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|Rimexolone

Rimexolone

Trade Names:
Vexol
- Ophthalmic Suspension 1%

Mechanism of Action

Pharmacology

Suppresses inflammatory response to stimuli of a mechanical, chemical, or immunological origin.

Pharmacokinetics

Absorption

Ophthalmic preparation is absorbed systemically, reaching serum levels ranging from 80 to 470 pg/mL (mean level 130 pg/mL) after hourly waking doses for 1 wk.

Metabolism

Undergoes extensive metabolism with metabolites less active than parent drug.

Indications and Usage

Treatment of postoperative inflammation following ocular surgery; treatment of anterior uveitis.

Contraindications

Acute purulent untreated infections, which may be masked or enhanced by steroid administration; epithelial herpes simplex keratitis (dendritic keratitis); fungal diseases of the eye; mycobacterial infection of the eye; vaccinia; varicella; viral diseases of the cornea and conjunctiva; hypersensitivity to any ingredient.

Dosage and Administration

1 to 2 drops into conjunctival sac of affected eye qid, beginning 24 hr after surgery and continuing throughout the first 2 wk of postoperative period.

1 to 2 drops into conjunctival sac of affected eye every hour during waking hours for first week; 1 drop q 2 hr during waking hours of second week; taper until uveitis resolves.

Storage/Stability

Store ophthalmic suspension in refrigerator (36° to 46°F) or at controlled room temperature (68° to 77°F). Protect from freezing.

Drug Interactions

None well documented.

Laboratory Test Interactions

None well documented.

Adverse Reactions

Cardiovascular

Hypotension (less than 2%).

CNS

Headache (less than 2%).

EENT

Blurred vision, discharge, discomfort, foreign body sensation, hyperemia, increased IOP, ocular pain, pruritus (which may be associated with optic nerve damage), visual acuity, and field defects, perforation of globe where there is thinning of cornea or sclera, posterior subcapsular cataract formation, secondary ocular infection (eg, herpes simplex) (1% to 5%); pharyngitis, rhinitis (less than 2%).

GI

Taste perversion (less than 2%).

Precautions

Pregnancy

Category C .

Lactation

Undetermined.

Children

Safety and efficacy not established.

Fungal infections

Fungal infections of cornea are prone to develop coincidentally with long-term local steroid application.

IOP

Prolonged use may result in ocular hypertension or glaucoma. Monitor IOP if product is used for 10 days or longer.

Patient Information

• Explain name, dose, action, and potential side effects of drug.
• Advise patient to read the Patient Information Leaflet before starting therapy.
• Remind patient that eye drops are for use in eye only.
• Remind patient to shake well before using.
• Teach patient proper technique for instilling eye drops: wash hands; do not allow dropper to touch eye. Tilt head back, look up; pull lower eyelid down; instill prescribed number of drops. Close eye for 1 to 2 min and apply gentle pressure to bridge of nose for 1 to 3 min. Do not rub eye.
• Caution patient not to touch top of dropper bottle to eye, fingers, or any other surface.
• Advise patient that if more than 1 topical ophthalmic medication is being used, to use each medication at least 5 min apart. Instill ophthalmic ointment last.
• Inform patient that temporary stinging of the eye and blurred vision are the most common side effects and to contact health care provider if these or other symptoms occur and are bothersome.
• Advise patient to contact eye doctor if symptoms do not improve after 2 days, if symptoms worsen, or if eye or eyelid inflammation is noted.
• Advise patient that the entire course of therapy must be completed to ensure max benefit and to complete full course of therapy even if symptoms have resolved.
• Advise patient that preservative in eye drops is absorbed by soft contact lenses. Advise patient not to administer eye drops while wearing soft contact lenses and to wait at least 15 min after instilling medication before inserting their lenses.
• Remind patient that follow-up eye examinations may be necessary while using this medication and to keep appointments.
• Advise patient to continue taking other medications for same condition as prescribed by health care provider.
• Caution patient not to increase dose if symptoms do not seem to be improving or are worsening, and to inform health care provider.
• Advise women to notify health care provider if pregnant, planning to become pregnant, or breastfeeding.
• Caution patient to not take any prescription, OTC medications, herbal preparations, or dietary supplements unless advised by health care provider.
• Advise patient that follow-up visits may be required to monitor therapy and to keep appointments.