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(1) Mild/Moderate: 1-2 gtts q4-6hrs
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1 gtt QID x 7 days (Pulse) to treat recurrence
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(2) Severe: For the first 24-48hrs, 1-2 gtts q1-2hr. Frequency should be decreased gradually as warranted by improvement in clinical signs. Care should be taken not to discontinue therapy prematurely.
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GENERIC
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tobramycin 0.3%, loteprednol etabonate 0.5%
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INDICATIONS
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ZYLET® (loteprednol etabonate and tobramycin ophthalmic suspension) is a topical anti-infective and corticosteroid combination for steroid-responsive inflammatory ocular conditions for which a corticosteroid is indicated and where superficial bacterial ocular infection or a risk of bacterial ocular infection exists.
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Off label usage for blepharitis related dry eye and GPC
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MECHANISM OF ACTION
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aminoglycoside, ester steroid: Aminoglycosides prevent bacterial protein synthesis. Corticosteroids inhibit arachidonic acid release.
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MICROBIOLOGY
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Active against a wide variety of gram-negative and gram-positive bacteria including some penicillin-resistant and gentamicin-resistant strains.
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The particular anti-infective drug in this product (tobramycin) is active against the following common bacterial eye pathogens:Staphylococci, including S. aureus and S. epidermidis (coagulase-positive and coagulase-negative), including penicillin-resistant strains. Streptococci, including some of the Group A-beta-hemolytic species, some nonhemolytic species, and some Streptococcus pneumoniae, Pseudomonas aeruginosa, Escherichia coli, Klebsiella pneumoniae, Enterobacter aerogenes, Proteus mirabilis, Morganella morganii, most Proteus vulgaris strains, Haemophilus influenzae, and H. aegyptius, Moraxella lacunata, Acinetobacter calcoaceticus and some Neisseria species.
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CONTRAINDICATIONS & WARNINGS
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ZYLET, as with other steroid anti-infective ophthalmic combination drugs, 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
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Hypersensitivity to this or other aminoglycosides, corticosteroids, or any components of the medication.
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PEDIATRIC USE
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Safety and effectiveness in pediatric patients have not been established.
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Teratogenic effects: Loteprednol etabonate has been shown to be embryotoxic (delayed ossification) and teratogenicy. Loteprednol etabonate had no effect on the duration of gestation or parturition when administered orally to pregnant rats at doses up to 50 mg/kg/day during the fetal period.
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NOTE
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IOP spike risk (if used more than 10 days), Cataract
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