Loteprednol
LOTEMAX
What it isRapidly inactivated ophthalmic glucocorticoid; ocular inflammation and dry-eye flares.
Why this oneIts ester design permits rapid local inactivation and tends to raise pressure less than ketone-based ocular steroids.
What limits itPressure elevation, cataract, and infection still require monitoring with prolonged use; severe inflammation may need a stronger steroid.
FDA-approved for
- ocular inflammation
- dry eye disease flares (2020)
FDA label
Read the full label on DailyMed ↗
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Steroid-responsive ocular inflammatory conditions | Adults | 1 drop in affected eye(s) QID |
Renal Undefined
Hepatic Undefined
Instructions
- Shake vigorously before use
- Instill 1 drop into the affected eye(s) four times daily
Contraindications
- Most viral corneal/conjunctival diseases — epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, varicella
- Mycobacterial ocular infection
- Fungal diseases of ocular structures
Cautions
- Elevated intraocular pressure (may damage optic nerve, cause visual acuity/field defects)
- Posterior subcapsular cataract formation
- Secondary ocular infection (incl. herpes simplex)
- Globe perforation where cornea/sclera is thinned
- Delayed healing
Adverse reactions
- Abnormal vision/blurring
- Burning on instillation
- Chemosis
- Discharge
- Dry eyes
- Epiphora
- Foreign body sensation
- Itching
- Injection
- Photophobia
- Elevated IOP
Pregnancy Embryotoxic and teratogenic in animals at high oral doses; no adequate human data
Lactation Undefined
NO BOXED WARNINGS
Principal riskSteroid-induced pressure rise on prolonged use
Cost, est. cash$10–$400/month
Generic entry2019
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityLocal tissue effects and irritation; systemic corticosteroid toxicity is uncommon at usual exposure.
Mechanism of action: Loteprednol ballicule
