Barcin-D (0.3/0.1%) 5ml Eye Suspension

Dexamethasone is a potent synthetic corticosteroid that primarily exhibits its anti-inflammatory effects by suppressing the immune system. It binds to cytoplasmic glucocorticoid receptors in target cells, leading to the modulation of gene expression. This results in the inhibition of pro-inflammatory mediators, such as cytokines and enzymes involved in the inflammatory process. Tobramycin, on the other hand, is an aminoglycoside antibiotic that acts by binding to the 30S ribosomal subunit of susceptible bacteria, interfering with protein synthesis. It primarily targets gram-negative bacteria and works by disrupting the bacterial cell wall, leading to bacterial cell death. When combined in a syrup or suspension form, these two components work synergistically to reduce inflammation and eradicate bacterial infections in the respiratory tract.

Dexamethasone, Tobramycin

Corticosteroid, Aminoglycoside antibiotic.

Suspension

The following are the uses of Dexamethasone, Tobramycin Syrup/Suspension:

• Used for treating bacterial infections in the eyes, especially in patients with conjunctivitis or corneal ulcers.
• Used for reducing inflammation and managing post-operative pain after eye surgeries such as cataract removal or corneal transplants.
• Used for managing severe allergic reactions in the eyes, helping to reduce itching, swelling, and redness.
• Used for preventing and treating eye infections in patients with weakened immune systems or those undergoing prolonged steroid therapy.
• Used for managing inflammatory conditions of the eye, including uveitis and iritis, to reduce pain and inflammation.
• Used for treating and preventing infections in patients with eye injuries or foreign bodies in the eye.
• Used for providing relief from eye discomfort and promoting healing in various eye conditions as advised by an ophthalmologist.

In the case of an overdose of Dexamethasone, immediate medical attention is necessary. Symptoms may include increased thirst, frequent urination, and muscle weakness. For Tobramycin Syrup/Suspension overdose, seek medical help for potential side effects such as hearing loss, kidney problems, and balance issues. Prompt medical intervention can effectively manage these overdose situations and minimize potential complications.

In the case of a missed dose of Dexamethasone, it is generally advised to take the missed dose as soon as you remember, but if it's almost time for the next scheduled dose, skip the missed dose and continue with your regular dosing schedule. For Tobramycin Syrup/Suspension, if a dose is missed, administer it as soon as possible. However, if it's almost time for the next dose, skip the missed dose and resume the regular dosing schedule. It's important not to double the dose to make up for a missed one unless specifically instructed by your healthcare provider.

To administer Dexamethasone and Tobramycin Syrup/Suspension, shake the bottle well, measure the prescribed dose with a measuring device like a syringe, and give it orally, following the dosage instructions provided by your healthcare professional, typically twice a day, 12 hours apart, with or without food.

Following are the conditions/situations when Dexamethasone, Tobramycin Syrup/Suspension should not be used:

• Must not be used in patients with a known allergy to dexamethasone, tobramycin, or any other ingredients in the medication.
• Not suitable for individuals with viral, fungal, or certain parasitic infections unless specifically indicated for managing associated inflammatory conditions.
• Contraindicated in patients with active tuberculosis.
• Should not be used in patients with a history of hypersensitivity or severe reactions to other aminoglycoside antibiotics.
• Not recommended for patients with myasthenia gravis.
• Avoid using in patients with recent or current botulinum toxin (Botox) injections.
• Must not be used in patients with perforated ear drums or untreated ear infections.

