Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Dexamethasone sodium phosphate may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
e Dropodex® Do not use Dropodex®:
If you are using more than one sort of eye drops leave five minutes between applications. Eye ointments should be applied last. Pregnancy and breast-feeding If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. There is insufficient information available to determine the potential harmful effects on pregnancy. Dropodex® should not be used during pregnancy and breast-feeding unless considered appropriate by your doctor. Driving and using machines Your eyesight may become blurred for a short time following the use of Dropodex®. You must not drive or operate hazardous machinery until your eyesight has returned to normal. Dropodex® contains phosphates This medicine contains 1.0 I mg phosphates in each 0.4 ml dose which is equivalent to 2.52 mg/ml phosphates (from 9.5 mg/ml disodium phosphate dodecahydrate). If you suffer from severe damage to the clear layer at the front of the eye (the cornea), phosphates may cause in very rare cases cloudy patches on the cornea due to calcium build-up during treatment.
Dropodex® Always use this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure. If your eye problem is severe, you may be asked to use these eye drops more frequently at first. The frequency can then be reduced as the eye gets better. More detailed instructions will be given to you by your doctor or pharmacist. Make sure you follow these instructions carefully. The recommended dose is I drop in one or both eyes, 4 to 6 times a day in the affected eye. In severe cases, treatment may be started with I drop every hour at the start of the therapy but dosage should be reduced to I drop every 4 hours when a favourable response is observed. Do not stop using the treatment abruptly. Gradual tapering off is recommended in order to avoid a relapse. The duration of treatment will generally vary from a few days to a maximum of 14 days. Use in children and adolescents Follow the instructions given by your doctor because the dose may vary. Do not allow the tip of the single-dose container to touch your eye or areas around your eye. It may become contaminated with bacteria that can cause eye infections leading to serious damage to the eye, even loss of vision. To avoid possible contamination of the single-dose container, keep the tip of the container away from contact with any surface. The solution from one individual single-dose container of Dropodex® is to be used immediately after opening for administration to the affected eye(s). Since sterility cannot be maintained after the individual single-dose container is opened, a new single-dose container must be opened prior to each use and must be discarded immediately after administration.
Instructions for use of Dropodex®: I . Break off one single-dose container from the strip. 2. Open the single-dose container by bending/ twisting the tab (Figure I ) 3 . Tilt your head backwards 4. Gently pull down the lower lid to form a pouch (Figure 2). 5. Place the dropper tip close to your eye, but do not touch the eye or lid, and gently squeeze the single-dose container to release one drop into your eye. (Figure 3). 6. Close the eye for about 30 seconds and at the {Figure 3) same time gently press a finger against the comer of the closed eye.nearest the nose. (Figure 4). 7. Some drops may roll down your face. This �·� i,ao""'. Tho.,. hdd, "'' d,mooo dro• Wipe away the excess with a clean tissue. If the drop of medication is not retained for (Figure 4) any reason, another drop should be dropped -;, 1 into the eye pouch. 8. If you use more than one type of eye medicine, wait five minutes before putting in the next one. This prevents the first drop from being washed away. Eye ointments should be applied last. 9. Repeat instructions 3-8 for the other eye. I 0. After instillation, discard the used single-dose container even if there is solution remaining. I I. Store the remaining single-dose containers in the foil sachet. After opening the sachet, the unopened ampoules can be stored for 28 days. Follow these instructions carefully. Consult your doctor or pharmacist if there is anything you do not understand. If you use more Dropodex® than you should If you put too much Dropodex® into your eye(s), close your eyes and rinse off any excess with warm water. If the contents of Dropodex® are accidentally swallowed, tell your doctor immediately or go to your nearest hospital casualty department. Take your medicine with you. If you forget to use Dropodex® Do not use a double dose to make up for a forgotten dose. If you forget to use a dose of Dropodex, use them as soon as you remember and then carry on as before. If you stop using Dropodex® Do not stop using this medicine suddenly.Always tell your doctor if you are thinking about stopping the treatment. If you have any further questions on the use of this medicine, ask your doctor or pharmacist.
Very rare:
Like all medicines, this medicine can cause side effects, although not everybody gets them. Most people who are treated with these eye drops do not suffer from any unwanted side effects. Hormone conditions Frequency not known:
Dropodex® Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the sachet, single-dose containers and carton after 'EXP'. The expiry date refers to the last day of that month. Do not store above 25° C. Do not refrigerate or freeze. Store in original package.After opening the sachet, the unopened ampoules can be stored for 28 days. The Dropodex® single-dose container should be discarded immediately after use, even if some solution remains. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment.
