Loteprednol Etabonate (Lotemax® and Alrex®)

How Loteprednol Etabonate Works

Loteprednol Etabonate is a corticosteroid, specifically designed for ophthalmic use to reduce inflammation in the eye. Loteprednol etabonate works by inhibiting the body's inflammatory response, which helps to alleviate symptoms like redness, swelling, pain, and irritation associated with various eye conditions.

Loteprednol Etabonate, known as a "soft steroid," is designed to have fewer systemic side effects and a lower risk of increased intraocular pressure compared to traditional steroids.

Mechanism of Action

Loteprednol etabonate exerts its effects by:

1. Inhibiting Pro-inflammatory Mediators: Loteprednol works by binding to receptors in immune cells, which blocks the production of inflammatory proteins like prostaglandins and cytokines. This reduces the release of chemicals that cause swelling, redness, and irritation, thereby calming inflammation in the eye.

2. Regulating Gene Expression: Loteprednol binds to glucocorticoid receptors in immune cells, and then moves into the cell's nucleus to regulate gene activity. This reduces the production of inflammatory proteins and increases anti-inflammatory proteins.

3. Reducing Immune Cell Activation: Loteprednol also decreases the activity of certain immune cells, such as macrophages, T-cells, and neutrophils, which are involved in sustaining inflammation. By limiting their activity, Loteprednol helps control the immune system's response, preventing it from causing further damage to the eye tissues.

Lotemax® SM (Loteprednol Etabonate Ophthalmic Gel 0.38%)

Lotemax® SM is specifically indicated for the treatment of post-operative inflammation and pain following ocular surgery​.

• How Lotemax® SM Works: Lotemax® SM contains loteprednol etabonate, which helps reduce inflammation in the eye after surgeries such as cataract extraction. It is formulated as a gel to improve absorption and retention on the eye's surface.

• Dosing: Apply one drop of Lotemax® SM three times daily starting the day after surgery, and continuing for the first 2 weeks of the post-operative period.

Common Side Effects:

• Temporary blurred vision, stinging, or discomfort upon application.

• Increased intraocular pressure (IOP) with prolonged use, potentially leading to glaucoma.

• Cataract formation and delayed healing after surgery.

Alrex® (Loteprednol Etabonate Ophthalmic Suspension 0.2%)

Alrex® is prescribed for the temporary relief of signs and symptoms of seasonal allergic conjunctivitis, such as eye redness and itching.

• How Alrex® Works: Alrex® works by reducing the inflammation that causes discomfort during allergy flare-ups, such as eye redness and itching. It is often prescribed for short-term use during allergy seasons.

• Dosing: Alrex® is typically prescribed at one drop into the affected eye four times a day.

Common Side Effects:

• Mild eye irritation, burning, or blurred vision upon use.

• Increased intraocular pressure with prolonged use, leads to potential optic nerve damage or cataract formation​.

Important Safety Information for Loteprednol Etabonate

• Prolonged use may lead to increased intraocular pressure, which can cause glaucoma or optic nerve damage. Your eye doctor will monitor your eye pressure if you're using this medication for more than 10 days​.

• Contact lenses should not be worn while using Lotemax® SM or Alrex® if your eyes are inflamed. The preservatives in these medications may be absorbed by soft lenses, and contact lens use may exacerbate symptoms.

• Patients with a history of herpes simplex eye infections should use corticosteroids cautiously, as they may worsen viral infections.

How to Use Loteprednol Etabonate

1. Shake the bottle well before using.

2. Instill one drop in the affected eye(s), as prescribed by your doctor.

3. Avoid touching the dropper tip to prevent contamination.

4. Wait at least 10-15 minutes before wearing contact lenses​.