prednisolone acetate: clinical use

Prescribing considerations

• Confirm that inflammation is steroid-responsive and exclude bacterial, fungal and viral pathogens before treatment.
• The selected product is licensed for adults; paediatric safety and efficacy have not been established.
• Use punctal occlusion to limit systemic absorption where appropriate.
• Consider specialist review for persistent blurred vision or other visual disturbance.

Contraindications and cautions

• Hypersensitivity to prednisolone acetate or an excipient
• Acute untreated purulent ocular infection
• Acute superficial herpes simplex keratitis and most other viral corneal or conjunctival diseases
• Fungal or mycobacterial eye infection

Monitoring

• Assess clinical response and signs of secondary infection.
• Monitor intraocular pressure under ophthalmic supervision where treatment is prolonged.
• Consider cataract, glaucoma, delayed healing and corneal or scleral thinning when clinically relevant.
• Monitor for systemic corticosteroid effects if exposure is extensive or combined with a strong CYP3A inhibitor.

Clinical pharmacology

Prednisolone acetate is a synthetic glucocorticoid that penetrates the cornea and binds intracellular receptors, altering transcription of anti-inflammatory proteins and suppressing several components of the acute inflammatory response.

Formulation and product differences

• The selected product is a sterile white eye-drop suspension and must be shaken before use.
• It contains benzalkonium chloride, which can irritate the eye and be absorbed by or discolour soft contact lenses.
• The bottle should be discarded 28 days after first opening.

Eye drops

Route: Ophthalmic

Strengths: 1% w/v