A sterile, topical ophthalmic solution combining the bactericidal aminoglycoside antibiotic Gentamicin with the potent corticosteroid Dexamethasone. It is primarily indicated for the treatment of steroid-responsive inflammatory ocular conditions where a risk of bacterial infection exists or where such infection is present. The combination provides anti-inflammatory, anti-allergic, and anti-infective actions.
Adult: One or two drops into the conjunctival sac(s) every 4 to 6 hours. In severe disease, drops 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 the dropper tip to eye or any surface. 5. Close eyes gently for 1-2 minutes. Apply gentle pressure to the nasolacrimal duct (inner corner of eye) for 1 minute to minimize systemic absorption. 6. Wait at least 5-10 minutes before instilling any other ophthalmic medication. Do not wear soft contact lenses during treatment.
Gentamicin binds irreversibly to the 30S ribosomal subunit of susceptible bacteria, inhibiting protein synthesis and causing bacterial cell death (bactericidal). Dexamethasone is a potent glucocorticoid that induces phospholipase A2 inhibitory proteins (lipocortins), which inhibit the release of arachidonic acid, thereby reducing the production of inflammatory mediators like prostaglandins and leukotrienes. It also suppresses migration of polymorphonuclear leukocytes and reverses increased capillary permeability.
Pregnancy: Category C (US FDA). Dexamethasone may be teratogenic in animal studies. Gentamicin carries risk of fetal ototoxicity. Use only if the potential benefit justifies the potential risk to the fetus. Avoid prolonged use or high doses.
Driving: May cause temporary blurred vision after instillation. Patients should not drive or operate machinery until vision clears.
| Other topical ophthalmic corticosteroids | Additive risk of elevated IOP and cataract formation. | Major |
| Systemic corticosteroids (e.g., Prednisolone) | Increased systemic corticosteroid effects and side effects. | Moderate |
| Other topical aminoglycosides (e.g., Tobramycin) or systemic aminoglycosides | Potential additive ototoxicity and nephrotoxicity if significant systemic absorption occurs. | Moderate |
| Neuromuscular blocking agents (e.g., Succinylcholine) | Gentamicin may potentiate neuromuscular blockade. | Moderate |
| Loop diuretics (e.g., Furosemide) | Increased risk of ototoxicity and nephrotoxicity with systemic gentamicin. | Moderate |
Same composition (Gentamicin (0.3%) + Dexamethasone (0.1%)), different brands: