DISCLAIMER: Dexaron® Plus is a prescription-only ophthalmic/otic medicine.
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Incorrect use may worsen infections or cause complications.
Dexaron® Plus (Eye/Ear Drops & Ointment): Triple-Action Corticosteroid + Dual Antibiotics
Summary
Dexaron® Plus (Amoun, Egypt) combines a potent corticosteroid (dexamethasone) with two broad-spectrum antibiotics (neomycin and polymyxin B) to manage steroid-responsive inflammatory conditions of the eye or external ear when bacterial infection is present or suspected. It targets inflammation, pain, and likely bacterial pathogens simultaneously. Use is short-term and monitored.
Category & Active Ingredients
- Category: Ophthalmic/Otic corticosteroid + antibiotics combination.
- Actives: Dexamethasone; Neomycin sulfate; Polymyxin B sulfate.
Available Forms & Pack Sizes
- Eye/Ear Drops (suspension): plastic dropper bottle, ~5 mL.
- Eye/Ear Ointment: tube, ~5 g.
- *Note: Exact concentrations may vary by market batch/leaflet; always check the pack insert you dispense.
How It Works (Mechanism)
- Dexamethasone: Suppresses inflammatory mediators → reduces redness, swelling, pain, cellular exudate.
- Neomycin (aminoglycoside): Bactericidal; inhibits protein synthesis—active vs many Gram-negative and some Gram-positive organisms.
- Polymyxin B: Bactericidal; disrupts bacterial cell membrane—especially effective vs Pseudomonas aeruginosa and other Gram-negatives.
Indications
- Ocular: Steroid-responsive inflammatory conditions of palpebral/bulbar conjunctiva, cornea, and anterior segment where bacterial infection exists or risk of infection is high (e.g., postoperative inflammation with suspected bacterial component).
- Otic: External otitis (otitis externa) when inflammation coexists with suspected/confirmed bacterial infection and intact tympanic membrane.
Dosage & Administration
Use exactly as prescribed. Shake drops well before each use.
- Eye/Ear Drops: 1–2 drops into affected eye(s) or ear(s) up to 4× daily; in severe cases, dosing may be more frequent initially then tapered by the physician.
- Ophthalmic Ointment: Thin ribbon in conjunctival sac up to 3× daily; commonly used at bedtime with daytime drops.
- Duration: Short courses are preferred. Prolonged use only under close monitoring (IOP checks, corneal status).
- Tapering: Do not stop abruptly after high-frequency use; prescriber may taper to prevent rebound inflammation.
Contraindications
- Hypersensitivity to dexamethasone, neomycin, polymyxin B, or formulation excipients.
- Ocular viral infections (e.g., herpes simplex keratitis—dendritic ulcer), vaccinia, varicella.
- Ocular mycobacterial or fungal infections.
- Otic: Perforated tympanic membrane (risk of ototoxicity from aminoglycosides/polymyxin).
Warnings & Precautions
- Intraocular Pressure (IOP): Prolonged steroid use can elevate IOP → glaucoma, optic nerve damage; monitor if >10 days.
- Corneal/ scleral thinning & delayed healing: Risk of perforation, especially in disease with corneal thinning.
- Masking/Worsening infection: Steroids may mask clinical signs; monitor for non-response or superinfection (incl. fungi).
- Contact lenses: Avoid wearing contact lenses during active ocular infection/inflammation; preservatives can discolor soft lenses.
- Cross-contamination: Do not use the same bottle for eye and ear simultaneously; avoid touching tip to eye/ear/skin.
- Allergic sensitization: Neomycin may cause contact sensitization; discontinue if hypersensitivity occurs.
Side Effects
- Ocular: Transient burning/stinging, blurred vision, photophobia; with longer use: elevated IOP, posterior subcapsular cataract, delayed wound healing, secondary infection.
- Otic: Local irritation, itching; with membrane breach risk of ototoxicity (hearing/balance issues).
- Allergy: Lid itching, redness, periocular dermatitis; neomycin sensitization possible.
Drug Interactions
- Other topical ocular steroids: Additive risk of ↑IOP, cataract, delayed healing.
- Topical/systemic aminoglycosides: Additive risk of hypersensitivity/ototoxicity (otic setting).
- Live vaccines (systemic context): Not typically relevant to short topical use; systemic immunosuppression minimal but caution with prolonged/high-frequency use.
Use in Special Populations
- Pregnancy: Systemic absorption from topical ocular/otic use is low; use only if potential benefit justifies potential risk—limit duration.
- Breastfeeding: Unlikely to affect infant at ophthalmic/otic doses; minimize exposure and duration.
- Pediatrics: Higher susceptibility to steroid effects (↑IOP, adrenal suppression if prolonged). Use the lowest effective dose for the shortest time with monitoring.
- Elderly: Monitor IOP and corneal integrity closely.
- Hepatic/Renal impairment: Clinically significant systemic exposure is low; standard precautions apply.
How to Use (Technique)
- Eye drops: Wash hands → shake bottle → tilt head back → pull lower lid → instill drop without touching tip → close eye and press inner canthus 1–2 min (nasolacrimal occlusion) to reduce systemic absorption.
- Ophthalmic ointment: Apply a thin ribbon to lower conjunctival sac → close eye gently for 1–2 min.
- Ear drops: Clean/ dry external canal; for adults pull pinna up/back; instill drops; keep head tilted ~2–3 min.
- Separate from other eye meds by ≥5–10 minutes (drops before ointment).
Monitoring & When to Seek Care
- No improvement or worsening after 48–72 hours → reassess; consider culture/sensitivity.
- Longer than 10 days of ocular use → check IOP periodically.
- Stop and seek urgent care if severe pain, sudden vision changes, marked swelling, rash, or signs of hypersensitivity occur.
Storage & Handling
- Store at room temperature per leaflet; protect from excessive heat; do not freeze.
- Keep bottle/tube tightly closed; avoid contaminating the tip.
- Discard drops 28 days after opening (common practice unless the leaflet states otherwise).
- Keep out of reach of children.
FAQ
Why must the drops be shaken? They are a suspension; shaking ensures accurate dosing.
Can I use it for any “red eye”? No. Steroid drops can worsen herpes or fungal keratitis. Always use after proper diagnosis.
How long can I use it? Short courses only; prolonged use requires close medical follow-up (IOP checks, infection surveillance).
Can I wear contact lenses? Avoid during active infection/inflammation and while using preserved drops.
References
- DailyMed: Neomycin/Polymyxin B/Dexamethasone ophthalmic products (prescribing information).
- American Academy of Ophthalmology (AAO): Patient guidance on red eye, keratitis, and steroid risks.
- Amoun Product Leaflet: Local pack insert for Dexaron® Plus (consult latest version with the dispensed pack).