Lotepro DS

Indications

0.5% Ophthalmic Suspension: Lotepro DS suspension is prescribed for inflammatory eye conditions that respond to steroids, including issues with the palpebral and bulbar conjunctiva, cornea, and anterior eye segments. Conditions treated include allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, and cyclitis. It is also effective for managing inflammation post-surgery.

1% Ophthalmic Suspension: Lotepro DS 1% suspension is indicated for steroid-responsive inflammation in the palpebral and bulbar conjunctiva, cornea, and anterior eye segment, including allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, and cyclitis. It is beneficial in controlling post-operative inflammation as well.

0.5% Ophthalmic Ointment: Lotepro DS ointment is used for steroid-responsive inflammation of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the eye, covering conditions like allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, and uveitis. It is also prescribed to manage inflammation and pain after ocular surgeries.

0.5% Ophthalmic Gel: Lotepro DS gel treats post-surgical inflammation and pain, as well as steroid-responsive inflammatory conditions in the palpebral and bulbar conjunctiva, cornea, and anterior eye segment, such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, and cyclitis.
(Only take medication as advised by a registered physician)

Pharmacology

Corticosteroids like Lotepro DS are known to suppress inflammatory responses to various triggers, potentially slowing the healing process. They inhibit elements such as edema, fibrin deposition, capillary dilation, leukocyte migration, and collagen deposition that contribute to inflammation. Though the exact mechanism of ocular corticosteroids is unclear, they are believed to work by inducing phospholipase A2 inhibitory proteins, or lipocortins, which prevent the release of arachidonic acid, a precursor to inflammatory mediators like prostaglandins and leukotrienes.

Dosage & Administration

0.5% Ophthalmic Suspension:

• For steroid-responsive inflammation: Instill 1 drop into the conjunctival sac 4 times daily.
• Post-surgery: Instill 1 drop 4 times daily in the operated eye(s), starting 24 hours post-surgery and continuing for two weeks.

1% Ophthalmic Suspension:

• For steroid-responsive inflammation: Apply 1 drop to the conjunctival sac twice daily.
• Post-surgery: Instill 1 drop twice daily in the operated eye(s) starting 24 hours after surgery for two weeks.

0.5% Ophthalmic Ointment: Apply a small ribbon (approx. ½ inch) into the conjunctival sac 4 times daily, beginning 24 hours post-surgery and continuing for two weeks.

Ophthalmic Gel: Instill 1–2 drops into the conjunctival sac of the affected eye 4 times daily, starting the day after surgery and continuing for two weeks.

Pediatric Use: Safety in children is not established.
Geriatric Use: No major safety or efficacy differences observed between elderly and younger patients.

(Only take medication as advised by a registered physician)

Drug Interactions

Lotepro DS, administered topically, is not detected in plasma, making it unlikely to interact with systemically administered medications.

Contraindications

Loteprednol, like other ophthalmic corticosteroids, should not be used in certain viral infections of the cornea and conjunctiva (e.g., herpes simplex keratitis, vaccinia, varicella) or in mycobacterial or fungal eye infections. Individuals with known sensitivities to corticosteroids or specific ingredients in this preparation should avoid use.

Side Effects

Common reactions to ophthalmic steroids may include increased intraocular pressure (which can impact optic nerve function), visual field issues, posterior subcapsular cataract formation, secondary ocular infections (e.g., herpes simplex), and eye globe perforation where the cornea or sclera is thin. Side effects occurring in 5%-15% of patients include blurred vision, burning, chemosis, discharge, dry eyes, foreign body sensation, itching, redness, and photophobia. Other less frequent ocular side effects include conjunctivitis, corneal abnormalities, eyelid erythema, and ocular pain or irritation. Non-ocular side effects (occurring in under 15% of patients) include headache, rhinitis, and pharyngitis.

Pregnancy & Lactation

Pregnancy: Category C. Loteprednol Etabonate lacks sufficient clinical data regarding exposure during pregnancy. Animal studies indicate reproductive toxicity, and the risk to humans is unknown. It should only be used in pregnancy when necessary. It is unclear if topically applied corticosteroids reach levels detectable in breast milk, so caution is advised for nursing mothers.

Precautions & Warnings

If symptoms persist after two days of use, a re-evaluation is advised. For treatments extending 10 days or longer, intraocular pressure should be monitored. Persistent corneal ulceration under steroid use may indicate fungal invasion. If redness or itching worsens, patients should consult their physician and avoid wearing contact lenses during treatment.

Therapeutic Class

Ophthalmic Steroid Preparations

Storage Conditions

Store below 30°C in a dry area, away from light. Avoid contact between the tube tip and surfaces. Once opened, it’s recommended to discard the contents within one month. Protect from freezing.