Dexamethasone (intraocular)

Overview

Dexamethasone is an intravitreal implant that is used to treat swelling on the back of your eye, known as a macular edema. You will experience a macular edema if a blood vessel in the back of your eye becomes clogged. This needs to be treated right away as the edema can cause changes to how your vision works. Dexamethasone is able to treat this condition as it is a steroid medicine (corticosteroid).

It can also be used to treat swelling in the middle part of your eye. The eye disease that occurs there is called uveitis. Finally, it can be used on patients who are suffering from a diabetic macular edema, and who are scheduled for cataract surgery or have an artificial lens implant.

You will need to be prescribed this medication, and it is to be applied in a clinical setting by a trained doctor or nurse. Under no circumstances should you attempt to self-prescribe or access the Dexamethasone implant. Your doctor will first need to give you a full medical assessment to ensure this is the best course of treatment for you. It can lead to a number of interactions and unwanted side effects, and your doctor is best placed to advise you on how to avoid these effects.

Conditions Treated

Type Of Medicine

  • Implant

Side Effects

The Dexamethasone medical implant is known to cause a variety of possible side effects. Some patients may experience no side effects, and others may have more worrying ones. Directly below you can find a list of more serious side effects which can potentially occur. If you do experience them at any time, then you should seek emergency medical assistance.

More common

  • Blurred vision

Less common

  • Seeing a curtain or veil covering part of your vision

If you experience any other side effects that are not listed above, and if they worry you, then you should contact your doctor. They may be able to advise on a way to lessen the effects, or may deem it necessary to remove the implant.

Dosage

Dexamethasone is a medical implant that will be placed in your eye, and it is not necessary for you to remove it. Your doctor can tell you exactly how big it is and for what purpose, and will not differ from patient to patient.

Interactions

Dexamethasone, similar to other forms of medication, is known to interact with a wide variety of other drugs. In some cases, it is still the best course of action to use both drugs, despite the interactions. However, in other cases, you should not take both together. Directly below is a list of drugs you should not take alongside Dexamethasone. Your doctor can advise you on a more suitable course of treatment. However, you should be open and honest with your doctor about all drugs you are on, including prescription, non-prescription, supplements and herbal remedies.

  • Rilpivirine

Directly below is another list of drugs. With these, it is usually not recommended you take them alongside Dexamethasone. However, it may be necessary for your circumstances. Your doctor can advise you on the best course of action.

  • Aceclofenac

The list below refers to drugs which are known to increase the risk of certain side effects occurring. However, it may still be necessary you use them together. In this case, your doctor may advise you change your dosage or the frequency with which you take it.

  • Alcuronium

As well as these drugs, there is a chance that your Dexamethasone implant will cause have an interaction with other parts of your dietary intake. This includes what you eat, drink and smoke. Your doctor will need to get an understanding of your typical dietary intake to decide if anything needs to be altered, so as to avoid any unpleasant interactions. In particular, they may be interested in your intake of tobacco and alcohol. It may be that you will need to cut back on your intake of either or both of these.

Dexamethasone may also have some unpleasant interactions with other medical problems you have. Your doctor will likely want to discuss your full medical history, to see if it could have an effect. Below is a list of more dangerous health problems, with which it is more dangerous to then have a Dexamethasone implant. Make yourself aware of this list, and point out any appropriate issues to your doctor.

Warnings

As a means to reduce any risks associated with the implant, your doctor will need you to make them aware of any allergies you have. These allergies could be to the implant itself, as well as any other drugs you have taken. Furthermore, include any allergies to foods, preservatives, dyes, and animals. It may be that the Dexamethasone implant could aggravate such allergies, and steps would need to be taken to mitigate this.

As of writing, no safety and efficacy standards have been established for the use of the Dexamethasone implant in pediatric patients. This is because no suitable tests have been carried out. Your doctor is equipped with the most recent information regarding this and can advise you on any increased risks. Together, you can decide whether any possible risks outweigh the benefits of the implant.

Any studies carried out on geriatric patients with the Dexamethasone implant have not indicated any adverse effects. There are no geriatric-specific problems that would make it advisable that geriatric patients receive this implant. However, depending on your exact physical condition and any other eye disorders you may have, your doctor may not recommend Dexamethasone.

As of writing, there is a lack of appropriate studies indicating the safety of Dexamethasone in pregnant women. Your doctor can let you know about any potential risks, and together you can see if these outweigh the benefits.

This is the same for women who are breastfeeding. No appropriate studies have been performed, so the decision to use the implant will need to be made on a case-by-case basis. If, at any time you have the implant you become pregnant, let your doctor know right away.

While you are using this implant, your doctor will likely require you to attend regular appointments. During these, your doctor will be able to monitor any improvements being made in your condition. They can also see if any adverse side effects have occurred for which they need to make adjustments. It is vital you attend all scheduled appointments, especially during the first few weeks after receiving the implant.

Dexamethasone does have the potential to cause some harmful side effects, so notify them immediately if you receive any effects from the list above. Similarly, if you suddenly develop a sensitivity to light, have changes in your vision, or your eye becomes red, you should contact your doctor immediately. Also, if you develop increased pressure in your eye, tell your doctor straight away.

Directly after receiving the implant, your vision may become blurred for a period. During this time you should avoid driving or performing any other tasks which would be more dangerous without you being able to see properly.

If the back part of the lens becomes torn or broken, there's a chance the implant could move to another part of your eye. If you think this may have occurred, contact your doctor immediately.

Storage

You will not be required to store Dexamethasone implants at any time. It is administered by a trained nurse or doctor in a clinical setting, and they are responsible for its safe storage.

Summary

If you are suffering from macular edema or swelling in the middle or back part of your eye, then the Dexamethasone implant can be a useful means to help reduce the swelling and improve your vision. However, it is only ever prescribed following a full medical consultation with your doctor. It has the possibility to react with a wide range of other drugs or medical conditions, so can be dangerous for some patients.

During your consultation, you should be open and honest with your doctor in deciding if this is the best course of treatment for you. After you receive the implant, you should monitor your condition closely and inform your doctor immediately of any harmful or worrying side effects. Your doctor will likely establish a series of follow-up appointments where they can monitor your condition. You should attend all of these and, if you are unable to make an appointment, then reschedule as soon as you can.