A sterile, topical ophthalmic solution combining a broad-spectrum bacteriostatic antibiotic (Chloramphenicol) with a potent corticosteroid (Dexamethasone). This combination is primarily used for the treatment of inflammatory ocular conditions where there is a risk of bacterial infection or where such an infection is suspected. It addresses both the infectious and inflammatory components of conditions like bacterial conjunctivitis, blepharitis, and keratitis.
Adult: One to two drops into the conjunctival sac(s) every 4 to 6 hours. In severe conditions, may be used hourly initially, tapering as inflammation subsides.
Note: 1. Wash hands. 2. Tilt head back. 3. Gently pull lower eyelid to form a pouch. 4. Instill prescribed drops without touching dropper tip. 5. Close eyes gently for 1-2 minutes, applying gentle pressure to the nasolacrimal duct (inner corner of eye) to minimize systemic absorption. 6. Wait at least 5-10 minutes before instilling any other eye medication.
Chloramphenicol inhibits bacterial protein synthesis by binding reversibly to the 50S ribosomal subunit, preventing peptide bond formation. Dexamethasone is a potent synthetic glucocorticoid that binds to cytoplasmic glucocorticoid receptors, modulating gene expression to inhibit phospholipase A2, thereby reducing the synthesis of prostaglandins, leukotrienes, and other mediators of inflammation, edema, and capillary dilation.
Pregnancy: Category C (US FDA). Dexamethasone crosses placenta. Chloramphenicol crosses placenta, and near term may cause 'Gray Baby Syndrome'. Use only if potential benefit justifies potential fetal risk. Avoid prolonged use.
Driving: May cause temporary blurring of vision after instillation. Patients should not drive or operate machinery until vision clears.
| Other topical ophthalmic NSAIDs (e.g., Ketorolac, Nepafenac) | Increased risk of corneal healing impairment and ulceration. | Major |
| Systemic or other topical corticosteroids | Additive risk of elevated IOP, cataract, and systemic steroid effects. | Moderate |
| Erythromycin, Clindamycin (systemic) | Theoretical antagonism as both inhibit 50S ribosomal subunit; clinical significance for topical use is minimal. | Minor |
| Vitamin B12, Iron supplements, Folic Acid | Chloramphenicol may antagonize the hematopoietic response to these agents. | Moderate (with significant systemic absorption) |
| Warfarin, Acenocoumarol | Chloramphenicol may inhibit metabolism, potentiating anticoagulant effect and increasing INR. | Moderate (with significant systemic absorption) |
Same composition (Chloramphenicol (1% w/v) + Dexamethasone (0.1% w/v)), different brands: