Dexaguard Eye Drop

Indications

Ocular Uses:
Dexaguard is designed for the management of acute purulent conjunctivitis and fresh inflammation of the superficial and deeper layers of the cornea, including corneal ulcers. It is effective for treating keratitis disciformis and more severe forms of post-herpetic keratitis. Additionally, it addresses allergic conjunctivitis, allergic blepharitis, acute and chronic iritis, chronic anterior uveitis, and corneal injuries due to chemical, radiation, or thermal burns, as well as foreign body penetration. This combination is particularly useful for steroid-responsive inflammatory ocular conditions where corticosteroids are indicated, especially when there is a bacterial infection or a risk of bacterial ocular infection. Dexaguard is also utilized for managing post-operative inflammation and any ocular inflammation associated with infections.

Aural Uses:
In the ear, Dexaguard is indicated for otitis externa, otitis media, and chronic suppurative otitis media.

Pharmacology

Dexamethasone:
As a glucocorticoid, dexamethasone possesses anti-inflammatory and anti-allergic properties. It is applied topically for inflammatory conditions affecting the anterior segment of the eye. Following oral administration, dexamethasone is rapidly absorbed, with a half-life of approximately 190 minutes. Topical application may lead to systemic effects due to sufficient absorption through the skin and eye.

Chloramphenicol:
Chloramphenicol is a broad-spectrum bacteriostatic antibiotic effective against various gram-negative and gram-positive organisms. It acts by binding to bacterial ribosomes and inhibiting protein synthesis early in the process, thereby exerting its antibacterial effects.

Dosage & Administration

Ocular Dosage:

• Bacterial Conjunctivitis: Instill 1 to 2 drops into the conjunctival sac every 2 hours for the first 2 days, then reduce to 1 or 2 drops every 4 hours for the following 5 days while awake.
• Corneal Ulcers: For corneal ulcers, administer 2 drops into the affected eye(s) every 15 minutes for the first 6 hours, followed by 2 drops every 30 minutes for the remainder of the first day. On the second day, continue with 2 drops hourly in the affected eye(s). For days 3 to 14, instill 2 drops every 4 hours. If corneal re-epithelialization has not occurred after 14 days, treatment may continue.

Aural Dosage:
For all ear infections, begin with 2 to 3 drops every 2 to 3 hours initially. Gradually reduce frequency as clinical signs improve. Avoid prematurely discontinuing therapy.

Note: Always follow the doctor’s advice regarding medication use.

Interaction

Chloramphenicol may enhance the effects of anticoagulants like warfarin if absorbed from the eye. Simultaneous use with phenobarbital can inhibit Chloramphenicol’s action. The effectiveness of dexamethasone may be diminished when taken alongside phenytoin, phenobarbital, ephedrine, and rifampicin.

Contraindications

This combination should not be used in cases of epithelial herpes simplex keratitis, fungal, viral, or tuberculous infections of the eye, and in patients with glaucoma. Prior myelosuppression due to Chloramphenicol, as well as hypersensitivity to Chloramphenicol, Dexamethasone Phosphate, or any other ingredients, are also contraindications.

Side Effects

Common side effects associated with Chloramphenicol may include transient ocular burning or discomfort, stinging, redness, itching, conjunctivitis, foreign body sensation, photophobia, blurred vision, dryness, and eye pain. Allergic sensitization can occur with local Chloramphenicol use. Potential side effects also include elevated intraocular pressure, which may lead to glaucoma, and infrequent optic nerve damage or posterior subcapsular cataract formation.

Pregnancy & Lactation

Currently, there are no adequate and well-controlled studies in pregnant women. Use during pregnancy should be considered only when the potential benefits outweigh the risks to the fetus. Caution is advised when administering Chloramphenicol and Dexamethasone ophthalmic solutions to nursing mothers.

Precautions & Warnings

Be aware of the risk of persistent fungal infections of the cornea following prolonged corticosteroid use. Extended use of steroid-containing products can lead to posterior subcapsular cataract formation and glaucoma, potentially causing optic nerve damage. Regular monitoring of intraocular pressure is essential. Prolonged antibiotic use may result in the overgrowth of non-susceptible organisms, including fungi. If new infections arise during treatment, discontinue the drug and seek alternative therapy.

Therapeutic Class

Combined ophthalmic steroid-antibiotic preparations.

Storage Conditions

Store in a cool, dry place away from light and out of reach of children. Discard 30 days after the first opening.