Loteprednol etabonate

How it works

It is an ester-based corticosteroid that binds glucocorticoid receptors to suppress inflammatory mediators, and is designed to be metabolised to inactive products to reduce the propensity for steroid-related rises in intraocular pressure.

Prescribing in practice

• As with all ocular corticosteroids, prolonged use can raise intraocular pressure, cause cataract and mask or worsen ocular infection, so it must not be used in untreated infective eye conditions.
• Treatment should generally be tapered rather than stopped abruptly after prolonged use, and a specialist should oversee extended courses.
• Use with caution in patients with a history of herpes simplex keratitis or glaucoma.

Monitoring

Intraocular pressure should be monitored during prolonged therapy, with regular ophthalmic review for cataract and signs of infection.

Counselling the patient

• Use only for as long as your clinician advises and do not stop suddenly after a long course without guidance.
• Report any eye pain, increasing redness, discharge or visual change promptly.
• Attend follow-up appointments so the pressure in your eye can be checked.

Evidence & guidelines

Topical corticosteroids are a long-established treatment for ocular inflammation, with their risks and place in therapy detailed in ophthalmology references and the SPC.