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TriMoxi+
TriMoxi+ is a compounded ophthalmic injection used after cataract surgery to reduce inflammation, prevent infection, and manage pain. It contains three active ingredients: triamcinolone acetonide (a corticosteroid), moxifloxacin (an antibiotic), and sometimes vancomycin (another antibiotic), depending on the formulation. TriMoxi+ is designed to be injected into the eye during or after cataract surgery, eliminating the need for patients to use multiple eye drops post-surgery. The combination of steroids and antibiotics helps reduce swelling and prevent bacterial infections during the critical recovery phase.
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Frequently Asked Questions
How long does TriMoxi+ last after surgery?
TriMoxi+ is designed to provide extended anti-inflammatory and antibiotic protection for several days to weeks after surgery, reducing the need for post-operative eye drops.
Do I still need eye drops after receiving TriMoxi+?
In many cases, TriMoxi+ eliminates the need for post-operative eye drops. However, your surgeon will provide specific instructions based on your individual case.
Can TriMoxi+ affect my vision?
Immediately after the injection, you may experience blurry vision or difficulty focusing. These effects are typically temporary, but any prolonged vision changes should be reported to your doctor.
Is TriMoxi+ safe for people with glaucoma?
TriMoxi+ can increase intraocular pressure due to its corticosteroid component, so it may not be recommended for patients with glaucoma or those at risk for glaucoma. Discuss any concerns with your ophthalmologist.
What should I do if I experience eye pain or vision loss after surgery?
Contact your ophthalmologist immediately if you experience any unusual symptoms such as severe pain, vision loss, or signs of infection (redness, swelling) after surgery. These could indicate a serious complication.
Comprehensive Drug Guide
How Does TriMoxi+ Work?
- Triamcinolone acetonide: A potent corticosteroid that reduces inflammation by inhibiting the release of substances in the body that cause swelling and allergic reactions.
- Moxifloxacin: A fluoroquinolone antibiotic that kills bacteria by inhibiting bacterial DNA replication.
- Vancomycin (if included): An antibiotic that works by inhibiting bacterial cell wall synthesis, effective against certain Gram-positive bacteria.
Common Dosages
- Triamcinolone acetonide: Commonly used in concentrations of 3 mg to 4 mg
- Moxifloxacin: Typically compounded at 0.1 mg
- Vancomycin (if included): Customarily compounded at 1 mg
Typical Dosing
- TriMoxi+ is administered as a single intravitreal injection during or immediately after cataract surgery. The medication provides extended anti-inflammatory and antibiotic protection, reducing or eliminating the need for eye drop medications after surgery.
Typical Dosing
FDA Approved Indications
- Post-cataract surgery inflammation and infection prevention
- Reducing the need for post-operative eye drops by providing sustained-release anti-inflammatory and antibacterial action
Who Shouldn't Take TriMoxi+?
- Known hypersensitivity to any component of the injection (triamcinolone, moxifloxacin, or vancomycin)
- Active ocular infections, such as viral or fungal infections
- Glaucoma or significant risk of increased intraocular pressure, due to the corticosteroid component
Advice From The Pharmacist
- TriMoxi+ is injected by your surgeon, so there are no special instructions for self-administration.
- After receiving TriMoxi+, you may not need additional post-surgical eye drops for infection or inflammation. Follow your surgeon’s instructions closely regarding any further medications.
- Avoid rubbing your eyes after surgery and follow any recommendations about wearing an eye shield, particularly while sleeping.
- Report any unusual symptoms, such as eye pain, vision changes, or signs of infection, to your ophthalmologist immediately.
Side Effects of TriMoxi+
Common Side Effects
- Increased intraocular pressure (typically temporary)
- Blurry vision or difficulty focusing immediately after the injection
- Mild discomfort or eye irritation
Uncommon/Severe Side Effects
- Endophthalmitis (an infection inside the eye)
- Severe increases in intraocular pressure, which can lead to glaucoma if left untreated
- Retinal detachment or other serious vision changes
Risks and Warnings of TriMoxi+
- Increased intraocular pressure: Triamcinolone, a corticosteroid, can cause a temporary increase in eye pressure. Patients with a history of glaucoma should be monitored closely.
- Infection risk: Though TriMoxi+ contains antibiotics to prevent bacterial infections, there is a rare risk of developing an infection in the eye after surgery.
- Blurred vision: Temporary blurred vision or difficulty focusing may occur immediately after the injection. Avoid driving or operating machinery until your vision clears.
Interactions with TriMoxi+
Common Drug Interactions
- Ocular medications: If other eye medications are prescribed, ensure they are spaced appropriately to avoid interactions or irritation. Discuss with your ophthalmologist before using any additional treatments.
- Systemic corticosteroids: Using systemic corticosteroids alongside TriMoxi+ may increase the risk of systemic side effects such as immune suppression or adrenal suppression.
Alternatives to TriMoxi+
- Separate eye drops: In traditional post-cataract surgery care, patients are prescribed separate anti-inflammatory (steroid) and antibiotic eye drops to use multiple times per day.
- Dexamethasone ophthalmic (Ozurdex): Another long-acting intravitreal corticosteroid implant used for treating inflammation in certain eye conditions.
- Prednisolone acetate: A common steroid eye drop used for post-surgery inflammation.
