Loteprednol
Synonym :
Loteprednol Etabonate
Mechanism :
Loteprednol etabonate (LE) is a "soft" steroid belonging to a unique class of glucocorticoids. Loteprednol etabonate is structurally similar to other glucocorticoids. However, the number 20 position ketone group is absent. It is highly lipid soluble which enhances its penetration into cells. Loteprednol etabonate is synthesized through structural modifications of prednisolone- related compounds so that it will undergo a predictable transformation to an inactive metabolite. It first binds to the type II glucocorticoid receptor. Corticosteroids inhibit the inflammatory response to a variety of inciting agents and probably delay or slow healing. They inhibit the edema, fibrin deposition, capillary dilation, leukocyte migration, capillary proliferation, fibroblast proliferation, deposition of collagen, and scar formation associated with inflammation. There is no generally accepted explanation for the mechanism of action of ocular corticosteroids. However, corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2.
Indication :
- Allergic conjunctivitis
- Ocular inflammation
- Post-operative ocular inflammation
Contraindications :
Viral infections of the cornea and conjunctiva; mycobacterial eye infection; fungal infections of ocular structures.
Hypersensitivity to drug/class/component.
Dosing :
0.5% suspension: Instill 1-2 drops 4 times/day. May start with 1 drop hourly, then reduce.
Adverse Effect :
Headache, abnormal vision/blurring, chemosis, burning sensation on instillation, eyelid erythema, itching, conjunctivitis/irritation, photophobia, epiphora, corneal abnormalities, dry eyes, papillae uveitis. Glaucoma and optic nerve injury, posterior subcapsular cataracts (prolonged use). Changes in visual acuity, field defects. Secondary ocular infection.
Interaction :
No known interactions.
Hepatic Dose :
No dosage adjustments are recommended.