The side effects of Dexamethasone, Tobramycin Syrup/Suspension may include:

• Nausea and vomiting
• Stomach pain or upset
• Diarrhea
• Skin rash or itching
• Dizziness
• Increased thirst and urination
• Weight gain
• Mood changes, including irritability or anxiety

Following are the precautions and warnings for Dexamethasone, Tobramycin Syrup/Suspension:

• Do not use if you are allergic to any of its ingredients, including dexamethasone or tobramycin.
• This medication should be used with caution in patients with kidney disease, as it may worsen kidney function.
• Avoid using this medication if you have a history of myasthenia gravis, as it can exacerbate muscle weakness.
• Patients with a history of gastrointestinal problems like peptic ulcers should exercise caution, as dexamethasone can increase the risk of gastrointestinal bleeding.
• Tobramycin can cause hearing loss and balance problems, especially in patients with kidney problems or those receiving high doses. Monitor for any hearing changes.
• Prolonged use of dexamethasone may lead to adrenal insufficiency, particularly after abrupt discontinuation. Gradual tapering is recommended.
• Children and elderly patients may be more susceptible to the side effects of this medication, and dosage adjustments may be necessary.
• Inform your doctor if you are pregnant, breastfeeding, or planning to become pregnant, as this medication may have potential risks.

Following are the drug interactions for Dexamethasone, Tobramycin Syrup/Suspension:

• May interact with other nephrotoxic or ototoxic drugs, increasing the risk of kidney or ear damage, especially with nonsteroidal anti-inflammatory drugs (NSAIDs), loop diuretics, or other aminoglycosides.
• Dexamethasone may enhance the effects of other immunosuppressants and decrease the effectiveness of vaccines.
• It can increase the risk of bleeding when taken with anticoagulants, antiplatelet drugs, or thrombolytic agents.
• Tobramycin may have additive effects with other neuromuscular blocking agents, increasing the risk of respiratory depression.
• The effects of dexamethasone may be decreased by enzyme inducers such as rifampicin.
• The risk of hypokalemia may increase when used with other potassium-depleting drugs.
• Caution is advised when combining with diuretics, as it may increase the risk of dehydration and electrolyte imbalances.
• Dexamethasone may alter the metabolism of certain medications, including CYP3A4 substrates, potentially affecting their effectiveness.

Following are the food interactions for Dexamethasone, Tobramycin Syrup/Suspension:

• Dexamethasone may increase appetite, leading to increased food consumption. Monitor dietary intake to maintain a balanced diet.
• High-sodium foods should be limited as Dexamethasone can cause sodium retention, affecting fluid balance.
• Avoid grapefruit and grapefruit juice as they may interfere with the metabolism of Dexamethasone, altering its effectiveness.
• There is no specific food interaction with Tobramycin, but maintaining adequate hydration is essential for kidney health.
• Tobramycin absorption can be affected by antacids containing aluminum, magnesium, or calcium. Avoid taking them simultaneously.
• Consuming a healthy diet rich in protein and calories is recommended to support the body's recovery process.
• No significant food interactions are known, but consult your healthcare provider for personalized advice based on your medical condition.

Dexamethasone and Tobramycin Syrup/Suspension should be stored properly to maintain its effectiveness and safety. Keep the medication in a cool and dry place, preferably at room temperature, ensuring it is protected from direct sunlight and moisture. Store it in its original container with the cap tightly secured to maintain its integrity. Avoid extreme temperatures by not placing it in the bathroom or near heat sources like stoves or radiators. Always check the expiration date, and if the medication is expired or no longer needed, proper disposal is crucial. Contact your pharmacist or healthcare provider for guidance on safe disposal methods, and never flush or pour the medication down the drain. Keep it out of children's reach to prevent accidental consumption.

Following are the quick tips for Dexamethasone, Tobramycin Syrup/Suspension:

• Ensure you understand the prescribed dosage and duration from your healthcare provider.
• Administer the syrup/suspension accurately using the provided measuring device.
• Take the medication at evenly spaced intervals to maintain consistent blood levels.
• Avoid sudden discontinuation; follow your doctor's instructions for tapering the dose.
• Inform your doctor about any existing medical conditions or medications.
• Store the medication as directed, away from moisture and light.
• Regularly monitor your condition and report any side effects to your healthcare provider.