ГКС для местного применения в офтальмологии. Оказывает выраженное противовоспалительное, противоаллергическое и антиэкссудативное действие. Взаимодействуя со специфическими белковыми рецепторами в тканях-мишенях, регулирует экспрессию кортикоидзависимых генов и влияет таким образом на синтез белка. Уменьшает образование, высвобождение и активность медиаторов воспаления (в т.ч. гистамина, кинина, простагландинов, лизосомальных ферментов). Подавляет миграцию клеток к месту воспаления. Уменьшает вазодилатацию и повышенную проницаемость сосудов в очаге воспаления. Стабилизирует лизосомальные ферменты мембран лейкоцитов. Подавляет синтез антител и нарушает распознавание антигена. Тормозит высвобождение интерлейкина 1 и интерлейкина 2, γ .-интерферона из лимфоцитов и макрофагов. Индуцирует образование липокортина, угнетает высвобождение эозинофилами медиаторов воспаления и стабилизирует мембраны тучных клеток. Все эти эффекты участвуют в подавлении воспалительной реакции в тканях в ответ на механическое, химическое или иммунное повреждение. Продолжительность противовоспалительного действия препарата после закапывания 1 капли раствора составляет от 4 до 8 ч.
Показания к применению
Конъюнктивит (негнойный и аллергический)
Кератит
Кератоконъюнктивит (без повреждения эпителия)
Блефарит
Склерит
Эписклерит
Хориоретинит
Увеит
Блефароконъюнктивит
Неврит зрительного нерва
Симпатическая офтальмия
Профилактика и лечение воспаления после оперативных вмешательств и травм
Восстановление прозрачности роговицы и снижение неоваскуляризации после кератитов, ожогов
Повышенная чувствительность к компонентам препарата
Применение при беременности и в период грудного вскармливания
Применение препарата при беременности в период лактации (грудного вскармливания) противопоказано.
Способ применения и дозы
Взрослым при острых воспалительных процессах препарат закапывают в конъюнктивальный мешок по 1-2 капли 4-5 раз/сут в течение 2 дней . в дальнейшем препарат применяют по 1-2 капли 3-4 раза/сут в течение 4-6 дней. При хронических воспалительных процессах препарат закапывают 2 раза/сут в течение 3-6 недель. Максимальная длительность применения препарата — 6 недель. При аллергических заболеваниях глаз препарат закапывают в конъюнктивальный мешок по 1-2 капли 4-5 раз/сут в течение 2 дней с постепенной отменой в течение 1-2 недель. При повреждениях глазного яблока в результате травм или при оперативных вмешательствах после противоглаукомной фильтрующей операции препарат применяют в день операции или на следующий день. После операции экстракции катаракты, операции по поводу косоглазия, отслойки сетчатки, а также после травмы препарат применяют, начиная с 8-го дня. В зависимости от степени выраженности симптомов воспаления препарат следует закапывать по 1-2 капли 2-4 раза/сут в течение 2-4 недель. Детям в возрасте от 6 до 12 лет при лечении аллергических и воспалительных состояний закапывают по 1 капле 2-3 раза/сут в течение 7-10 дней. При необходимости лечение продолжают после проведения на 10 день флюоресцеиновой пробы (для проверки целостности роговичного эпителия).
Побочное действие
В основном препарат обладает хорошей переносимостью. Местные реакции: непосредственно после закапывания препарата возможно быстро проходящее чувство жжения, слезотечение, затуманивание зрения. При длительном применении препарата (более 2-х недель) возможно повышение внутриглазного давления, развитие глаукомы с поражением зрительного нерва, снижение остроты зрения и выпадение полей зрения, а также формирование задней субкапсулярной катаракты, истончение и перфорация роговой оболочки . очень редко - распространение герпетической и бактериальной инфекции. У пациентов с повышенной чувствительностью к дексаметазону или бензалкония хлориду может развиться аллергический конъюнктивит и блефарит. Возможно развитие зуда, палпебральной или конъюнктивальной эритемы. При появлении язв роговицы или склеры, препарат может замедлить заживление и способствовать развитию повторной инфекции. При длительном применении возможно увеличение риска развития системных побочных эффектов, характерных для ГКС. Со стороны эндокринной системы: снижение толерантности к глюкозе, стероидный сахарный диабет или манифестация латентного сахарного диабета, угнетение функции надпочечников, синдром Иценко-Кушинга. Со стороны пищеварительной системы: тошнота, рвота, повышение или снижение аппетита, обострение хронических заболеваний ЖКТ. Со стороны сердечно-сосудистой системы: аритмия, брадикардия, повышение АД. Со стороны ЦНС: повышение внутричерепного давления, нервозность или беспокойство, бессонница, головокружение, головная боль.
Особые указания
В основном препарат обладает хорошей переносимостью. Местные реакции: непосредственно после закапывания препарата возможно быстро проходящее чувство жжения, слезотечение, затуманивание зрения. При длительном применении препарата (более 2-х недель) возможно повышение внутриглазного давления, развитие глаукомы с поражением зрительного нерва, снижение остроты зрения и выпадение полей зрения, а также формирование задней субкапсулярной катаракты, истончение и перфорация роговой оболочки . очень редко - распространение герпетической и бактериальной инфекции. У пациентов с повышенной чувствительностью к дексаметазону или бензалкония хлориду может развиться аллергический конъюнктивит и блефарит. Возможно развитие зуда, палпебральной или конъюнктивальной эритемы. При появлении язв роговицы или склеры, препарат может замедлить заживление и способствовать развитию повторной инфекции. При длительном применении возможно увеличение риска развития системных побочных эффектов, характерных для ГКС. Со стороны эндокринной системы: снижение толерантности к глюкозе, стероидный сахарный диабет или манифестация латентного сахарного диабета, угнетение функции надпочечников, синдром Иценко-Кушинга. Со стороны пищеварительной системы: тошнота, рвота, повышение или снижение аппетита, обострение хронических заболеваний ЖКТ. Со стороны сердечно-сосудистой системы: аритмия, брадикардия, повышение АД. Со стороны ЦНС: повышение внутричерепного давления, нервозность или беспокойство, бессонница, головокружение, головная боль.
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