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SENSORY ORGANS › OPHTHALMOLOGICALS › ANTIINFLAMMATORY AGENTS › Corticosteroids and mydriatics in combination
prednisolone and mydriatics
S01BB02
Forms & Strengths
- Ophthalmic suspension: Prednisolone acetate 1% / Homatropine hydrobromide 2%
- Ophthalmic solution: Prednisolone sodium phosphate / Mydriatic combinations vary by specific regional products
Adult Dosing
- Instill 1 to 2 drops into the conjunctival sac of the affected eye(s) up to 4 to 6 times daily
- Frequency may be tapered gradually as inflammation subsides
- Monitor intraocular pressure during prolonged therapy
Pediatric Dosing
- Safety and efficacy in pediatric patients have not been firmly established
- Use lowest possible effective dose if indicated, with close monitoring of intraocular pressure and systemic absorption
Indications
- Treatment of steroid-responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe where a mydriatic effect is also required
- Management of acute anterior uveitis and iritis
Mechanism of Action
- Prednisolone: Glucocorticoid that suppresses the inflammatory response by inhibiting edema, fibrin deposition, capillary dilation, leukocyte migration, capillary proliferation, fibroblast proliferation, and scar formation
- Mydriatic (e.g., homatropine): Anticholinergic agent that blocks responses of the sphincter muscle of the iris and the ciliary muscle to cholinergic stimulation, producing pupillary dilation (mydriasis) and paralysis of accommodation (cycloplegia)
Contraindications
- Acute epithelial herpes simplex keratitis (dendritic keratitis)
- Vaccinia, varicella, and other viral diseases of the cornea and conjunctiva
- Mycobacterial infection of the eye
- Fungal diseases of ocular structures
- Hypersensitivity to any component of the formulation
Adverse Reactions
- Elevation of intraocular pressure with possible development of glaucoma
- Posterior subcapsular cataract formation
- Secondary ocular infection from pathogens suppressed by steroids
- Delayed wound healing
- Blurred vision, stinging upon instillation, mydriasis, cycloplegia, photophobia, and systemic anticholinergic effects
Drug Interactions
- Concomitant use of other anticholinergic drugs may enhance systemic anticholinergic adverse effects
- Other topical ophthalmic medications should be administered at least 5 to 10 minutes apart
- Prolonged concurrent use of topical NSAIDs and topical corticosteroids may increase the potential for healing complications in the cornea
Curated Content: Needs Vetting Before Put to Clinical Use