Home Drug Guide Loteprednol Etabonate

Drug Guide

Generic Name

Loteprednol Etabonate

Brand Names Lotemax, Alrex, Lotemax Sm, Inveltys, Eysuvis

Classification

Therapeutic: Anti-inflammatory (ophthalmic corticosteroid)

Pharmacological: Topical corticosteroid

FDA Approved Indications

Inflammation of the eyelids, conjunctiva, and cornea (e.g., allergic conjunctivitis, non-infectious conjunctivitis)
Postoperative ocular inflammation following ocular surgery
Dry eye disease (Eysuvis)

Mechanism of Action

Loteprednol Etabonate reduces inflammation by inhibiting the release of inflammatory mediators and decreasing vascular permeability, with a reduced likelihood of increased intraocular pressure compared to other corticosteroids due to its soft drug design.

Dosage and Administration

Adult: Apply to the affected eye(s) as prescribed, typically one to two drops 3-4 times daily. For example, Eysuvis: one drop 4 times daily initially, then taper.

Pediatric: Use under medical supervision; safety and efficacy established in children over 2 years for specific formulations.

Geriatric: Use with caution; monitor intraocular pressure regularly as elderly may have increased susceptibility to corticosteroid effects.

Renal Impairment: No specific dosage adjustment required.

Hepatic Impairment: No specific dosage adjustment required.

Pharmacokinetics

Absorption: Minimal systemic absorption when applied ophthalmically.

Distribution: Primarily localized; systemic levels are generally very low.

Metabolism: Rapidly metabolized in ocular tissues to inactive metabolites.

Excretion: Excreted primarily via the renal route after systemic absorption.

Half Life: Approximately 1.8 hours in ocular tissues; systemic half-life is not clinically significant.

Contraindications

Hypersensitivity to loteprednol etabonate or any components of the formulation.

Precautions

Use with caution in patients with existing ocular infections.
May increase intraocular pressure; monitor intraocular pressure regularly.
Long-term use can lead to ocular side effects such as cataract formation.

Adverse Reactions - Common

Eye irritation (Unknown)
Blurred vision (Uncommon)
Dry eyes (Uncommon)

Adverse Reactions - Serious

Increased intraocular pressure leading to glaucoma (Rare)
Corneal thinning or perforation (Rare)
Secondary ocular infection (Rare)

Drug-Drug Interactions

Other ocular corticosteroids or medications that increase intraocular pressure.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor intraocular pressure, ocular symptoms, and for signs of infection.

Diagnoses:

Risk for increased intraocular pressure
Risk for secondary infection

Implementation: Administer as prescribed, ensure proper technique, and monitor response.

Evaluation: Assess reduction in inflammation, ocular comfort, and intraocular pressure levels.

Patient/Family Teaching

Do not touch the tip of the dropper to the eye or other surfaces.
Use exactly as prescribed.
Report any new or worsening symptoms, such as pain, visual changes, or signs of infection.
Attend follow-up appointments for intraocular pressure monitoring.

Special Considerations

Black Box Warnings:

Prolonged use may result in increased intraocular pressure and/or cataract formation.

Genetic Factors: None specific.

Lab Test Interference: May alter intraocular pressure readings.

Overdose Management

Signs/Symptoms: No specific systemic overdose symptoms expected from ophthalmic use; topical overdose may cause increased intraocular pressure.

Treatment: Discontinue medication, monitor intraocular pressure, and manage symptoms supportively.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable until expiration date on the package.