Dexamethason – composition, action, dosage, contraindications

Dexamethason is eye drops that are used topically when inflammation occurs. The active substance in Dexamethason is dexamethasone, a medicine that belongs to the group of corticosteroids. Dexamethason is a prescription medicine.

Dexamethason – composition

Dexamethason is a drug that is produced in the form of drops. The active ingredient in Dexamethason is dexamethasonewhich can also be found in many other preparations, but mostly in the form of tablets. We can also find benzalkonium chloride in them.

Dexamethason is applied topically. Its active substance belongs to synthetic glucocorticosteroids, therefore it has antiallergic, anti-inflammatory and antipruritic properties. For this reason, Dexamethason is a drug that can be used at any stage of the inflammatory process. Dexamethason works by reducing the permeability of blood vessels. In addition, the drug also reduces leukocyte migration and increases antibody production.

Dexamethason – action

Dexamethason eye drops are used in acute inflammation of the eye caused by allergies. Dexamethason is also prescribed to patients who have undergone surgery involving an interference with the eyeball or in the case of injuries associated with piercing the eyeball. Treatment with Dexamethason eye drops is also justified in the treatment of thermal and chemical burns of the eyeball.

The action of Dexamethason is based on the properties of dexamethasone, which has anti-inflammatory and anti-allergic properties. Dexamethason also has anti-itching and anti-swelling properties. It is worth remembering that Dexamethason eye drops do not treat the causes of inflammation, they only counteract its symptoms. Dexamethason eye drops administered topically are absorbed into the aqueous humor, iris, cornea, choroid, ciliary body, and also the retina. The level of absorption of Dexamethason eye drops is influenced by the degree of damage or irritation to the corneal epithelium.

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Dexamethason – indications

Dexamethason drops are used to treat eye inflammation. The indication for the use of Dexamethason is diagnosed inflammation of the conjunctiva, cornea or anterior segment of the eye. The effectiveness of Dexamethason drops depends on whether the factors causing inflammation react properly to the administration of the active substance.

The indications for administering Dexamethason drops are:

  1. uveitis;
  2. iris inflammation;
  3. inflammation of the ciliary body;
  4. spring conjunctivitis;
  5. allergic conjunctivitis;
  6. inflammation of the cornea caused by shingles.

In addition, Dexamethason can also be used to treat damage to the cornea resulting from chemical, heat or radiation burns. The drops can also be used by patients who have had foreign body damage to the surface of the eye.

The indication for the use of Dexamethason drops is the treatment of postoperative patients in order to reduce inflammation, as well as to prevent transplant rejection. The drug can be given to children over 2 years of age, adolescents and adults.

Dexamethason – doses

The dosage of Dexamethason is determined by the doctor, based on the severity of symptoms and the indication for treatment. Dexamethason eye drops doses depend on the patient’s age. In adults, the daily dose is usually from 0,5 mg to 10 mg, depending on the type of disease. It is recommended to gradually reduce the dose with the achievement of the desired effects, until the lowest effective dose is obtained.

After dropping the drops into the conjunctival sac, press the nasolacrimal canal and close the eyelid, which will reduce the systemic absorption of Dexamethason. Such action minimizes the risk of side effects.

In people with an acute course of inflammation, 1 to 2 drops of the preparation are most often prescribed. The drops should be placed directly into the conjunctival sac every 30 to 60 minutes. The high frequency of Dexamethason instillations is maintained until the patient’s condition clearly improves. If treatment is unsuccessful, treatment should be changed and the administration of subconjunctival or systemic steroids should be started.

The doses of Dexamethason eye drops in children depend on the body weight of the little patient. It is assumed that per kilogram of body weight, a child should receive 0,01 mg to 0,1 mg daily.

It should be remembered that Dexamethason eye drops are a prescription drug and the doses are selected by the treating physician individually for each patient. Dexamethason eye drops should not be used without medical consultation as they may cause unwanted side effects.

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Dexamethason – contraindications

Dexamethason eye drops should not be used in the presence of certain diseases or other circumstances that may raise doubts by the treating physician. Dexamethason cannot be used over contact lenses, and you can put them back in 30 minutes after putting the medicine in your eye.

