Loteprednol Etabonate Suspension Eye Drops (Lotemax) is a topically administered glucocorticoid drug, mainly used for the treatment of ocular inflammatory conditions such as allergic conjunctivitis and post-operative inflammation. As a highly effective anti-inflammatory medication, its use requires balancing therapeutic effects with potential risks.

What Are the Side Effects of Loteprednol Etabonate Suspension Eye Drops (Lotemax)?

Ocular Reactions

Blurred vision (15%).

Increased intraocular pressure (10%-15%).

Ocular irritation (e.g., burning, stinging sensation) (8%).

Conjunctival hyperemia (5%).

Systemic Reactions

Headache (3%-5%).

Dysgeusia (abnormal taste) (2%).

Severe Side Effects of Loteprednol Etabonate Suspension Eye Drops (Lotemax) Requiring Vigilance

Increased Intraocular Pressure and Glaucoma

Risk: Long-term use may induce steroid-induced glaucoma, characterized by optic nerve damage and visual field defects.

High-Risk Populations: Patients with diabetes mellitus and patients with primary open-angle glaucoma.

Management: Monitor intraocular pressure every 2-4 weeks during treatment; if intraocular pressure exceeds 21mmHg, dose reduction or discontinuation of the drug is required.

Corneal Perforation

Precipitating Factors: Use in patients with ocular herpes virus infection or corneal thinning disorders may exacerbate the condition.

Prevention: Screen for a history of corneal disease before medication; avoid use in patients with active infections.

Cataract Formation

Risk: Long-term use (for more than 6 months) may accelerate the progression of posterior subcapsular cataracts.

Recommendation: Limit the treatment course to within 2 weeks (for post-operative inflammation) or use short-term as needed.

Secondary Infections

Types: Increased risk of bacterial, fungal, or viral (e.g., herpes simplex virus) infections.

Measures: Avoid concurrent use of other ophthalmic preparations; if purulent discharge appears, discontinue the drug immediately.

Precautions for Using Loteprednol Etabonate Suspension Eye Drops (Lotemax)

Contraindications

Active ocular infections (bacterial/viral/fungal).

Patients with hypersensitivity to loteprednol etabonate or excipients (e.g., benzalkonium chloride).

Special Populations

Pediatric Patients: Efficacy in patients under 2 years of age has not been established; careful assessment of the risk-benefit ratio is required.

Pregnant Women: Use only when the potential benefit outweighs the risk (FDA Pregnancy Category C).

Lactating Women: Suspend breastfeeding or discontinue the drug (a small amount of the drug may pass into breast milk).

Drug Interactions

Other Ophthalmic Preparations: An interval of at least 5 minutes should be maintained between administrations to avoid physical interactions.

Systemic Corticosteroids: Concurrent use may increase the risk of adrenal suppression; avoid combined use.

Patient Monitoring and Education

Baseline Examinations: Measurement of intraocular pressure, assessment of corneal integrity, and visual acuity testing.

During Treatment: Recheck intraocular pressure every 2-4 weeks; for long-term users, evaluate for cataracts every 3 months.

Avoid Contact Lens Use: Benzalkonium chloride (an excipient) may be absorbed by contact lenses.

Seek Immediate Medical Attention: If persistent redness, eye pain, or vision loss occurs.