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loteprednol and antiinfectives

S01CA12

Forms & Strengths

Ophthalmic suspension 0.5% loteprednol etabonate / 0.3% tobramycin, 5 mL bottle

Adult Dosing

Instill 1–2 drops into each affected eye every 6–12 h for 7–10 days; taper if therapy exceeds 5 days
Maximum of 8 drops per day per eye

Pediatric Dosing

Same regimen as adults for children ≥1 month old
Use lowest effective dose; avoid in neonates <1 month
Monitor intra‑ocular pressure closely in long‑term use

Indications

Post‑operative ocular inflammation
Allergic conjunctivitis
Anterior uveitis with presumed bacterial component
Bacterial keratitis or conjunctivitis requiring anti‑infective coverage

Mechanism of Action

Loteprednol etabonate: soft corticosteroid that binds glucocorticoid receptors, inhibiting phospholipase A2 and reducing prostaglandin and cytokine synthesis
Tobramycin: aminoglycoside that binds the 30S ribosomal subunit, causing misreading of mRNA and bacterial protein synthesis inhibition

Contraindications

Viral (e.g., herpes simplex) or fungal ocular infection
Active ocular tuberculosis
Known hypersensitivity to loteprednol, tobramycin, aminoglycosides, or any excipients
Contact lens wear during therapy (risk of reduced drug delivery and infection)

Adverse Reactions

Transient ocular burning, stinging or foreign‑body sensation
Blurred vision or transient increase in intra‑ocular pressure
Cataract formation with prolonged corticosteroid use
Allergic conjunctivitis or lid edema
Secondary bacterial or fungal infection on prolonged therapy

Drug Interactions

Concurrent ocular steroids may have additive IOP‑raising effect
Systemic CYP3A inhibitors (e.g., ketoconazole) can increase corticosteroid exposure
Systemic nephrotoxic or ototoxic drugs (e.g., vancomycin, loop diuretics) may potentiate aminoglycoside toxicity if absorbed
Anticholinergic eye drops can reduce corneal penetration of loteprednol

Curated Content: Needs Vetting Before Put to Clinical Use