celecoxib/ibuprofen), mifepristone.This medication can speed up the removal of other medications from your body, which may affect how they work. Examples of affected drugs include certain cancer drugs (such as dasatinib, lapatinib, sunitinib), praziquantel, rilpivirine, among others.If your doctor has directed you to take low-dose aspirin for heart attack or stroke prevention (usually 81-162 milligrams a day), you should continue taking it unless your doctor instructs you otherwise. Ask your doctor or pharmacist for more details.This medication may interfere with certain lab tests (including skin tests), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.

OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.

NOTES: Do not share this medication with others.If this medication is used for an extended time, lab and/or medical tests (such as blood mineral levels, blood glucose, complete blood count, bone density tests, blood pressure, eye exams) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.This medication may cause bone problems (osteoporosis) when taken for an extended time. Lifestyle changes that may help reduce the risk of bone problems include doing weight-bearing exercise, getting enough calcium and vitamin D, stopping smoking, and limiting alcohol. Discuss with your doctor lifestyle changes that might benefit you.

MISSED DOSE: If you are taking this medication daily and on a regular schedule, and you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.If you are taking this medication every other day or are slowly reducing your dose, and you miss a dose, then ask your doctor or pharmacist right away for a new dosing schedule.

STORAGE: Store at room temperature away from light and moisture. Do not freeze. Do not store in the bathroom. After the bottle has been opened, discard the medication after 90 days. Keep all medications away from children and pets.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.

MEDICAL ALERT: Your condition can cause complications in a medical emergency. For information about enrolling in MedicAlert, call 1-888-633-4298 (US) or 1-800-668-1507 (Canada).

Information last revised March 2023. Copyright(c) 2023 First Databank, Inc.

IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.

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Formulary

FormularyPatient Discounts

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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.
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Code Definition
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.