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Loteprednol
Pronunciation
U.S. Brand Names
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Mechanism of Action
Pharmacodynamics/Kinetics
Usual Dosage
Administration
Monitoring Parameters
Mental Health: Effects on Mental Status
Mental Health: Effects on Psychiatric Treatment
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Dosage Forms

Pronunciation
(loe te PRED nol)

U.S. Brand Names
Alrex™; Lotemax®

Generic Available

No


Synonyms
Loteprednol Etabonate

Pharmacological Index

Corticosteroid, Ophthalmic


Use

0.2% suspension (Alrex™): Temporary relief of signs and symptoms of seasonal allergic conjunctivitis

0.5% suspension (Lotemax®): Inflammatory conditions (treatment of steroid-responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivitis, when the inherent hazard of steroid use is accepted to obtain an advisable diminution in edema and inflammation) and treatment of postoperative inflammation following ocular surgery


Pregnancy Risk Factor

C


Contraindications

Viral diseases of the cornea and conjunctiva; mycobacterial infection of the eye; fungal diseases of ocular structures; hypersensitivity to loteprednol and any ingredients; hypersensitivity to other corticosteroids


Warnings/Precautions

For ophthalmic use only; patients should be re-evaluated if symptoms fail to improve after 2 days. Intraocular pressure should be monitored if this product is used >10 days. Prolonged use may result in glaucoma and injury to the optic nerve. Visual defects in acuity and field of vision may occur. Posterior subcapsular cataracts may form after long-term use. Use with caution in presence of glaucoma (steroids increase intraocular pressure). Perforation may occur with topical steroids in diseases which thin the cornea or sclera. Steroids may mask infection or enhance existing infection. Steroid use may delay healing after cataract surgery.


Adverse Reactions

10% to 15%:

Central nervous system: Headache

Respiratory: Rhinitis, pharyngitis

5% to 10%: Ocular: Abnormal vision/blurring, burning on instillation, chemosis, dry eyes, itching, injection

<5%: Ocular: Conjunctivitis/irritation, corneal abnormalities, eyelid erythema, papillae uveitis

<1%: Ocular: Increased intraocular pressure, changes in visual acuity and/or field defects, cataract formation, secondary ocular infection, global perforation in disease which thins cornea or sclera


Mechanism of Action

Corticosteroids inhibit the inflammatory response including edema, capillary dilation, leukocyte migration, and scar formation. Loteprednol is highly lipid soluble and penetrates cells readily to induce the production of lipocortins. These proteins modulate the activity of prostaglandins and leukotrienes.


Pharmacodynamics/Kinetics

Plasma levels following intraocular administration were not detectable


Usual Dosage

Adults: Ophthalmic:

0.5% suspension (Lotemax®):

Inflammatory conditions: Apply 1-2 drops into the conjunctival sac of the affected eye(s) 4 times/day. During the initial treatment within the first week, the dosing may be increased up to 1 drop every hour. Advise patients not to discontinue therapy prematurely. If signs and symptoms fail to improve after 2 days, re-evaluate the patient.

Postoperative inflammation: Apply 1-2 drops into the conjunctival sac of the operated eye(s) 4 times/day beginning 24 hours after surgery and continuing throughout the first 2 weeks of the postoperative period


Administration

Shake well before using


Monitoring Parameters

Intraocular pressure (if >10 days)


Mental Health: Effects on Mental Status

None reported


Mental Health: Effects on Psychiatric Treatment

None reported


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

No effects or complications reported


Patient Information

Solution: Store in a cool place. Tilt head back, place medication in conjunctival sac, and close eyes. Apply finger pressure at corner of eye for 1 minute following application. Do not allow tip of applicator to touch eye or any contaminated surface.


Dosage Forms

Suspension, ophthalmic, as etabonate:

0.5% (Lotemax®): 2.5 mL, 5 mL, 10 mL, 15 mL


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