Dosing and uses of Maxidex, AKDex (dexamethasone ophthalmic)
Adult dosage forms and strengths
ophthalmic suspension
- 0.1%
Inflammatory Ocular Conditions
Solution
- 1-2 gtt in conjunctival sac q1hr during day and q2hr at night, THEN
- Decrease to 1 gtt q4-6hr, THEN
- Decrease to 1 gtt q6-8hr
Suspension
- 1-2 gtt in conjunctival sac q4-6hr; in severe cases may use as in soluiton
Pediatric dosage forms and strengths
Safety and efficacy not established
Maxidex, AKDex (dexamethasone ophthalmic) adverse (side) effects
Frequency not defined
Cataract (4% )
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)
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
Pregnancy and lactation
Pregnancy category: C
Lactation: Excretion in milk unknown/use caution
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.
Pharmacology of Maxidex, AKDex (dexamethasone ophthalmic)
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
