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Rimexolone

Medically reviewed by Drugs.com. Last updated on Sep 24, 2020.

Pronunciation

(ri MEKS oh lone)

Pharmacologic Category

  • Corticosteroid, Ophthalmic

Pharmacology

Suppresses the inflammatory response by inhibiting edema, capillary dilation, leukocyte migration and scar formation.

Absorption

Through aqueous humor

Metabolism

Hepatic for any amount of drug absorbed

Excretion

Urine and feces (>80%)

Half-Life Elimination

1 to 2 hours

Use: Labeled Indications

Ophthalmic inflammatory conditions: Treatment of postoperative inflammation following ocular surgery; treatment of anterior uveitis

Contraindications

Hypersensitivity to rimexolone or any component of the formulation; acute untreated purulent ocular infections; viral diseases of the cornea and conjunctiva (eg, epithelial herpes simplex keratitis [dendritic keratitis], vaccinia, varicella); mycobacterial or fungal infections of the eye

Documentation of allergenic cross-reactivity for corticosteroids is limited. However, because of similarities in chemical structure and/or pharmacologic actions, the possibility of cross-sensitivity cannot be ruled out with certainty.

Dosing: Adult

Note: Vexol has been discontinued in the United States since September 2016.

Anterior uveitis: Ophthalmic: Instill 1 to 2 drops in conjunctival sac of affected eye every hour during waking hours for the first week, then 1 drop every 2 hours during waking hours of the second week, and then taper until uveitis is resolved

Postoperative ocular inflammation: Ophthalmic: Instill 1 to 2 drops in conjunctival sac of affected eye 4 times daily beginning 24 hours after surgery and continuing through the first 2 weeks of the postoperative period

Dosing: Geriatric

Refer to adult dosing.

Administration

For topical ophthalmic use only; to avoid contamination, do not touch dropper tip to eyelids or other surfaces when placing drops in eyes. Shake well before using. The use of the same bottle for both eyes is not recommended in surgical patients.

Storage

Store upright at 2°C to 25°C (36°F to 77°F). Do not freeze.

Drug Interactions

Aldesleukin: Corticosteroids may diminish the antineoplastic effect of Aldesleukin. Avoid combination

Nonsteroidal Anti-Inflammatory Agents (Ophthalmic): May enhance the adverse/toxic effect of Corticosteroids (Ophthalmic). Healing of ophthalmic tissue during concomitant administration of ophthalmic products may be delayed. Monitor therapy

Adverse Reactions

1% to 5%:

Central nervous system: Foreign body sensation of eye

Ophthalmic: Blurred vision, eye discharge, eye discomfort, eye pain, eye pruritus, increased intraocular pressure, ocular hyperemia

<2%:

Cardiovascular: Hypotension

Central nervous system: Headache

Gastrointestinal: Dysgeusia

Respiratory: Pharyngitis, rhinitis

Frequency not defined:

Infection: Secondary ocular infection

Ophthalmic: Cataract, eye disease (defects in visual activity), eye perforation, optic nerve damage

<1%, postmarketing, and/or case reports: Anterior chamber fibrin deposition, brow ache, conjunctival edema, corneal edema, corneal erosion, corneal infiltrates, corneal staining, corneal ulcer, crusting of eyelid, eye irritation, keratitis, lacrimation, ocular edema, photophobia, sticky sensation of eye, xerophthalmia

Warnings/Precautions

Concerns related to adverse effects:

• Cataracts: Prolonged use of corticosteroids may result in posterior subcapsular cataract formation. Use following cataract surgery may delay healing or increase the incidence of bleb formation.

• Corneal thinning: Various ophthalmic disorders, as well as prolonged use of corticosteroids, may result in corneal and scleral thinning. Continued use in a patient with thinning may result in perforation.

• Glaucoma: Prolonged use of corticosteroids may result in elevated intraocular pressure (IOP) and/or glaucoma; damage to the optic nerve; and defects in visual acuity and fields of vision. Use with caution in patients with glaucoma; monitor IOP in any patient receiving treatment for ≥10 days.

• Immunosuppression: Prolonged use of corticosteroids may increase the incidence of secondary infection (including fungal infections). Acute purulent ocular infections may be masked or exacerbated with use. Fungal infection should be suspected in any patient with persistent corneal ulceration who has received corticosteroids.

Special populations:

• Contact lens wearers: Some preparations contain benzalkonium chloride which may be adsorbed by contact lenses.

Other warnings/precautions:

• Appropriate use: Patients should be re-evaluated if symptoms fail to improve after 2 days. Initial prescription and renewal of medication should be made by healthcare provider only after examination with the aid of magnification such as slit lamp biomicroscopy or fluorescein staining (if appropriate). Corticosteroids should not be used to treat ocular herpes simplex. Use of same bottle in both eyes of postoperative patients is not recommended.

Monitoring Parameters

Intraocular pressure and periodic examination of lens (with prolonged use ≥10 days)

Pregnancy Risk Factor

C

Pregnancy Considerations

Adverse events have been observed in animal reproduction studies following subcutaneous administration. The amount of rimexolone absorbed systemically following ophthalmic administration is low (<80 to 470 pg/mL).

Patient Education

What is this drug used for?

• It is used to treat eye swelling.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Foreign body sensation of eye

WARNING/CAUTION: Even though it may be rare, some people may have very bad and sometimes deadly side effects when taking a drug. Tell your doctor or get medical help right away if you have any of the following signs or symptoms that may be related to a very bad side effect:

• Vision changes

• Eye pain

• Severe eye irritation

• Eye discharge

• Signs of an allergic reaction, like rash; hives; itching; red, swollen, blistered, or peeling skin with or without fever; wheezing; tightness in the chest or throat; trouble breathing, swallowing, or talking; unusual hoarseness; or swelling of the mouth, face, lips, tongue, or throat.

Note: This is not a comprehensive list of all side effects. Talk to your doctor if you have questions.

Consumer Information Use and Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only the healthcare provider has the knowledge and training to decide which medicines are right for a specific patient. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a limited summary of general information about the medicine's uses from the patient education leaflet and is not intended to be comprehensive. This limited summary does NOT include all information available about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not intended to provide medical advice, diagnosis or treatment and does not replace information you receive from the healthcare provider. For a more detailed summary of information about the risks and benefits of using this medicine, please speak with your healthcare provider and review the entire patient education leaflet.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.