For package information leaflet in large font please go to www.xpil.medicines.org.uk For large print, audio or braille versions contact the RNIB on the Medicine Leaflet Line 0800 198 5000. .&.Rayner 30MOl5
Non-printed information Artwork details
What Dropodex® contains
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Dropodex Eye Drops comes as eye drops. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
The active substance in Dropodex Eye Drops is dexamethasone sodium phosphate.
Medicines with the same active substance, strength and form include: Minims Dexamethasone sodium phosphate 0.1% w/v, Eye drops solution. They are interchangeable only if your prescriber or pharmacist says so.
This leaflet reproduces the patient information leaflet approved for Dropodex Eye Drops, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
Dropodex is indicated for inflammatory conditions of the anterior segment of the eye, such as marginal keratitis, stromal oedema in keratitis, anterior uveitis, episcleritis (if NSAIDs are contraindicated or insufficient), scleritis, acute phase of severe allergic conjunctivitis not responding to standard therapy.
Posology
Adults (including the elderly)
The usual dose in adults, including the elderly, is 1 drop, 4 to 6 times daily.
In severe conditions, the treatment can be used more frequently at first (1 drop every hour), and then reduced to 1 drop every 4 hours as the eye inflammation subsides. Dexamethasone sodium phosphate dosage should be progressively reduced.
Paediatric population
The safety and efficacy of Dropodex in children aged less than 2 years have not yet been established. No data are available.
Use of Dropodex in children and adolescents must be restricted. In children, long-term continuous corticosteroid therapy should be avoided due to possible adrenal suppression (see section 4.4).
Method of administration
Dropodex is for ocular use.
Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.
Use is contra-indicated in herpes simplex and other viral diseases of the cornea and conjunctiva, fungal disease, ocular tuberculosis, untreated purulent infections, patients with a history of acute epithelial herpes simplex keratitis or hypersensitivity to any component of the preparation.
For ocular use only. Not for injection into the eye.
Care should be taken to ensure that the eye is not infected before initiating treatment.
In those diseases causing thinning of the cornea or sclera, perforations have been known to occur with the use of topical corticosteroids.
Caution is also necessary when used in conjunction with antiviral therapy in the treatment of stromal keratitis or uveitis and use of periodic slit-lamp microscopy.
Corticosteroids may reduce resistance to and aid in the establishment of bacterial, viral and fungal infections and mask the clinical signs of infections, preventing recognition of ineffectiveness of the antibiotic. In such cases antibiotic therapy is mandatory. Fungal infection should be suspected in patients with persistent corneal ulceration who have been or are receiving these drugs, and corticosteroids therapy should be discontinued if fungal infection occurs.
This medicinal product contains 1.01 mg phosphates in each 0.4 mL dose which is equivalent to 2.52 mg/mL phosphates (from 9.5 mg/mL disodium phosphate dodecahydrate), which may lead to corneal deposits or corneal opacity when topically administered. It should be used with caution in patients presenting with compromised cornea and in instances where the patient is receiving polypharmacy with other phosphate-containing eye medications (see section 4.5).
Topical corticosteroids should not be used for longer than one week except under ophthalmic supervision. Prolonged use of topical ophthalmic corticosteroids may result in ocular hypertension and/or glaucoma, with damage to the optic nerve, reduced visual acuity, visual field defects and posterior subcapsular cataract formation. In patients receiving prolonged ophthalmic corticosteroid therapy, intraocular pressure and the lens should be checked routinely and frequently, particularly in patients with a history or presence of glaucoma. The dose of anti-glaucoma medication may need to be adjusted in these patients. Prolonged use may also increase the hazard of secondary ocular infections. Topical ophthalmic corticosteroids may slow corneal wound healing.
Cushing's syndrome and/or adrenal suppression associated with systemic absorption of ophthalmic dexamethasone may occur after intensive or long-term continuous therapy in predisposed patients, including children and patients treated with CYP3A4 inhibitors (including ritonavir and cobicistat). In these cases, treatment should be progressively discontinued.
Contact lenses should not be worn during treatment with corticosteroid eye drops due to increased risk of infection.
Systemic absorption may be reduced by compressing the lacrimal sac at the medial canthus for a minute during and following the instillation of the drops. (This blocks the passage of drops via the naso-lacrimal duct to the wide absorptive area of the nasal and pharyngeal mucosa. It is especially advisable in children).
Visual disturbance
Visual disturbance may be reported with systemic and topical corticosteroid use. If a patient presents with symptoms such as blurred vision or other visual disturbances, the patient should be considered for referral to an ophthalmologist for evaluation of possible causes which may include cataract, glaucoma or rare diseases such as central serous chorioretinopathy (CSCR) which have been reported after use of systemic and topical corticosteroids.
