The development of secondary infection has occurred after use of combinations containing corticosteroids and antimicrobials.
Fungal and viral infections of the cornea are particularly prone to develop coincidentally with long-term applications of corticosteroid.The possibility of fungal invasion must be considered in any persistent corneal ulceration where corticosteroid treatment has been used.Secondary bacterial ocular infection following suppression of host responses also occurs.
VASOCIDIN is indicated for corticosteroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where superficial bacterial ocular infection or a risk of bacterial ocular infection exists.Ocular corticosteroids are indicated in inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where the inherent risk of corticosteroid use in certain infective conjunctivitides is accepted to obtain diminution in edema and inflammation.They are also indicated in chronic anterior uveitis and corneal injury from chemical, radiation, or thermal burns or penetration of foreign bodies.The use of a combination drug with an anti-infective component is indicated where the risk of superficial ocular infection is high or where there is an expectation that potentially dangerous numbers of bacteria will be present in the eye.The particular anti-infective drug in this product is active against the following common bacterial eye pathogens: Escherichia coli, Staphylococcus aureus, Streptococcus pneumoniae, Streptococcus (viridans group), Haemophilus influenzae, Klebsiella species, and Enterobacter species.This product does not provide adequate coverage against: Neisseria species, Serratia marcescens.A significant percentage of staphylococcal isolates are completely resistant to sulfa drugs.
VASOCIDIN Ophthalmic Solution is contraindicated in most viral diseases of the cornea and conjunctiva including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella, and also in mycobacterial infection of the eye and fungal diseases of ocular structures.
VASOCIDIN is also contraindicated in individuals with known or suspected hypersensitivity to any of the ingredients of this preparation, to other sulfonamides, or to other corticosteroids.(Hypersensitivity to the antimicrobial components occurs at a higher rate than for other components).
NOT FOR INJECTION INTO THE EYE.
Prolonged use of corticosteroids may result in ocular hypertension/glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision, and in posterior subcapsular cataract formation.Acute anterior uveitis may occur in susceptible individuals, primarily Blacks.Prolonged use of VASOCIDIN may suppress the host response and thus increase the hazard of secondary ocular infections.
In those diseases causing thinning of the cornea or sclera, perforations have been known to occur with the use of topical corticosteroids.
In acute purulent conditions of the eye, corticosteroids may mask infection or enhance existing infection.If this product is used for 10 days or longer, intraocular pressure should be routinely monitored even though it may be difficult in pediatric patients and uncooperative patients.
Corticosteroids should be used with caution in the presence of glaucoma.
Intraocular pressure should be checked frequently.The use of corticosteroids after cataract surgery may delay healing and increase the incidence of filtering blebs.The use of ocular corticosteroids may prolong the course and may exacerbate the severity of many viral infections of the eye (including herpes simplex).
Employment of corticosteroid medication in the treatment of herpes simplex requires great caution.A significant percentage of staphylococcal isolates are completely resistant to sulfonamides.Topical corticosteroids are not effective in mustard gas keratitis and Sjögren's keratoconjunctivitis.Fatalities have occurred, although rarely, due to severe reactions to sulfonamides including Stevens-Johnson syndrome, toxic epidermal necrolysis, fulminant hepatic necrosis, agranulocytosis, aplastic anemia, and other blood dyscrasias.
Sensitizations may recur when a sulfonamide is readministered irrespective of the route of administration.
If signs of hypersensitivity or other serious reactions occur, discontinue use of this preparation.Cross-sensitivity among corticosteroids have been demonstrated (see ADVERSE REACTIONS).Do not administer this product to patients who are sensitive/allergic to thimerosal or any other mercury-containing ingredient.