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Dextenza

dexamethasone
Used for Eye Pain
Used for Eye Pain

Dextenza (dexamethasone) is a steroid-containing insert that's placed in the corner of your eye. It helps with eye swelling and pain after eye surgery. The insert works for 30 days, so you won't need to use additional steroid eye drops.

Reviewed by:
reviewer
Allison Gourley, PharmD
reviewer
Hope Chang, PharmD, AAHIVP
Last reviewed on November 30, 2021
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostContraindicationsAlternativesPricesMedicare
basics-icon

What is Dextenza (dexamethasone)?

What is Dextenza (dexamethasone) used for?

  • Eye inflammation and pain after eye surgery

  • Itchy eyes caused by allergies

How Dextenza (dexamethasone) works

Dextenza (dexamethasone) is a corticosteroid. Corticosteroids like Dextenza (dexamethasone) block your body's immune response to lower inflammation (swelling and redness). After eye surgery or when you have allergies, your body responds by releasing proteins (cytokines) that cause inflammation, discomfort, and itchiness. Because it blocks these proteins, placing Dextenza (dexamethasone) into the eye helps with pain, swelling, and comfort.

Are you looking for information on oral dexamethasone or dexamethasone eye drops (Maxidex) instead?

Drug Facts

Common BrandsDextenza
Drug ClassCorticosteroid
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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$641.76
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What are the side effects of Dextenza (dexamethasone)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Inflammation in the middle layer of the eye (following eye surgery, 10%)
  • Greater pressure in the eye (up to 6%)
  • Lower ability to see clearly (up to 2%)

Other Side Effects

Eye inflammation after eye surgery
  • Eye pain
  • Cystoid macular edema (a painless condition in center of the eye that can cause vision problems)
  • Swelling of the cornea
  • Red eyes
  • Headache
Itchy eyes caused by allergies
  • Eye discharge
  • Headache

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

  • Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
  • New or worsening eye pain, redness, irritation, or discharge
  • Sudden eye pain or change in vision such as blurry vision, seeing halos around lights, vision loss

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Dextenza (dexamethasone)

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Pros

Continuously releases medication and replaces steroid eye drops

Doesn't contain preservatives

Doesn't need to be removed

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Cons

Can be pricey, typically more expensive than eye drops

Not meant for children

Raises the risk of infection

pharmacist-tips

Pharmacist tips for Dextenza (dexamethasone)

pharmacist

  • Discomfort isn't a common side effect, so tell your provider if you feel pain, redness, or itching in the eye. This could be a sign of an infection or a more serious problem.

    • You don't need to remove the Dextenza (dexamethasone) insert after 30 days, your eye will eventually absorb the insert. Don't try to remove it on your own if you feel discomfort. Instead, call your provider right away. They'll be able to investigate the discomfort and remove the insert if necessary.

      • You might have blurry vision after your provider places the insert. Avoid driving or other tasks that require clear vision until this goes away.

        • Make sure to keep regular eye appointments with your provider so they can monitor your eye after surgery and make sure this medication is working safely for you.

          faqs

          Frequently asked questions about Dextenza (dexamethasone)

          Will I feel the Dextenza (dexamethasone) insert?
          You might feel the Dextenza (dexamethasone) insert and have some pain right after your eye surgery. Still, 96% of people using Dextenza (dexamethasone) described it as comfortable, and just as many said they were likely to ask for the insert again in the future.
          How do I take the Dextenza (dexamethasone) insert out of my eye after 30 days?
          You don't. The insert is resorbable, meaning that your eye basically absorbs the entire insert after 30 days. There's no need to go back to your provider to have it removed. If the insert has to be removed, your provider has ways to take it out. Never try to remove it on your own at home.
          Can I use Dextenza (dexamethasone) if I'm pregnant?
          There's little information about Dextenza (dexamethasone) use during pregnancy. But there are animal studies in pregnant mice and rabbits that showed that this medication can cause harm or birth defects to unborn mice and rabbits. Make sure to tell your provider if you're pregnant or plan on becoming pregnant, especially during the 30 days after Dextenza (dexamethasone) insert is placed.
          Do I need to be put to sleep to get the Dextenza (dexamethasone) insert placed?
          No. Your provider can dilate your eyes beforehand and give you eye drops to make your eyes moist. This will help your provider place the insert, but you don't need to be asleep for this. In clinical trials for Dextenza (dexamethasone) for eye inflammation after cataract surgery, the insert was placed right after the surgery.
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          What are the risks and warnings for Dextenza (dexamethasone)?

          Dextenza (dexamethasone) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

          risk-warning

          Greater pressure in the eye

          • Risk factors: Glaucoma | Using steroids for a long time

            Dextenza (dexamethasone) is a steroid medication. Steroids can raise eye pressure and raise the risk of causing glaucoma, especially if used for a long period of time. If you already have glaucoma, you can still use Dextenza (dexamethasone), but your provider might monitor your eye pressure more often when you're using the insert.

            risk-warning

            Infection

            Steroids like Dextenza (dexamethasone) help with eye pain, itchiness, and inflammation by lowering your body's immune response. But this can put you at a higher risk for bacterial, viral, and fungal eye infections. Additionally, steroids like Dextenza (dexamethasone) can mask the symptoms of an ongoing eye infection. Your provider will likely do an eye exam before inserting Dextenza (dexamethasone) to make sure you don't have an active infection. Be sure to report any redness, itching, or pain while using Dextenza (dexamethasone), as these could be signs of an infection.

            risk-warning

            Delayed healing

            Dextenza (dexamethasone) is a steroid medication. Steroids are known to slow down the healing time after cataract surgery and can raise your risk of getting blister-like, fluid-filled bumps on your eye (blebs). Make sure you have follow-up visits with your provider after your surgery so they can monitor your recovery and eye health.

            dosage

            Dextenza (dexamethasone) dosage forms

            The average cost for 1 insert of 0.4mg of Dextenza (dexamethasone) is $641.76 with a free GoodRx coupon.0
            carton
            Carton
            DosageQuantityPrice as low asPrice per unit
            10 inserts of 0.4mg1 carton$6309.60$6309.60
            insert
            Insert
            DosageQuantityPrice as low asPrice per unit
            0.4mg1 insert$641.76$641.76

            Typical dosing for Dextenza (dexamethasone)

            Each Dextenza (dexamethasone) insert contains 0.4 mg of medication. The insert will be placed in your eye by a trained healthcare provider, and then will slowly release medication for up to 30 days.

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            How much does Dextenza (dexamethasone) cost?

            To access savings, use a GoodRx coupon and pay just a fraction of the retail price.
            Dextenza (brand)
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            $641.76

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            contraindications-icon

            Dextenza (dexamethasone) contraindications

            Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Dextenza (dexamethasone) will not be safe for you to take.

            • Active eye infection

            alternatives

            What are alternatives to Dextenza (dexamethasone)?

            There are a number of medications that your doctor can prescribe in place of Dextenza (dexamethasone). Compare a few possible alternatives below.
            Dextenza (dexamethasone)
            Used for:

            • Eye inflammation and pain after eye surgery

            • Itchy eyes caused by allergies

            $641.76 Lowest GoodRx priceView Prices
            Loteprednol (Lotemax)
            Used for:

            • Dry eye disease

            • Eye inflammation conditions

            • Inflammation and pain after eye surgery

            • Eye inflammation due to seasonal allergies

            $49.07 Lowest GoodRx priceView Prices
            Dexamethasone (Maxidex)
            Used for:
            $77.06 Lowest GoodRx priceView Prices

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