The use of Dexamethason during pregnancy is allowed only if the doctor considers the use of the preparation absolutely necessary after considering the expected benefits and possible risks. Do not use during breastfeeding. There are insufficient data on the safety of the drug during breastfeeding.

There is no information on whether the active ingredient of Dexamethason passes into breast milk. Therefore, when treatment with drops is necessary, breast-feeding should be discontinued, if the analysis of the benefits of treatment and the risks associated with discontinuation of breast-feeding shows it. There are no data on the safety of use in children under 2 years of age.

The main contraindication to the use of Dexamethason is allergy, i.e. hypersensitivity to any component of the drug. In addition, a contraindication to the use of Dexamethason is another disease state of the body. The exclusion of the possibility of administering drops is, among others:

  1. Chickenpox;
  2. cow pox;
  3. viral diseases of the cornea and conjunctiva (except herpetic keratitis).

Dexamethason drops are also not recommended for people with herpetic keratitis, with an eye infection with a fungal basis, and in infections caused by Mycobacteriae. Irrigation of the eyes is also not recommended in the case of untreated acute eye infections with the presence of pus.

Certain patient groups should be especially careful. First of all, if the causes of eye redness are not known, the preparation is not recommended. In addition, corticosteroids, which are used for a long time, can lead to increased eye pressure, glaucoma and even damage to the optic nerve, deterioration of vision and visual field.

Due to the risks associated with long-term treatment, the intraocular pressure and lens condition should be measured regularly. These checks are of particular importance for children and adolescents, as these two groups of patients are particularly prone to ocular hypertension as a result of the administration of corticosteroids.

Diabetes is another group of patients who need to be especially careful. Treatment with Dexamethason drops for more than 7 days should be under the supervision of an ophthalmologist.

Long-term use of Dexamethason eye drops increases the patient’s susceptibility to eye infections due to fungal, bacterial and viral background. People under treatment with Dexamethason should remain under the constant care of an ophthalmologist and perform tests to measure the pressure inside the eyeball, the condition of the lens and the cornea.

Dexamethason eye drops should not be used just before driving or operating machinery.

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Dexamethason – interactions with other drugs

When using Dexamethason, it is necessary to exercise particular caution when taking certain medications. NSAIDs taken concomitantly may adversely affect the healing of the cornea. You should also be careful if you are treated concomitantly with CYP3A4 inhibitors, which in turn may increase the effect of Dexamethason drops, and also lead to the development of Cushing’s disease by suppressing the function of the adrenal glands.

Moreover, the combination of the aforementioned drugs may increase the risk of the appearance of undesirable systemic effects, therefore, patient observation is recommended. However, if a patient requires instillation of several different preparations into the conjunctival sac, remember about a 5-minute interval between the next instillation. Eye ointments should be used last. Tearing may appear after Dexamethason is instilled in the eyes.

Dexamethason – interaction with alcohol

Unfortunately, there are no conclusive data regarding interaction of Dexamethason drops with alcoholtherefore, it cannot be concluded whether there is an interaction between the drug and alcohol. At the same time, it should be borne in mind that any drug in combination with alcohol may cause side effects or interfere with its operation.

Dexamethason – side effects

Dexamethason, like all medicines, may cause certain side effects in certain groups of patients. The most commonly reported side effects include eye discomfort. In addition, there are also taste disturbances and inflammation of the conjunctiva, cornea, photophobia, itching in the eye, dry keratoconjunctivitis, visual acuity disturbances and corneal discoloration.

Some patients also reported a foreign body sensation in the eye, increased tearing, scabs on the edges of the eyelids, hyperemia, and eye irritation. Some people have had corneal ulceration, drooping eyelid, eye pain, and dilated pupils. Patients also report general side effects such as hypersensitivity, headache and dizziness, adrenal arrest and Cushing’s syndrome.

How often side effects occur depends on the time for which Dexamethason drops were applied to the eye. Remember that long-term use of the drops is dangerous to the patient’s eyesight and may lead to an increase in intraocular negative pressure.

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