Paediatric population
In children, long-term, continuous corticosteroid therapy should be avoided due to possible adrenal suppression.
The risk of increased intraocular pressure associated with prolonged corticosteroid therapy may be more likely to occur with concomitant use of anticholinergics, especially atropine and related compounds, in patients predisposed to acute angle closure.
The risk of corneal deposits or corneal opacity may be more likely to occur in patients presenting with compromised cornea and receiving polypharmacy with other phosphate-containing eye medications.
The following drug interactions are possible, but are unlikely to be of clinical significance, following the use of Dropodex in the eye:
The therapeutic efficacy of dexamethasone may be reduced by phenytoin, phenobarbitone, ephedrine and rifampicin.
Glucocorticoids may increase the need for salicylates as plasma salicylate clearance is increased.
CYP3A4 inhibitors (including ritanovir and cobicistat) may decrease dexamethasone clearance resulting in increased effects and adrenal suppression/Cushing's syndrome. The combination should be avoided unless the benefit outweighs the increased risk of systemic corticosteroid side-effects, in which case patients should be monitored for systemic corticosteroid effects.
If more than one topical ophthalmic medicinal product is being used, the medicines must be administered at least 5 minutes apart. Eye ointments should be administered last.
Pregnancy
There are no or limited amount of data from the use of dexamethasone eye drops in pregnant women. Studies in animals have shown that topically applied steroids can be absorbed systemically and can cause abnormalities of foetal development in pregnant animals (see section 5.3), although the relevance of these findings to human beings has not been established. As a precautionary measure, it is preferable to avoid the use of Dropodex during pregnancy.
Breastfeeding
Systemically administered corticosteroids appear in human milk in quantities that could affect the child being breastfed. However, when instilled topically, systemic exposure is low. It is unknown whether dexamethasone is excreted in human milk. A risk to the newborns/infants cannot be excluded. A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from Dropodex therapy taking into account the benefit of breastfeeding for the child and the benefit of therapy for the woman.
Fertility
There are no data on potential effects of Dropodex on fertility.
Dropodex has no or negligible influence on the ability to drive and use machines; however, instillation of eye drops may cause transient blurring of vision. Warn patients not to drive or operate hazardous machinery until vision is clear.
Tabulated list of adverse reactions
The following undesirable effects are classified according to the following convention: very common (≥ 1/10), common (≥ 1/100 to < 1/10), uncommon (≥ 1/1,000 to < 1/100), rare (≥ 1/10,000 to < 1/1000), very rare (< 1/10,000), or not known (cannot be estimated from the available data). Within each frequency grouping, undesirable effects are presented in decreasing order of seriousness.
System Organ Class
Frequency
Adverse Reactions
Eye disorders
Very common (> 1/10)
Intraocular pressure increased
Common (≥ 1/100, < 1/10)
Ocular discomfort*, irritation*, burning*, eye pruritus* (see also section 4.4)
Uncommon (≥ 1/1,000, < 1/100)
Allergic or hypersensitive reactions*, delayed in healing*, posterior subcapsular cataract*, opportunist infections*, glaucoma* and blurred vision*
Very rare (< 1/10,000, including isolated reports)
Conjunctivitis, eyelid oedema, corticoid-induced uveitis, keratitis, corneal thinning, corneal oedema and ulcerations, corneal calcification*, and corneal perforation*
Endocrine disorders
Not known (cannot be estimated from the available data)
Cushing's syndrome, adrenal suppression* (see section 4.4)
*see section Description of selected adverse reactions
Description of selected adverse reactions
Intraocular pressure increased may occur after 2 weeks of treatment.
Ocular discomfort after instillation, irritation, burning, eye pruritus (see also section 4.4) may occur. These symptoms are mild and transient with no consequences.
Signs and symptoms of allergic or hypersensitive reactions can occur. The following corticoid specific undesirable effects can occur: delay in healing, risk of posterior subcapsular cataract formation, opportunist infections glaucoma and blurred vision.
Cases of corneal calcification have been reported in association with the use of phosphate containing eye drops in some patients with significantly damaged corneas. Due to the steroid component, in diseases causing thinning of the cornea or sclera, there is a higher risk for perforation especially after topical long treatments.
After long treatment posology, systemic absorption can occur with an inhibition of the adrenal function.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme Website: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
Overdose is unlikely to occur as Dropodex are single-dose units. Excess Dropodex may be wiped away with a clean tissue.
Ask anything about Dropodex Eye Drops. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.
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