Durezol (emul)

Generic: difluprednate 0.05%

DOSAGE Post-op Surgery: 1 gtt QID 24hrs after surgery, continue x 2 weeks, BID x 1 week, then taper based on the response.
Anterior Uveitis Treatment (Mild/Moderate) Anterior Uveitis Treatment (Severe)
(1) Cyclopentolate 1% TID (2) PF 1% or Durezol 0.05% q1-6hrs, depending on severity, then taper QID x 1 week, TID x 1 week, then BID x 1 week. D/c when there is no AC reaction (1) Atropine 1% BID to QID (2) PF 1% or Durzol 0.5% q1-2 hours initial, consider a loading dosage q1min for 5 mins x 2 weeks, then taper QID x 1 week, TID x 1 week, then BID x 1 week. D/c when there is no AC reaction
Note: Long term, low dosage steroids like PredForte can be used q1-2 days to keep inflammation recurring.
GENERIC difluprednate 0.05%
INDICATIONS DUREZOL® (difluprednate ophthalmic emulsion) 0.05%, a topical corticosteroid, is indicated for the treatment of inflammation and pain associated with ocular surgery. Also indicated for the treatment of endogenous anterior uveitis.
MECHANISM OF ACTION (difluorinated) corticosteroid
MICROBIOLOGY Corticosteroids inhibit the inflammatory response to a variety of inciting agents and may delay or slow healing. They inhibit edema, fibrin deposition, capillary dilation, leukocyte migration, capillary proliferation, fibroblast proliferation, deposition of collagen, and scar formation associated with inflammation. There is no generally accepted explanation for the mechanism of action of ocular corticosteroids. However, corticosteroids are thought to act by the induction of phospholipase A2 inhibitory proteins, collectively called lipocortins. It is postulated that these proteins control the biosynthesis of potent mediators of inflammation, such as prostaglandins and leukotreines by inhibiting the release of their common precursor arachidonic acid. Arachidonic acid is released from membrane phospholipids by phospholipase A2. Difluprednate is structurally similar to other corticosteroids.
CONTRAINDICATIONS & WARNINGS The use of DUREZOL, as with other ophthalmic corticosteroids, is contraindicated in most active viral diseases of the cornea and conjunctiva, including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella, and also in mycobacterial infection of the eye and fungal disease of ocular structures.
Elevated IOP, Posterior subcapsular cataract formation, Secondary ocular infection, Perforation of the globe
PEDIATRIC USE DUREZOL was evaluated in a 3-month, multicenter, double-masked trial in 79 pediatric patients (39 DUREZOL; 40 prednisolone acetate) 0 to 3 years of age for the treatment of inflammation following cataract surgery. A similar safety profile was observed in pediatric patients comparing DUREZOL to prednisolone acetate ophthalmic suspension, 1%.
PREGNANCY Teratogenic Effects Category C However, since use of difluprednate during human pregnancy has not been evaluated and cannot rule out the possibility of harm, DUREZOL should be used during pregnancy only if the potential benefit justifies the potential risk to the embryo or fetus.
NOTE Prolonged use may cause glaucoma, cataracts, bacterial and fungal overgrowth. Contact lenses should not be used during the course of therapy.Excellent tissue penetration. Possible enhanced dose uniformity (no shaking required) and duration of action when compared to acetate suspensions.
More potent than prednisolone acetate 1%.
Long term, low dosage steroids like PredForte can be used q1-2 days to keep inflammation recurring due to Durezol higher risk of IOP Increase