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.
for Eythalm contains dexamethasone, which is a corticosteroid used to stop inflammatory symptoms (such as pain, heat, swelling and redness). Eythalm is used to treat inflammation of your eyes. If you have an infected eye (red eye, tears and mucous), you will be given another medicine to take at the same time as Eythalm. See Section 2. Eythalm eye drops solution is a sterile solution that does not contain a preservative.
e Eythalm Do not use Eythalm:
Other medicines and Eythalm Tell your doctor or pharmacist if you are using, have recently used or might use any other medicines. If you are using any other eye medicine, wait 15 minutes between using each medicine. Using eye drops containing steroids and eye drops containing beta-blockers (to treat high pressure in the eye) together may cause settling of calcium phosphate on the surface of the eye. Tell your doctor if you are using ritonavir or cobicistat, as this may increase the amount of dexamethasone in the blood. 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 using this medicine. There is not enough information on the use of dexamethasone during pregnancy to know the possible side effects. For this reason, the use of Eythalm during pregnancy is not recommended. It is not known if this medicine is present in breast milk. However, the dose of Eythalm is low. Eythalm can be used when breast-feeding. Driving and using machines You may have blurred vision for a short time after using your drops. Wait until your vision is normal before you drive or use machines. Eythalm contains phosphate buffer This medicine contains 1.976mg phosphates in each ml of solution, which is equivalent to 7.450mg 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.
Eythalm Always use this medicine exactly as your doctor has told you. Check with your doctor or pharmacist if you are not sure. The recommended dose is 1 drop, 4 to 6 times a day in the eye to be treated. If your condition is more serious, you may be told to start with 1 drop every hour and then change to 1 drop every 4 hours, after the medicine has started to work. It is important to lower the dose slowly to stop the condition getting worse again. Elderly There is no need to adjust the dose. Use in children Do not use this medicine for long-term treatment without a break. Method of administration Ocular use: this medicine is an eye drop to be used in the eye. Do not allow the tip of the multi-dose container to touch the eye or areas around the eye. It could cause injury to your eye. The eye drops solution may become contaminated with bacteria that can cause eye infections leading to serious damage of the eye, even loss of vision. To avoid possible contamination of the multi-dose container, keep the tip of the multi-dose container away from contact with any surface. Before instillation of the eye drops:
Do not touch anything with the tip of the bottle to avoid contamination of the solution. 2. Tilt your head backwards and hold the bottle above your eye. 3. Pull the lower eyelid down and look up. Squeeze the bottle gently in the middle and let a drop fall into your eye. Please note that there might be a few seconds delay between squeezing and the drop coming out. Do not squeeze too hard. If you are not sure how to administer your medicine, ask your doctor, pharmacist or nurse.
4. Blink a few times so that the drop spreads over the eye.
5. After using Eythalm, press a finger into the corner of your eye, by the nose for a few minutes. This helps to stop the eye drops getting into the rest of your body.
6. Repeat the instructions 2 – 5 to deliver a drop into the other eye also, if your doctor has instructed you to do this. Sometimes only one eye needs to be treated and your doctor will advise if this applies to you and which eye needs treatment.
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7. After use and prior to recapping, the bottle should be shaken once in a downwards direction, without touching the dropper tip, in order to remove any residual liquid on the tip. This is necessary in order to ensure delivery of subsequent drops.
After you have used all doses there will be some Eythalm left in the bottle. You should not be concerned since an extra amount of Eythalm has been added and you will get the full amount of Eythalm that your doctor has prescribed. Do not attempt to use the excess medicine remaining in the bottle after you have completed the course of treatment. Frequency of use 4 to 6 times a day.
What Eythalm looks like and contents of the pack Eythalm eye drops, solution is presented as a 6ml clear solution in a white opaque 11ml LDPE bottle with white Novelia nozzle (HDPE and silicone) and a white HDPE cap. Each carton contains 1 or 3 bottles. Not all pack sizes may be marketed. Marketing Authorisation Holder and Manufacturer Marketing Authorisation Holder Aspire Pharma Ltd Unit 4, Rotherbrook Court Bedford Road, Petersfield Hampshire, GU32 3QG, UK Manufacturer Pharmathen S.A., 6 Dervenakion 15351 Pallini Attiki, Greece Or EXCELVISION 27 st. La Lombardière, Zl La Lombardière, ANNONAY 07100, France This leaflet was last revised in 05/2021. 1010403-P3.3
Duration of treatment You will usually need to use your drops for a few days and no longer than 14 days. If you use more Eythalm than you should Rinse the eye with sterile water if you have put too much medicine in your eye and your eye feels sore. Immediately tell your doctor or pharmacist. If you forget to use Eythalm Do not use a double dose to make up for a forgotten dose. If you stop using Eythalm 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, pharmacist or nurse.
