Home Drug Guide Fluorometholone

Drug Guide

Generic Name

Fluorometholone

Brand Names Oxylone, Fml, Fml Forte, Fluor-op

Classification

Therapeutic: Anti-inflammatory, ophthalmic agent

Pharmacological: Topical corticosteroid

FDA Approved Indications

Inflammation of the conjunctiva, cornea, and anterior segment of the eye due to allergic, inflammatory, or irritative conditions

Mechanism of Action

Fluorometholone suppresses the migration of polymorphonuclear leukocytes and fibroblasts, decreases capillary permeability, and inhibits the release of inflammatory mediators, thus reducing inflammatory response in the eye.

Dosage and Administration

Adult: Typically, 1-2 drops in the affected eye(s) 4 times daily, adjusted by the physician.

Pediatric: Dosage should be individualized; usually, 1-2 drops 4 times daily, but safety and efficacy data are limited.

Geriatric: Use with caution; adjust based on response and tolerability.

Renal Impairment: No specific adjustments, but caution is advised due to systemic absorption.

Hepatic Impairment: No specific data; caution recommended.

Pharmacokinetics

Absorption: Minimal systemic absorption when used topically in the eye.

Distribution: Primarily localized in ocular tissues.

Metabolism: Metabolized in the eye tissues; systemic metabolism not well characterized.

Excretion: Systemic metabolites excreted primarily via urine.

Half Life: Not well defined due to topical use; systemic half-life is not applicable.

Contraindications

Hypersensitivity to fluorometholone or any components.
Active ocular infections,

Precautions

Use cautiously in patients with ocular herpes simplex, other viral infections, or fungal infections. Prolonged use may increase intraocular pressure, induce cataracts, or cause secondary infections. Use during pregnancy and lactation only if benefits outweigh risks.

Adverse Reactions - Common

Increased intraocular pressure (Uncommon)
Cataract formation (Uncommon)
Eyelid or conjunctival hyperemia (Common)
Transient burning or stinging (Common)

Adverse Reactions - Serious

Secondary ocular infections (Rare)
Corneal thinning or perforation (Rare)

Drug-Drug Interactions

Other ophthalmic medications, especially antiviral or antifungal agents, may reduce efficacy or increase risk of infection.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor intraocular pressure regularly, especially during prolonged use.

Diagnoses:

Risk for increased intraocular pressure
Risk for secondary infection

Implementation: Administer eye drops as prescribed, ensuring proper instillation technique. Advise patients to avoid touching tip of dropper to eye or surrounding structures.

Evaluation: Assess ocular comfort, signs of inflammation, intraocular pressure, and any adverse effects.

Patient/Family Teaching

Use exactly as prescribed. Do not increase or decrease the dosage without healthcare provider approval.
Report any eye pain, vision changes, increased redness, or discharge.
Follow recommended follow-up visits for intraocular pressure assessment.

Special Considerations

Black Box Warnings:

Prolonged use may result in increased intraocular pressure and secondary glaucoma, with possible permanent visual impairment.
Use caution in patients with herpes simplex keratitis due to risk of corneal perforation.

Genetic Factors: Not specifically relevant.

Lab Test Interference: None known.

Overdose Management

Signs/Symptoms: Overdose primarily concerns systemic absorption leading to corticosteroid effects; topical overdose is rare.

Treatment: Symptomatic treatment, discontinuation of the drug, and ocular monitoring.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F). Protect from light and moisture.

Stability: Stable until the expiration date provided on the packaging.