prednisolone ophthalmic (Rx)

Brand and Other Names:Pred Forte, Pred Mild, more...Inflamase Mild, Omnipred, Econopred Plus, Inflamase Forte
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic suspension

  • 0.12%
  • 1%

ophthalmic solution

  • 0.11%
  • 0.9%
  • 1%

Ophthalmic Inflammatory Conditions

1-2 gtt of 1% solution BID-QID (may be more frequent during initial 24-48 hr)

Conjunctivitis

1-2 gtt of 1% solution BID-QID (may be more frequent during initial 24-48 hr)

See also combo with gentamicin

Other Indications & Uses

Ocular corticosteroid, antiinflammatory agent

Effective in iritis, keratitis, conjunctivitis, and many ocular inflammatory diseases; bacterial and viral infections require concomitant antibacterial and antiviral coverage, respectively

Dosage Forms & Strengths

ophthalmic suspension

  • 0.12%
  • 1%

ophthalmic solution

  • 0.11%
  • 0.9%
  • 1%

Ophthalmic Inflammatory Conditions

1-2 gtt of 1% solution BID-QID (may be more frequent during initial 24-48 hr)

Conjunctivitis

1-2 gtt of 1% solution BID-QID (may be more frequent during initial 24-48 hr)

See also combo with gentamicin

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Adverse Effects

Frequency Not Defined

Increased IOP

Ocular hypertension

Conjunctival hyperemia

Conjuctivitis

Corneal ulcers

Delayed wound healing

Glaucoma

Keratitis

Loss of accommodation

Optic nerve damage

Mydriasis

Posterior subcapsular cataract formation

Ptosis

Secondary ocular infection

Hypercorticoidism (rare)

Postmarketing Reports

Eye pain

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Warnings

Contraindications

Hypersensitivity

Acute untreated purulent ocular infections, in most viral diseases of cornea and conjunctiva including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella, and also in mycobacterial infection of the eye and fungal diseases of ocular structures

Cautions

Use ocular steroids cautiously

Prolonged use of corticosteroids may result in posterior subcapsular cataract formation and may increase intraocular pressure in susceptible individuals, resulting in glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision

Prolonged use may also suppress the host immune response and thus increase the hazard of secondary ocular infections

Routinely monitor intraocular pressure if this product is used for 10 days or longer

Use caution in the presence of glaucoma; frequently check intraocular pressure

Various ocular diseases and long-term use of topical corticosteroids have been known to cause corneal and scleral thinning

Use of topical corticosteroids in the presence of thin corneal or scleral tissue may lead to perforation

Acute purulent infections of the eye may be masked or activity enhanced by the presence of corticosteroid medication

The use of steroids after cataract surgery may delay healing and increase the incidence of bleb formation

Use of ocular steroids may prolong the course and may exacerbate the severity of many viral infections of the eye (including herpes simplex)

Employment of a corticosteroid medication in the treatment of patients with a history of herpes simplex requires great caution; frequent slit lamp microscopy is recommended

Suspension formulation contains sodium bisulfite, a sulfite that may cause allergic-type reactions, including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people

The overall prevalence of sulfite sensitivity in the general population is unknown and probably low; sulfite sensitivity is seen more frequently in asthmatic than in non-asthmatic people

The initial prescription and renewal of medication order beyond 20 milliliters of suspension should be made by a physician only after examination of the patient with the aid of magnification, such as slit-lamp biomicroscopy, and, where appropriate, fluorescein staining; if signs and symptoms fail to improve after 2 days, the patient should be re-evaluated

As fungal infections of the cornea are particularly prone to develop coincidentally with long-term local corticosteroid applications, fungal invasion should be suspected in any persistent corneal ulceration where a corticosteroid has been used or is in use; fungal cultures should be taken when appropriately

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Pregnancy & Lactation

Pregnancy Category: C

Lactation: not known if distributed in milk

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.

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Pharmacology

Mechanism of Action

Inhibits edema, fibrin deposition, capillary dilation, and phagocytic response of acute inflammation; also inhibits capillary proliferation, collagen deposition, and scar formation

Pharmacokinetics

Absorption: Corneal penetration is good; absorbed into aqueous humor and some systemic absorption

Excretion: Urine

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Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.