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DOSAGE
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1 gtts BID-QID | Care should be taken not to discontinue therapy prematurely.
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Cornea SPK (Moderate/Severe) (1) AT 4-8/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/PTG (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 qDay 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 ophthalmic suspension 0.25%
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INDICATIONS
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FML FORTE suspension is indicated for the treatment of corticosteroid-responsive inflammation of the palpebral and bulbar conjunctiva, cornea and anterior segment of the globe.
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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, alcohol derived, fluorinated "soft" steroid.
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MICROBIOLOGY
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Corticosteroids inhibit the inflammatory response to a variety of inciting agents and probably delay or slow healing. They inhibit the edema, fibrin deposition, capillary dilation, leukocyte migration, capillary proliferation, fibroblast proliferation, deposition of collagen, and scar formation associated with inflammation.
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CONTRAINDICATIONS & WARNINGS
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FML FORTE suspension is contraindicated in most 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 diseases of ocular structures. FML FORTE suspension is also contraindicated in individuals with known or suspected hypersensitivity to any of the ingredients of this preparation and to other corticosteroids.
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PEDIATRIC USE
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Safety and effectiveness in infants below the age of two years have not been established.
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NOTE
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Shake well before use. Preserved with BAK
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0.25% FML Forte is no more efficacious than 0.1% FML
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