prednisolone ophthalmic

Action and Spectrum

Actions and spectrum: 

• Anti-inflammatory Action: prednisolone ophthalmic works by reducing inflammation in the eye. It inhibits the production of inflammatory mediators, such as prostaglandins and leukotrienes, and suppresses the migration of inflammatory cells. This action helps to alleviate symptoms of inflammation, including redness, swelling, and pain. 
• Immunosuppressive Action: prednisolone ophthalmic has immunosuppressive properties, which means it can suppress the immune response in the eye. It helps to prevent or control excessive immune reactions that can lead to inflammation and tissue damage. By dampening the immune response, prednisolone ophthalmic can be effective in managing various inflammatory eye conditions. 

Spectrum of Use: prednisolone ophthalmic is used to treat a wide range of ocular conditions characterized by inflammation, including: 

• Allergic conjunctivitis: It can help relieve symptoms such as itching, redness, and swelling associated with allergic reactions in the eyes. 
• Non-infectious anterior uveitis: prednisolone ophthalmic is commonly used in the management of anterior uveitis, an inflammation of the iris and ciliary body in the front part of the eye. 
• Postoperative inflammation: After eye surgery, prednisolone ophthalmic is often prescribed to reduce postoperative inflammation and promote healing. 
• Keratitis and corneal inflammation: prednisolone ophthalmic can be used to manage inflammatory conditions affecting the cornea, such as keratitis. 
• Scleritis and episcleritis: These inflammatory conditions of the outer layers of the eye can be treated with prednisolone ophthalmic to reduce inflammation and discomfort. 

Drug Interaction

Adverse Reaction

Frequency not defined 

Ocular hypertension 

Conjuctivitis 

Delayed wound healing 

Keratitis 

Optic nerve damage 

Secondary ocular infection 

Increased IOP 

Conjunctival hyperemia 

Corneal ulcers 

Glaucoma 

Loss of accommodation 

Mydriasis 

Hypercorticoidism (rare) 

Ptosis  

Post marketing Reports 

Adrenal suppression and Cushing’s syndrome 

Eye pain 

Black Box Warning

Black Box Warning: 

there is no specific black box warning issued for prednisolone ophthalmic. 

Contraindication / Caution

Contraindication/Caution: 

Contraindication: 

• Viral Eye Infections: prednisolone ophthalmic is contraindicated in the presence of viral eye infections, such as herpes simplex keratitis or viral conjunctivitis. Corticosteroids can worsen or prolong viral infections in the eye. 
• Fungal or Bacterial Eye Infections: The use of prednisolone ophthalmic is contraindicated in active fungal or bacterial eye infections. Corticosteroids can mask or exacerbate these infections, leading to potentially severe consequences. 
• Hypersensitivity: Individuals who have a known hypersensitivity or allergy to prednisolone or any of its components should not use prednisolone ophthalmic. 
• Ocular Tuberculosis: prednisolone ophthalmic is contraindicated in patients with ocular tuberculosis. Corticosteroids may suppress the immune response and worsen the infection. 
• Epithelial Herpetic Keratitis: prednisolone ophthalmic is contraindicated in cases of epithelial herpetic keratitis, a form of corneal inflammation caused by the herpes simplex virus. Corticosteroids can exacerbate the infection and prolong healing. 
• Fungal Corneal Infections: The use of prednisolone ophthalmic is contraindicated in fungal corneal infections. Corticosteroids can worsen fungal infections and delay appropriate treatment.

Caution: 

• Intraocular Pressure: prednisolone ophthalmic may increase intraocular pressure (IOP) in some individuals. It is important to monitor IOP regularly, especially in patients with pre-existing glaucoma or a family history of glaucoma. 
• Cataracts: Long-term use of prednisolone ophthalmic, especially at high doses, may increase the risk of developing cataracts. Regular eye examinations are recommended to monitor for any signs of cataract formation. 
• Infections: Corticosteroids can suppress the immune system, potentially increasing the risk of infections. Care should be taken when using prednisolone ophthalmic in patients with a history of recurrent or chronic infections. Close monitoring for signs of infection is important during treatment. 
• Delayed Healing: Prednisolone ophthalmic may delay wound healing, particularly in individuals with corneal ulcers. Extra caution is necessary in such cases, and close monitoring by a healthcare professional is important. 
• Contact Lens Use: Contact lens wearers should be cautious when using prednisolone ophthalmic, as the preservatives in the eye drops may cause irritation or allergic reactions. It is recommended to remove contact lenses before instilling the eye drops and wait at least 15 minutes before reinserting them. 
• Pediatric Use: prednisolone ophthalmic should be used with caution in pediatric patients. The safety and effectiveness in children may differ from adults, and close monitoring is necessary to assess the response and potential side effects. 

Comorbidities: 

• Glaucoma: prednisolone ophthalmic can increase intraocular pressure (IOP) in some individuals, which can be problematic for individuals with glaucoma. Patients with pre-existing glaucoma or a history of elevated IOP should be closely monitored during treatment with prednisolone ophthalmic. 
• Herpes Simplex Keratitis: prednisolone ophthalmic is contraindicated in cases of epithelial herpetic keratitis, a corneal inflammation caused by the herpes simplex virus. The use of corticosteroids in such cases can worsen the infection and delay healing. 
• Ocular Infections: prednisolone ophthalmic should be used with caution in individuals with ocular infections, including bacterial or fungal infections. The use of corticosteroids in the presence of active infections can worsen the infection or delay appropriate treatment. 
• Diabetes: Corticosteroids, including prednisolone, can affect blood glucose levels and may require adjustments in diabetes management. Individuals with diabetes using prednisolone ophthalmic should closely monitor blood sugar levels. 
• Immunodeficiency: Patients with compromised immune systems or immunodeficiency disorders may have an increased risk of infections when using prednisolone ophthalmic. Close monitoring for any signs of infection and appropriate management are necessary in these individuals. 

