indicated in patients whose posterior lens capsule is torn or ruptured because of the risk of migration into the anterior chamber. Laser posterior capsulotomy in pseudophakic patients is not a contraindication for OZURDEX® use.
4.4 Hypersensitivity
OZURDEX® is contraindicated in patients with known hypersensitivity to any components of this product [see Adverse Reactions (6)].
5 WARNINGS AND PRECAUTIONS
5.1 Intravitreal Injection-related Effects
Intravitreal injections, including those with OZURDEX®, have been associated with endophthalmitis, eye inflammation, increased intraocular pressure, and retinal detachments. Patients should be monitored regularly following the injection [see Patient Counseling Information (17)].
5.2 Steroid-related Effects
Use of corticosteroids including OZURDEX® may produce posterior subcapsular cataracts, increased intraocular pressure, and glaucoma. Use of corticosteroids may enhance the establishment of secondary ocular infections due to bacteria, fungi, or viruses [see Adverse Reactions (6.1)].
Corticosteroids are not recommended to be used in patients with a history of ocular herpes simplex because of the potential for reactivation of the viral infection.
6 ADVERSE REACTIONS
6.1 Clinical Studies Experience
Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical studies of a drug cannot be directly compared to rates in the clinical studies of another drug and may not reflect the rates observed in practice.
Adverse reactions associated with ophthalmic steroids including OZURDEX® include elevated intraocular pressure, which may be associated with optic nerve damage, visual acuity and field defects, posterior subcapsular cataract formation, secondary ocular infection from pathogens including herpes simplex, and perforation of the globe where there is thinning of the cornea or sclera.
Retinal Vein Occlusion and Posterior Segment Uveitis
The following information is based on the combined clinical trial results from 3 initial, randomized, 6-month, sham-controlled studies (2 for retinal vein occlusion and 1 for posterior segment uveitis):
Table 1: Adverse Reactions Reported by Greater than 2% of Patients
MedDRA Term
OZURDEX®
N=497 (%) Sham
N=498 (%)
Intraocular pressure increased 125 (25%) 10 (2%)
Conjunctival hemorrhage 108 (22%) 79 (16%)
Eye pain 40 (8%) 26 (5%)
Conjunctival hyperemia 33 (7%) 27 (5%)
Ocular hypertension 23 (5%) 3 (1%)
Cataract 24 (5%) 10 (2%)
Vitreous detachment 12 (2%) 8 (2%)
Headache 19 (4%) 12 (2%)
Increased IOP with OZURDEX® peaked at approximately week 8. During the initial treatment period, 1% (3/421) of the patients who received OZURDEX® required surgical procedures for management of elevated IOP.
Following a second injection of OZURDEX® in cases where a second injection was indicated, the overall incidence of cataracts was higher after 1 year.
Diabetic Macular Edema
The following information is based on the combined clinical trial results from 2 randomized, 3-year, sham-controlled studies in patients with diabetic macular edema. Discontinuation rates due to the adverse reactions listed in TABLE 2 were 3% in the OZURDEX® group and 1% in the Sham group. The most common ocular (study eye) and non-o |
