Dosing and uses of Alrex, Lotemax (loteprednol ophthalmic)
Adult dosage forms and strengths
ophthalmic suspension
- 0.2% (Alrex)
- 0.5% (Lotemax)
ophthalmic ointment
- 0.5% (Lotemax)
ophthalmic geL
- 0.5% (Lotemax)
Seasonal Allergic Conjunctivitis
0.2% suspension: 1 gtt into affected eye QId
Steroid-Responsive Inflammatory Conditions
Indicated for the treatment of steroid-responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe (eg, allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, selected infective conjunctivitides)
0.5% suspension: 1-2 gtt into conjunctival sac of the affected eye(s) QID; if necessary, may increase dose up to 1 gtt every hour during initial treatment within the first week
Re-evaluate if signs and symptoms do not improve after 2 days
Postoperative Ocular Inflammation
0.5% suspension or gel: Apply 1-2 gtt into the conjunctival sac of the operated eye(s) QID beginning 24 hr after surgery and continuing throughout the first 2 weeks of the postoperative period
0.5% ointment: Apply small amount (~0.5-in ribbon) into conjunctival sac(s) QID beginning 24 hr after surgery and continue throughout the first 2 weeks of the postoperative period
Pediatric dosage forms and strengths
Safety and efficacy not established
Alrex, Lotemax (loteprednol ophthalmic) adverse (side) effects
Frequency not defined
Glaucoma
Cataract
Potentiate super infection
Slow wound healing
Blurred vision
Burning sensation in eye
Itching of eye
Light intolerance
Raised intraocular pressure
Warnings
Contraindications
Hypersensitivity to any component of the formulation
Absolute: herpes simplex (keratitis, dendritic), keratitis (vaccinia virus), ocular infection (fungal), ocular infection (viral), ocular tuberculosis
Relative: glaucoma
Cautions
Close monitoring should occur: ocular surgery
Pregnancy and lactation
Pregnancy category: C
Lactation: ophthalmic corticosteroids have not been reported to cause problems in nursing babies
Pregnancy categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA: Information not available.
Pharmacology of Alrex, Lotemax (loteprednol ophthalmic)
Mechanism of action
Synthetic nonfluorinated corticosteroid
Pharmacokinetics
Absorption: Following topical instillation into the conjunctival sac, absorbed into the aqueous humor and minimal systemic absorption occurs