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DOSAGE
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1-2 gtts QID, q2hr within 1st 48hrs if needed, then taper. If there is no improvement after 2 weeks, consult a doctor. Shake prior to use.
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Cornea SPK (Moderate/Severe) (1) AT 4-8x/day + Gel qHS (2) Mild Topical Steroid (FML 0.1% of Lotemax QID) x 1-4 weeks, then taper (3) Add on Restasis BID to QID as alternative or adjunctive treatment (if steroid responder)
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EKC (Viral) with mild SEI: Mild Topical Steroid/gel BID
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Inflammed Ping/Pterygium (Moderate/Severe): (1) UV protection (2) AT 4/day (3) FML 0.1% or Lotemax 0.2% to 0.5% QID (3) NSAID like ketoralac 0.4% or Mast cell combo Pataday qD to decrease symptoms
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Severe GPC: Short-term use of FML 0.1% or Lotemax 0.2%-0.5% QID (d/c CL wear), addition to topical combo anti-allergies like Pataday 0.2% qDay
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GENERIC
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fluorometholone acetate 0.1%
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SIZE
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5mL
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INDICATIONS
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FLAREX (fluorometholone acetate ophthalmic suspension) is indicated for use in the treatment of steroid responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the eye.
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Used off label for inflammatory dry eye and as a brief initial adjunctive with Restasis.
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Used off label to reduce inflammatory sequelae of EKC.
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MECHANISM OF ACTION
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Ketone, acetate derived, fluorinated steroid
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MICROBIOLOGY
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Corticosteroids suppress the inflammatory response to inciting agents of mechanical, chemical or immunological nature. No generally accepted explanation of this steroid property has been advanced. Corticosteroids cause a rise in intraocular pressure in susceptible individuals. In a small study, FLAREX (fluorometholone acetate ophthalmic suspension) demonstrated a significantly longer average time to produce a rise in intraocular pressure than did dexamethasone phosphate; however, the ultimate magnitude of the rise was equivalent for both drugs and in a small percentage of individuals a significant rise in intraocular pressure occurred within three days.
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CONTRAINDICATIONS & WARNINGS
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Fungal infections of the cornea are particularly prone to develop coincidentally with long-term local steroid application. Fungus invasion must be considered in any persistent corneal ulceration where a steroid has been used or is in use.
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PEDIATRIC USE
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Safety and effectiveness in pediatric patients have not been established.
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PREGNANCY
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Pregnancy Category C | Fluorometholone has been shown to be embryocidal and teratogenic in rabbits when administered at low multiples of the human ocular dose. Fluorometholone was applied ocularly to rabbits daily on days 6-18 of gestation, and dose-related fetal loss and fetal abnormalities including cleft palate, deformed rib cage, anomalous limbs and neural abnormalities such as encephalocele, craniorachischisis, and spina bifida were observed. There are no adequate and well controlled studies of fluorometholone in pregnant women, and it is not known whether fluorometholone can cause fetal harm when administered to a pregnant woman. Fluorometholone should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
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NOTE
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Fungal and bacterial overgrowth, cataract formation, globe perforation possible with longterm use.Sold as Eflone (Novartis Ophthalmics), Flarex (Alcon)
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