Steroid Ointments
It seems like we have always had dexamethasone and fluorometholone
ophthalmic ointments available, yet for reasons we are unable
to determine, dexamethasone ointment is no longer being produced.
Corticosteroid ointments are very useful in treating periocular
contact blepharodermatitis, and in rare cases for nocturnal
supplemental therapy when treating severe acute anterior uveitis.
For those who prefer a cream-based steroid over an ointment,
we recommend triamcinolone (Kenalog, Bristol-Meyers Squibb).
It is not an ophthalmic preparation, but is excellently suited
for dermatologic use. It is available in three dosage concentrations:
0.025%, 0.1%, and 0.5%. We generally recommend the 0.1% dermatological
cream; of course the lower or higher concentration could be
prescribed depending upon the severity of the clinical condition.
As always, consult Drug Facts and Comparisons for detailed
clinical guidance.
Should the pharmacy not have fluorometholone (FML) ointment,
useful alternative options could be Vasocidin, Blephamide,
Cetapred, TobraDex or Pred-G ointments. However, when treating
a purely inflammatory condition like contact blepharodermatitis,
a pure steroid preparation is desirable. Hopefully, dexamethasone
will rejoin our armamentarium in the future.
1. Fiscella RG, et al. Generic prednisolone suspension substitution.
Arch Ophthalmol 1998;116(5):703.
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