Dextrobac Eye Drop – (0.1%+0.3%)

Indications

Dextrobac is prescribed for steroid-responsive inflammatory conditions of the eye, affecting the palpebral and bulbar conjunctiva, cornea, and the anterior segment of the globe, especially when accompanied by superficial bacterial infections. It is also effective in treating chronic anterior uveitis and corneal injuries caused by chemical burns, radiation, or foreign body penetration. The combination with an anti-infective agent is recommended when there is a heightened risk of superficial ocular infections.

Pharmacology

Similar to other aminoglycosides, Tobramycin exhibits bactericidal properties by specifically inhibiting protein synthesis in susceptible bacteria. Although the exact mechanism remains largely unexplored, it is believed that it disrupts ribosomal function, leading to errors in messenger RNA translation. Dexamethasone acts by inhibiting phospholipase A2, the initial step in prostaglandin synthesis, and reduces neutrophil infiltration at the inflammation site. This results in anti-inflammatory potency that is 25 times greater and overall therapeutic effectiveness that is 8-10 times superior to hydrocortisone.

Dosage & Administration

• Eye Drops: Instill 1 drop into the conjunctival sac 3-5 times daily. For the first 24 to 48 hours, the dosage may be increased to 1 drop every 2 hours.
• Eye Ointment: Apply a small amount into the conjunctival sac 3-4 times daily. Close your eyes gently without blinking and keep them shut for 1 to 2 minutes.
• Pediatric Use: The safety and efficacy of Dextrobac in children under 2 years have not been established. Always follow your physician’s guidance when using this medication.

Interactions

There are no specific interaction studies for Dextrobac eye drops. If using other topical ophthalmic medications concurrently, wait at least 10 minutes between applications.

Contraindications

Dextrobac should not be used in cases of epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella, and various other viral infections affecting the cornea and conjunctiva. It is also contraindicated in patients with mycobacterial eye infections or hypersensitivity to any ingredients in the formulation.

Side Effects

Common side effects associated with topical ocular Tobramycin include hypersensitivity reactions and localized ocular toxicity, such as eyelid itching, swelling, and conjunctival redness, occurring in less than 4% of patients. The steroid component may cause elevated intraocular pressure, potentially leading to glaucoma, optic nerve damage, posterior subcapsular cataracts, and delayed wound healing.

Pregnancy & Lactation

• Pregnancy: Adequate and well-controlled studies in pregnant women are lacking. Dextrobac should only be used during pregnancy if the potential benefits outweigh the risks to the fetus.
• Nursing Mothers: It is unclear whether topical corticosteroids can be absorbed systemically in quantities detectable in human milk. Caution is advised when administering this solution to nursing mothers.

Precautions & Warnings

Consider the risk of fungal infections in the cornea following prolonged steroid use. Extended use of antibiotic preparations may lead to overgrowth of non-susceptible organisms, including fungi. If superinfection occurs, appropriate treatment should be initiated. Be aware of potential cross-sensitivity with other aminoglycoside antibiotics; discontinue use if hypersensitivity develops.

Overdose Effects

Local administration overdose effects are unknown. In case of accidental oral ingestion, measures to reduce absorption should be taken, as no specific antidote is available.

Therapeutic Class

Ophthalmic steroid-antibiotic combination preparations.

Storage Conditions

Store at room temperature. Always close the bottle immediately after use and do not use beyond one month after opening.