Pregnancy / Lactation

Pregnancy consideration: US FDA pregnancy category: C 

Lactation: Excreted into human milk: Unknown  

Pregnancy category: 

• Category A: well-controlled and Satisfactory studies show no risk to the fetus in the first or later trimester. 
• Category B: there was no evidence of risk to the fetus in animal studies, and there were not enough studies on pregnant women. 
• Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   
• Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits. 
• Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women. 
• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

prednisolone ophthalmic is a corticosteroid medication that exerts its pharmacological effects locally in the eye. Here is an overview of the pharmacology of prednisolone ophthalmic: 

prednisolone is a synthetic glucocorticoid that binds to intracellular glucocorticoid receptors in target cells. Upon binding, prednisolone-receptor complexes translocate into the nucleus and modulate gene expression.

prednisolone acts by inhibiting the synthesis and release of various inflammatory mediators, such as prostaglandins, leukotrienes, and cytokines. It also suppresses the migration of inflammatory cells to the site of inflammation and reduces capillary permeability.  

Pharmacodynamics: 

• Anti-inflammatory Effects: prednisolone ophthalmic is a potent anti-inflammatory medication. It acts by inhibiting the production and inflammatory mediators release, such as prostaglandins, leukotrienes, and cytokines. By suppressing the local inflammatory response, prednisolone reduces swelling, redness, and other signs of inflammation in the eye. 
• Immunomodulatory Effects: prednisolone ophthalmic has immunomodulatory properties, meaning it can modulate or regulate the immune response in the eye. It suppresses the migration of inflammatory cells to the site of inflammation and inhibits the release of immune mediators. This helps to reduce tissue damage caused by excessive immune reactions. 
• Stabilization of Cell Membranes: prednisolone ophthalmic can stabilize cell membranes in the eye, preventing the release of inflammatory substances and reducing tissue damage. 
• Antiallergic Effects: prednisolone ophthalmic can alleviate symptoms associated with allergic reactions in the eye, such as itching, redness, and swelling. It acts by suppressing the release of allergic mediators and inhibiting the inflammatory response. 
• Vasoconstriction: prednisolone ophthalmic may cause mild vasoconstriction, leading to reduced blood flow and decreased permeability of blood vessels in the eye. This contributes to the reduction of inflammation and swelling.

Pharmacokinetics: 

Absorption 

When prednisolone ophthalmic is applied topically to the eye, it is absorbed into the ocular tissues. The medication primarily acts locally in the eye, and systemic absorption is minimal compared to oral or systemic administration. The extent of absorption can vary depending on factors such as the specific formulation, concentration, and duration of application. 

Distribution 

After absorption, prednisolone is distributed within the ocular tissues, including the cornea, conjunctiva, and anterior chamber. It exerts its pharmacological effects primarily at the site of application. The distribution to systemic circulation and other body tissues is limited due to the localized nature of the ophthalmic formulation. 

Metabolism 

prednisolone is metabolized in the liver through various enzymatic reactions, including oxidation and conjugation. The metabolites formed include inactive compounds such as prednisone and conjugated forms of prednisolone. Systemic metabolism occurs when prednisolone enters the bloodstream via systemic absorption or systemic administration. 

Elimination and excretion 

The metabolites of prednisolone, including prednisone and conjugated forms, are eliminated primarily through the urine. The elimination half-life of prednisolone can vary but is in the range of a few hours. The majority of the elimination occurs through hepatic metabolism and renal excretion. 

Adminstartion

Administration: 

• Wash hands thoroughly with soap and water before handling the medication or touching your eyes. 
• Shake the bottle of eye drops well before use, if applicable. 
• Tilt your head back and look up at the ceiling. 
• Gently pull lower eyelid to create a small pocket. 
• Hold the bottle or tube above the eye and squeeze the prescribed number of drops or a small ribbon of ointment (as directed by your healthcare provider) into the lower eyelid pocket.  
• Close eyes gently and keep them closed for a brief period, typically for about 1-2 minutes, to allow the medication to spread evenly over the eye. 
• If you are using other eye medications, wait at least 5 minutes between administering different eye drops or ointments unless otherwise instructed by your healthcare provider. 
• After administering the medication, wipe away any excess liquid or ointment around the eye with a clean tissue or cloth. 
• Recap the bottle tightly or close the tube securely to prevent contamination. 
• Wash hands again after administering the medication. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: prednisolone ophthalmic 

Pronounced: (pred-ni-soh-lohn oh-thal-mik)  

Why do we use prednisolone ophthalmic? 

• Ocular Inflammation: prednisolone ophthalmic is commonly prescribed to reduce inflammation and swelling in the eye. It can be used to manage conditions such as uveitis, episcleritis, scleritis, and iritis. 
• Allergic Conjunctivitis: prednisolone ophthalmic can be used to alleviate inflammation and symptoms associated with allergic conjunctivitis. It helps to reduce redness, itching, and swelling caused by an allergic reaction. 
• Post-operative Inflammation: After certain eye surgeries, such as cataract extraction or corneal transplant, prednisolone ophthalmic may be prescribed to control post-operative inflammation and promote healing. 
• Corneal Inflammation: prednisolone ophthalmic is sometimes used in the treatment of corneal inflammation, including conditions like keratitis, keratoconjunctivitis, and corneal ulcers. 
• Ocular Trauma: In cases of eye trauma or injury resulting in inflammation, prednisolone ophthalmic may be prescribed to help reduce swelling and promote healing.