4. Possible side effects Like all medicines, this medicine can cause side effects, although not everybody gets them. Endocrine disorders: Not known (frequency cannot be estimated from the available data):
not listed in this leaflet. You can also report side effects directly 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). By reporting side effects you can help provide more information on the safety of this medicine.
Eythalm Keep this medicine out of the sight and reach of children. Do not use the eye drops for longer than 28 days after first opening the bottle. Write down the date you opened the bottle in the space on the bottle label and box. Do not use this medicine after the expiry date which is stated on the carton and bottle after EXP. The expiry date refers to the last day of that month. This medicine does not require any special storage conditions. 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.
What Eythalm contains
Eythalm 1mg/ml eye drops solution comes as eye drops containing 1mg/ml. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
The active substance in Eythalm 1mg/ml eye drops solution is dexamethasone sodium phosphate.
Medicines with the same active substance, strength and form include: Puradex 1mg/ml eye drops, solution. They are interchangeable only if your prescriber or pharmacist says so.
This leaflet reproduces the patient information leaflet approved for Eythalm 1mg/ml eye drops solution, 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.
For treatment of non-infectious inflammatory conditions affecting the anterior segment of the eye.
This medicinal product should be used only under close ophthalmic supervision.
Posology
The usual posology is of 1 drop 4 to 6 times daily in the affected eye.
In severe cases, treatment may be started with 1 drop every hour but dose should be reduced to one drop every 4 hours when favourable response is observed. 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.
Elderly patients
There has been wide experience with the use of dexamethasone eye drops in elderly patients. The dose recommendations given above reflect the clinical data derived from this experience.
Paediatric population
Efficacy and safety has not been established in the paediatric population.
In children, long-term continuous corticosteroid therapy should be avoided due to possible adrenal suppression (see section 4.4).
Method of administration
Ocular use.
Eythalm is a sterile solution that does not contain a preservative.
Patients should be instructed to wash their hands before use and avoid allowing the tip of the container to come into contact with the eye or surrounding structures as this could cause injury to the eye.
Patients should also be instructed that ocular solutions, if handled improperly, can become contaminated by common bacteria known to cause ocular infections. Serious damage to the eye and subsequent loss of vision may result from using contaminated solutions.
Nasolacrimal occlusion by compression of lacrimal ducts may reduce systemic absorption.
- Hypersensitivity to the active substance or to any of the excipients listed in section 6.1.
- Eye infections not controlled by anti-infectious treatment, such as:
• Acute purulent bacterial infections including Pseudomonas and mycobacterial infections,
• Fungal infections,
• Epithelial Herpes simplex keratitis (dendritic keratitis), vaccinia, varicella zoster and most other viral infections of the cornea and conjunctiva,
• Amoebic Keratitis,
- Perforation, ulceration and injury of cornea with uncompleted epithelialisation (see also section 4.4),
- Known glucocorticosteroid-induced ocular hypertension.
Topical steroids should never be given for an undiagnosed red eye.
Patients should be monitored at frequent intervals during treatment with dexamethasone eye drops. Prolonged use of corticosteroid treatment may result in ocular hypertension/glaucoma (especially for patients with previous IOP induced by steroids or with pre-existing high IOP or Glaucoma) and also cataract formation, especially in children and elderly population.
The use of corticosteroids may also result in opportunistic ocular infections (bacterial, viral or fungal) due to the suppression of host response or to the delay of their healing. In addition, topical ocular corticosteroids may promote, aggravate or mask signs and symptoms of opportunistic eye infections.
Patients with an eye infection should only receive local steroid treatment when the infection has been controlled by an effective anti-infectious treatment. Such patients should be carefully and regularly monitored by an ophthalmologist.
In some particular inflammatory conditions such as episcleritis, NSAIDS are the first line treatment, Dexamethasone should be used only if NSAIDS are contra-indicated.
Patients with a corneal ulcer should generally not receive topical dexamethasone except when inflammation is the main cause of healing delay and when the appropriate aetiological treatment has already been prescribed. Such patients should be carefully and regularly monitored by an ophthalmologist.
Thinning of the cornea and sclera may increase the risk of perforations with the use of topical corticosteroids.
