Steroids with Maximum Clinical Action
Prednisolone Acetate1%
 Prednisolone acetate 1% (Pred Forte, Allergan) is a highly
prescribed and clinically proven topical steroid. Its chemical
properties and relatively high concentration give it the greatest
anti-inflammatory efficacy of all topical ophthalmic steroids.
Prednisolone acetate is available in 1% and 0.125% concentrations,
of which the 1% is by far the more clinically useful.
Because it is an acetate suspension, prednisolone acetate
is optimally suited for penetrating the cornea and the anterior
chamber. This makes it effective for treating anterior chamber
inflammation and remains the drug of choice in treating anterior
uveitis.
There have been past reports of poor quality generic prednisone
acetate.1 Because of these reports, and the potential seriousness
of uveitis, we do not allow generic substitution when writing
for Pred Forte when the inflammatory condition merits the use
of 1% prednisolone acetate.
Prednisolone acetate 1% works well for moderate to severe
forms of ocular inflammation such as episcleritis, iritis,
inflammatory keratitis, uveitic glaucoma, chemical or thermal
burns of the cornea, and a host of other ocular inflammatory
conditions. Because of the side effect profile, we use Lotemax
for almost all inflammatory conditions except uveitis and severe
episcleritis, where we use Pred Forte.
As with any steroid, prescribe frequent instillation schedules
until the inflammation is under control. Then begin to taper
the therapy based upon the nature of the specific condition
and the patient's response to treatment.
Be sure to instruct your patients to shake any suspension
formulation prior to each instillation. Instruct the patient
verbally and also write it on the prescription. Keep in mind
that the solution form of prednisolone does not have to be
shaken, and so may be more patient-friendly when treating ocular
surface inflammations.
|
