Drug Interaction:
Corticosteroids include -
Dexamethasone, Prednisolone, Triamcinolone.Hydrocortisone,
Flurometholone
Refer - Dexamethasone
Interacting drugs - summary
+Corticosteroids
Aminoglutethimide + dexamethosone
possible loss of dexamethosone-induced adrenal suppression
Barbiturates
decreased pharmacolgic effects of the corticosteroids metabolism
through the induction of hepatic microsomal enzymes
Cholestyramine + Hydrocortisone
hydrocortisine AUC decreased
Contraceptives Oral
Hepatic metabolism decreased by OCs, resulting in
increased therapeutic effects or toxicity
Ephedrine + Dexamethasone
a decreased half-life and increased clearance of dexamethsone
may occur
Estrogens
estrogen coadministration reduce the clearance and
increase the elimination half-life of corticosteroids
Hydantoins
corticosteroids clearance decreased and the AUC increased
resulting in reduced therapeutic effects
Ketoconazole
corticosteroid clearance decreased and the AUC increased
Macrolide Antibiotics + Methyl prednisolone
significant decrease in methylprednisolone clearance has been used
to decrease methylprednisolone dose
Rifampicin
corticosteroid clearance increased resulting in decreased
therapeutic effects
Corticosteroids +
Anticholinesterases
anticholinesterase effect antagonised in myasthenia gravis
Anticoagulants oral
anticoagulant dose requirements reduced. Conversely,
corticosteroids may oppose the anticoagulant action.
Cyclosporine
although this combination is therapeutically beneficial for organ
transplant, toxicity may be enhanced
Digitalis glycosides
coadministratin enhance the possibility ofdigitalis toxicity
associated with hypokalemia
Isoniazid
isoniazid serum concentration decreased
Nondepolarising muscle relaxants
corticosteroids potentiate, counteract or have no effect on the
neuromuscular blocking action
Poatssium depleting agents eg.diuretics
observe patients for hypokalemia
Salicylates
corticosteroids will reduce serum salicylate levels and decrease
their effectiveness
Somatrem
growth-promoting effect of somatrem inhibited
Theophyllines
alterations in the pharmacologic activity of either agent occur
Indication:
FIXED DOSE COMBINATIONS APPROVED BY DCG(I)
FROM JANUARY 1961 TILL NOVEMBER 2014
Name of Drug Indication Date of Approval
1.Flurometholone 1mg+ 04-09-1996
Neomycin sulphate 3.5mg (as base) +
Benzalkonium chloride 0.04mg per ml
Ophthalmic suspension
In the treatment of infected Inflammatory ocular condition
2.Flurometholone USP 1mg+ 28-07-2000
Gentamicin 3mg (as sulphate) per ml drops
The infection of the anterior segment of the eye due to
bacteria susceptible to gentamicin
3.Flurometholone 10mg + 28-04-1997
Gentamicin sulphate 3mg per ml
Eye drops
The infection of the anterior segment of the eye due to
bacteria susceptible to Gentamicin
Coticosteroid sensitive inflammation
Corticosteroids include - Dexamethasone, Prednisolone, Triamcinolone.Hydrocortisone, Flurometholone
Refer - Dexamethasone
Adverse Reaction:
Elevated IOP, optic nerve damage, post subcapsular cataract formation, delayed wound healing, rarely systemic hypercorticoidism, uveitis, perforation of the globe, keratitis, conjuntivitis, corneal ulcers, loss of accomodation, secondary ocular infections.
Contra-Indications:
Viral diseases of the cornea, and conjuntiva, including epithelial herpes, simplex keratitis (dendritis keraatitis). Vaccinia & Varicella, mycobacterial eye infection, ocular fungal infections, Hypersensitivity
Special precautions:
Prolonged use of corticosteroids may result in gaucoma resulting in damage to the optic nerve, with defects in visual acuity and field vision. Steroids should be used with caution in presence of glaucoma
Host immune response may be suppressed by prolonged use of corticosteroids Use of topical coticosteroids in presence of thin corneal or scleral tissue may lead to perforation.. Acute purulent infections of the eye may be masked or activity enhanced by presence of corticosteroid medication.
If fluromrtholone suspension is to be used for 10 days or longer then the intraocular pressure should be routinely measured.
Pregnancy and lactation no reports
Safety use in pediatric below 2 years not established
Dosages/ Overdosage Etc:
Indication:
Corticosteroid sensitive inflammations
Dosage:
Instil one drop into the conjuntivial sac four times a day. during the initial 24 to 48 hrs, the dosage may be increased to one application every for hours. Avoid premature discontinuation of the medicine.
Patient Information:
Refer Dexamethasone
Pharmacology/ Pharmacokinetics:
Refer Dexamethasone
Pregnancy and lactation:
Refer Dexamethasone
Pregnancy and lactation no reports
Safety use in pediatric below 2 years not established
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