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Lotemax 0.50% Ophthalmic Suspension (eye drops)
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Indications & Clinical Uses
- Lotemax 0.5% eye drops are a sterile ophthalmic SUSPENSION of loteprednol etabonate, a corticosteroid used on the surface of the eye.
- It is approved for steroid-responsive inflammatory conditions of the eyelid lining, conjunctiva, cornea and front of the eye, including allergic conjunctivitis, acne rosacea affecting the eye, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis and selected infective conjunctivitis where a steroid is judged appropriate, and for inflammation and pain after eye surgery.
- The usual dose is one to two drops into the affected eye four times daily; during the first week this may be increased to one drop every hour if needed.
- After surgery, treatment starts 24 hours afterwards and continues for 2 weeks.
- Bausch & Lomb also make Lotemax gel 0.5% (four times daily), Lotemax ointment 0.5% and Lotemax SM gel 0.38% (three times daily), which are DIFFERENT products.
- It is prescribed by an eye specialist and used at home.
Side Effects
- Lotemax has NO boxed warning.
- In clinical studies, eye-related side effects occurred in 5% to 15% of people and included blurred or abnormal vision, burning on instillation, swelling of the conjunctiva, discharge, dry eyes, watering, a foreign body sensation, itching, redness and sensitivity to light.
- A rise in the pressure inside the eye was reported in about 2% of patients.
- Because Lotemax is a steroid, longer or repeated courses can cause raised intraocular pressure with damage to the optic nerve, loss of visual field and glaucoma, and can cause a posterior subcapsular cataract.
- Steroid drops may also slow healing after cataract surgery, thin the cornea and, rarely, lead to perforation, and they can mask or worsen eye infections, including bacterial, fungal and herpes simplex infections.
- Seek urgent advice for worsening eye pain, falling vision, increasing redness or sensitivity to light.
Precautions & Warnings
- SHAKE THE BOTTLE VIGOROUSLY before every dose, because the medicine is a suspension that settles.
- Store the bottle UPRIGHT at 15°C to 25°C and do not freeze.
- If Lotemax is used for 10 days or longer, the pressure inside the eye must be checked regularly, and it should be measured in children too.
- Do not use Lotemax in viral diseases of the cornea and conjunctiva such as active herpes simplex keratitis (dendritic keratitis), vaccinia or varicella, or in fungal or mycobacterial eye infections.
- Use with caution if you have glaucoma, a thin cornea or previous herpes eye disease.
- Do not let the dropper tip touch the eye, eyelid or any surface, as this can contaminate the bottle.
- Remove contact lenses before instilling the drops and wait 15 minutes before putting them back, because the benzalkonium chloride preservative is absorbed by soft lenses.
- Vision may blur briefly, so wait before driving.
Avoid Interactions
- No specific drug interaction studies are listed for Lotemax, and very little loteprednol reaches the bloodstream from the eye, so interactions with tablets or injections are unlikely.
- The important issues are local.
- Using other corticosteroid eye drops, or steroid tablets, injections, inhalers or nasal sprays at the same time, INCREASES total steroid exposure and the risk of raised eye pressure and cataract, so tell your eye specialist about all of them.
- Non-steroidal anti-inflammatory eye drops such as ketorolac, bromfenac or nepafenac used alongside a steroid may add to delayed corneal healing.
- If another eye drop is prescribed, leave at least 5 minutes between drops so one does not wash the other out and REDUCE its effect.
- Do not instil Lotemax with contact lenses in place.
- Tell your healthcare provider about all medicines, eye drops and supplements you use.
References
- LOTEMAX (loteprednol etabonate ophthalmic suspension) 0.5% - US Prescribing Information, DailyMed (Bausch & Lomb)
- LOTEMAX (loteprednol etabonate ophthalmic gel) 0.5% - US Prescribing Information, DailyMed (Bausch & Lomb)
- LOTEMAX SM (loteprednol etabonate ophthalmic gel) 0.38% - US Prescribing Information, DailyMed (Bausch & Lomb)
Frequently Asked Questions
Lotemax (loteprednol etabonate) 0.5% eye drops treat steroid-responsive eye inflammation, including allergic conjunctivitis, acne rosacea affecting the eye, superficial punctate keratitis, iritis and cyclitis, and inflammation and pain after eye surgery. After surgery, treatment starts 24 hours later and continues for 2 weeks.
Instil one to two drops of Lotemax (loteprednol etabonate) suspension into the affected eye four times daily. During the first week your eye specialist may increase this to one drop every hour. Shake the bottle vigorously before each dose and avoid touching the dropper tip to your eye.
Between 5% and 15% of Lotemax (loteprednol etabonate) users get blurred vision, burning on instillation, dry or watering eyes, itching, redness or light sensitivity. Eye pressure rose in about 2%. Prolonged use can cause glaucoma, cataract, delayed healing and masked eye infections.
Do not use Lotemax (loteprednol etabonate) for viral eye infections such as herpes simplex keratitis, or for fungal or mycobacterial eye infections. Remove contact lenses before each dose and wait 15 minutes before reinserting them. Avoid driving until blurring clears, and never share the bottle.
Store Lotemax (loteprednol etabonate) upright at 15°C to 25°C and do not freeze. Shake vigorously before every dose, because the suspension settles. Keep the cap tightly closed, do not let the dropper tip touch any surface, and discard the bottle as your eye specialist advises.
No. Lotemax (loteprednol etabonate) 0.5% comes as a suspension, a gel and an ointment, all dosed four times daily, while Lotemax SM is a 0.38% gel dosed three times daily. Inveltys 1% is twice daily. These are not interchangeable - never swap strength or schedule yourself.
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