Loteprednol etabonate
Anti-inflammatory · Rx
Trade namesLotemax 0.5%, Lotemax SM 0.38%, Inveltys 1%, Alrex 0.2%
Drug classCorticosteroid, ester
Strength0.2%, 0.38%, 0.5%, 1%
AvailabilityRx
Mechanism of actionEster (C-20) corticosteroid designed for rapid inactivation after acting locally; lower propensity for IOP rise and cataract than ketone steroids.
Indication / reason for usePost-operative inflammation (Lotemax SM, Inveltys), inflammatory ocular surface disease, giant papillary conjunctivitis, seasonal allergic conjunctivitis (Alrex 0.2%), mild-moderate uveitis.
Usual adult dosingLotemax 0.5% QID; Lotemax SM TID; Inveltys BID; Alrex QID. Shake gel/suspension.
PreservativeBAK 0.003%; gel formulations use lower/absent BAK
Contact lensesDo not wear lenses during treatment of ocular inflammation.
Common / important adverse effectsLower IOP-spike risk than prednisolone but still possible with prolonged use; blurred vision, burning.
Contraindications & cautionsActive epithelial herpes simplex, fungal, or mycobacterial infection.
Pregnancy / lactationLimited data; low systemic exposure.
Practice notesA reasonable choice for known steroid responders or when longer courses are anticipated, still monitor IOP.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.