Corneal calcification requiring corneal graft surgery for visual rehabilitation has been reported for patients treated with ophthalmic preparations containing phosphates such as dexamethasone. At the first sign of corneal calcification the drug should be withdrawn and the patient should be switched to a phosphate-free preparation. In children, long-term continuous corticosteroid therapy should be avoided due to possible adrenal suppression.
Posterior subcapsular cataract might occur at cumulative doses of dexamethasone.
Diabetics are also more prone to develop subcapsular cataracts following topical steroid administration.
The use of topical steroids in allergic conjunctivitis is only recommended for severe forms of allergic conjunctivitis not responding to standard therapy and only for a short period.
Wearing of contact lenses during treatment with corticosteroid eye drops should be avoided.
Patients with a history of contact hypersensitivity to silver should not use this product as dispensed drops may contain traces of silver.
Cushing's syndrome and/or adrenal suppression associated with systemic absorption of ocular 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.
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.
Wearing of contact lenses during treatment with corticosteroid eye drops should be avoided.
No interaction studies have been performed.
In case of concomitant treatment with other eye drops, solution, instillations should be spaced out by 15 minutes.
Superficial stromal corneal precipitations of calcium phosphate have been reported under combined use of corticosteroids and topical beta-blockers.
CYP3A4 inhibitors (including ritonavir 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.
Pregnancy
Insufficient data are available on the use of dexamethasone eye drops, solution in human pregnancy to assess possible harmful effects. Corticosteroids cross the placenta. Teratogenic effects have been observed in animals (see section 5.3). However, there is no evidence to date that teratogenic effects are induced in humans. After systemic use of corticosteroids, at higher doses, effects on the unborn/neonate (intrauterine growth inhibition, inhibition of the function of the adrenal cortex) have been reported. However, these effects have not been reported for ocular use.
As a precautionary measure, it is preferable to avoid the use of Eythalm during pregnancy.
Breast-feeding
It is not known whether this medicine is excreted in breast milk. However, the total dose of dexamethasone is low.
Eythalm can be used during lactation.
Fertility
There are no data on potential effects of dexamethasone 1 mg/ml on fertility.
No studies on the effects on the ability to drive and use machines have been performed.
As with any eye drops, temporarily blurred vision or other visual disturbances may affect the ability to drive or use machines. If blurred vision occurs, the patient must wait until the vision is clear before driving or using machines.
Tabulated list of adverse reactions
System Organ Class
Frequency
Adverse Reactions
Eye disorders
Very common
(≥ 1/10)
Increase of the intra-ocular pressure*
Common
(≥ 1/100 to <1/10)
Discomfort*, irritation*, burning*, stinging*, itching* and blurred vision (see section 4.4)*
Uncommon
(≥ 1/1,000 to <1/100)
Allergic and hypersensitivity reactions, delayed wound healing, posterior capsular cataract*, opportunistic infections, glaucoma*
Very rare
(<1/10,000, including isolated reports)
Conjunctivitis, mydriasis, facial oedema, ptosis, corticosteroid-induced uveitis, corneal calcifications, crystalline keratopathy, changes in corneal thickness*, corneal oedema, corneal ulceration and corneal perforation
Endocrine disorders
Not known
(frequency 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
Increase of the intra-ocular pressure, glaucoma and cataract may occur. Prolonged use of corticosteroid treatment may result in ocular hypertension/glaucoma (especially for patients with previous IOP induced by steroids or with pre-existing high IOP or Glaucoma) and also cataract formation, Children and elderly patients may be particularly susceptible to steroid-induced IOP rise (see section, 4.4).
Increase of the intra-ocular pressure induced by corticosteroid topical treatment has been generally observed within 2 weeks of treatment (see section 4.4.).
Diabetics are also more prone to develop subcapsular cataracts following topical steroid administration.
Discomfort, irritation, burning, stinging, itching and blurred vision frequently may occur immediately after instillation. These events are usually mild and transient and have no consequences.
In diseases causing thinning of the cornea, topical use of steroids could lead to perforation in some cases (see section 4.4).
Depression of adrenal function associated with systemic absorption of the product may occur when the instillations are administered with a frequent dosing schedule (see also sections 4.2 and 4.4).
Cases of corneal calcification have been reported very rarely in association with the use of phosphate containing eye drops in some patients with significantly damaged corneas.
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).
In the case of topical overdose, the treatment should be stopped. In case of prolonged irritation, the eye(s) should be rinsed with sterile water.
The symptomatology due to accidental ingestion is not known. As with other corticosteroids however, the physician may consider gastric lavage or emesis.
Ask anything about Eythalm 1mg/ml eye drops solution. 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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