loteprednol etabonate: clinical use

Prescribing considerations

• Confirm that inflammation follows ocular surgery and exclude infection or unexplained red eye.
• Use cautiously in glaucoma, dry eye, corneal compromise or conditions causing corneal or scleral thinning.
• Reassess if signs and symptoms do not improve promptly.
• Paediatric safety and efficacy data are unavailable.
• Consider CYP3A-inhibitor exposure and concurrent medicines affecting intraocular pressure.

Contraindications and cautions

• Hypersensitivity to loteprednol etabonate, an excipient or another corticosteroid.
• Most viral corneal or conjunctival diseases, including epithelial herpes simplex keratitis, vaccinia and varicella.
• Mycobacterial, fungal or amoebic ocular infection.
• Untreated acute purulent ocular infection or red eye without a diagnosis.
• Breastfeeding.

Monitoring

• Monitor intraocular pressure when use is prolonged or where glaucoma risk is relevant.
• Assess persistent blurred vision or other visual disturbance for glaucoma, cataract or other ocular pathology.
• Watch for secondary infection, delayed healing and corneal or scleral thinning or perforation.
• Consider fungal disease if a corneal ulcer persists.

Clinical pharmacology

An ophthalmic corticosteroid with local anti-inflammatory activity. It binds corticosteroid receptors and is metabolised towards inactive cortienic-acid derivatives; systemic exposure after ocular administration is limited.

Formulation and product differences

• The selected UK product is a preserved, milky-white eye-drop suspension rather than a solution.
• It contains benzalkonium chloride, which may irritate dry or compromised eyes and can be absorbed by soft contact lenses.
• The suspension requires vigorous shaking and upright storage; it must not be frozen.
• The bottle should be discarded 28 days after first opening.

Eye drops

Route: Ophthalmic

Strengths: 0.5%