A sterile, topical ophthalmic solution combining a broad-spectrum fluoroquinolone antibiotic (Ofloxacin) with a potent corticosteroid (Dexamethasone) and a lubricating demulcent (Hydroxypropylmethylcellulose). It is indicated for the treatment of steroid-responsive inflammatory conditions of the eye where the risk of superficial bacterial infection is high or where such an infection already exists. The combination provides anti-inflammatory, antibacterial, and soothing/lubricating actions.
Adult: One drop instilled into the affected eye(s) 4 times daily. In severe conditions, may be used every 1-2 hours initially, then tapered as inflammation subsides. Do not exceed prescribed duration (typically 7-10 days unless supervised for longer).
Note: 1. Wash hands. 2. Tilt head back. 3. Gently pull lower eyelid to form a pouch. 4. Instill one drop without touching the tip to eye or any surface. 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 drops. Do not wear soft contact lenses during treatment.
Ofloxacin inhibits bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for bacterial DNA replication, transcription, repair, and recombination, leading to bactericidal activity. Dexamethasone is a potent 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. Hydroxypropylmethylcellulose acts as a lubricating and demulcent agent, providing viscosity to prolong contact time and soothe ocular surfaces.
Pregnancy: Category C (US FDA). Dexamethasone may be teratogenic in animal studies. Ofloxacin has caused arthropathy in immature animals. Use only if potential benefit justifies potential fetal risk. Avoid prolonged use.
Driving: May cause temporary blurred vision after instillation. Patients should not drive or operate machinery until vision clears.
| Other Corticosteroids (oral/topical) | Additive systemic and ocular steroid effects, increasing risk of hypercortisolism, glaucoma, cataract. | Major |
| Non-steroidal Anti-inflammatory Drugs (NSAIDs) eye drops (e.g., Ketorolac, Nepafenac) | Increased risk of corneal healing impairment and ulceration. | Moderate |
| Antiglaucoma agents (e.g., Pilocarpine) | Dexamethasone may antagonize the IOP-lowering effect of some agents. Monitor IOP closely. | Moderate |
| Systemic Quinolones (e.g., Ciprofloxacin, Levofloxacin) | Theoretical risk of additive quinolone class effects, but minimal with topical use. | Minor |
Same composition (Ofloxacin (0.3% w/v) + Dexamethasone (0.05% w/v) + Hydroxypropylmethylcellulose (0.025% w/v)), different brands: