Lodoxamide

How it works

It stabilises mast cells and prevents the antigen-stimulated release of histamine and other inflammatory mediators that drive the ocular allergic response.

Prescribing in practice

• Acts prophylactically rather than as a rescue treatment, so it should be used regularly and continuously to be effective and may take some days to produce symptomatic benefit.
• Contact lenses should not be worn during treatment of allergic conjunctivitis, and the preservative may be absorbed by soft lenses.
• Transient stinging or burning on instillation is common but usually settles.

Monitoring

Treatment is monitored clinically by reviewing symptom control and ocular comfort, with the drops continued throughout the period of allergen exposure.

Counselling the patient

• Use the drops regularly every day as prescribed, not just when symptoms flare, because they work by preventing reactions.
• Remove contact lenses before instilling and follow your clinician's advice on when they can be reworn.
• Mild stinging when you put the drops in is normal and short-lived.

Evidence & guidelines

Mast cell stabilisers are an established option for allergic conjunctivitis and their place in therapy is supported by ophthalmology guidance and the SPC.