dexamethasone ophthalmic (Rx)

Brand and Other Names:Maxidex
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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

Glaucoma, epithelial defect

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

Mycobacterial infection of eye, fungal diseases

Cautions

Avoid prolonged treatment, if possible, because of the ocular side effects of glaucoma, secondary infection (herpes simplex), cataract formations, etc

May mask infection or enhance existing infection

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

Contact lenses should not be worn during treatment of ophthalmic infections

Perforations may occur in diseases that cause thinning of the cornea or sclera

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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
Maxidex ophthalmic (eye)
-
0.1 % drops
Decadron oral
-
0.5 mg tablet
Decadron oral
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4 mg tablet
Decadron oral
-
0.75 mg tablet
Dxevo oral
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1.5 mg (39 tabs) tablet
HiDex oral
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1.5 mg (21 tabs) tablet
Dexabliss oral
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1.5 mg (39 tabs) tablet
TaperDex oral
-
1.5 mg (49 tabs) tablet
TaperDex oral
-
1.5 mg (21 tabs) tablet
TaperDex oral
-
1.5 mg (27 tabs) tablet
dexamethasone oral
-
0.5 mg/5 mL solution
dexamethasone oral
-
4 mg tablet
dexamethasone oral
-
0.5 mg tablet
dexamethasone oral
-
1 mg tablet
dexamethasone oral
-
2 mg tablet
dexamethasone oral
-
6 mg tablet
dexamethasone oral
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4 mg tablet
dexamethasone oral
-
1.5 mg tablet
dexamethasone oral
-
1.5 mg (51 tabs) tablet
dexamethasone oral
-
1.5 mg (35 tabs) tablet
dexamethasone oral
-
1.5 mg (21 tabs) tablet
dexamethasone oral
-
1.5 mg tablet
dexamethasone oral
-
0.75 mg tablet
dexamethasone oral
-
0.75 mg tablet
dexamethasone oral
-
0.5 mg/5 mL elixir
dexamethasone oral
-
0.5 mg/5 mL elixir
dexamethasone oral
-
0.5 mg/5 mL elixir
dexamethasone oral
-
0.5 mg/5 mL solution
dexamethasone oral
-
6 mg tablet
dexamethasone oral
-
0.5 mg tablet
dexamethasone oral
-
4 mg tablet
dexamethasone oral
-
4 mg tablet
Dexamethasone Intensol oral
-
1 mg/mL drops

Copyright © 2010 First DataBank, Inc.

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Patient Handout

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Patient Education
dexamethasone oral

DEXAMETHASONE 20 MG - ORAL

(DEX-a-METH-a-sone)

COMMON BRAND NAME(S): Hemady

USES: This medication is used in combination with other drugs to treat a certain type of cancer (multiple myeloma). Dexamethasone belongs to a class of drugs known as corticosteroids. It is used to help your immune system control inflammation in your body. It may also be used to reduce the risk of nausea and vomiting caused by cancer chemotherapy.

HOW TO USE: Take this medication by mouth with or without food as directed by your doctor, usually once daily on specific days, depending on your treatment schedule. Take this medication with a full glass of water (8 ounces/240 milliliters) unless your doctor directs you otherwise. The dosage and schedule are based on your medical condition and response to treatment.Use this medication regularly to get the most benefit from it. To help you remember, take it at the same time each scheduled day. Carefully follow your dosing schedule. To help you remember, it may help to mark your calendar with a reminder.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.

SIDE EFFECTS: Stomach upset, headache, or trouble sleeping 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, chills, cough), bone pain, easy bruising/bleeding, unusual weight gain, puffy face, mental/mood changes (such as depression, mood swings, agitation), menstrual period changes, slow wound healing, thinning skin, vision problems, muscle pain/tenderness/weakness.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.This medication may rarely cause blood clots (such as pulmonary embolism, stroke, heart attack, deep vein thrombosis). You may be at increased risk for blood clots if you have a history of blood clots, heart/blood vessel disease, heart failure, stroke, if you are pregnant, or if you are immobile (such as on very long plane flights or being bedridden). If you use estrogen-containing products, these may also increase your risk. Before using this medication, if you have any of these conditions report them to your doctor or pharmacist. Get medical help right away if any of these side effects occur: shortness of breath/rapid breathing, chest/jaw/left arm pain, unusual sweating, confusion, sudden dizziness/fainting, pain/swelling/warmth in the groin/calf, sudden/severe headaches, trouble speaking, weakness on one side of the body, sudden vision changes.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 infections), high blood pressure, heart problems (such as heart failure, recent heart attack), 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), diabetes, eye problems (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.Dexamethasone can make you more likely to get infections or may worsen any current infections. Avoid contact with people who have infections that may spread to others (such as chickenpox, measles, flu). Consult your doctor if you have been exposed to an infection or for more details.Do not have immunizations/vaccinations without the consent of your doctor. Avoid contact with people who have recently received live vaccines (such as flu vaccine inhaled through the nose).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.Before having surgery, tell your doctor or dentist about all the products you use (including prescription drugs, nonprescription drugs, and herbal products).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. Your doctor may order a pregnancy test before starting this medication. Women of childbearing age should ask about reliable forms of birth control while using this medication and for at least 1 month after the last dose. Infants born to mothers who have been using this medication for a long 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. Because of the possible risk to the infant, breast-feeding while using this drug and for at least 2 weeks after the last dose is not recommended. 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 are: drugs that can cause bleeding/bruising (including antiplatelet drugs such as clopidogrel, NSAIDs such as ibuprofen/naproxen, "blood thinners" such as warfarin/dabigatran), 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 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 (such as 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.Lab and/or medical tests (such as blood mineral levels, blood sugar, complete blood count, bone density, blood pressure, eye exams) should be done while you are taking this medication. Keep all medical and lab appointments.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: It is important to take each dose of this medication as scheduled. If you miss a dose, ask your doctor or pharmacist right away for a new dosing schedule.

STORAGE: Store at room temperature away from light and moisture. Do not store in the bathroom. 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 August 2021. Copyright(c) 2021 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

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