Compare Corticosteriod

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At-a-Glance

Description

FDA

CE Mark

Active Ingredients

Application

Status

Strength

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  • Formulations offer combinations of the three primary classes of medications used around the time of ocular surgery
  • One bottle reduces the total number of drops needed with an easy-to-follow postoperative regimen
  • Combined, compounded formulations can be more affordable
  • LessDrops are dispensed from the practice which offers convenience and assures surgeons that the patient has the medications they need

Combined Corticosteroid, Antibiotic, and NSAID Compounded Formulations for Postoperative Management

No (compounded formulation)

No

Formulation dependent

Topical

Prescription

Formulation dependent

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  • Mechanism of Action: Corticosteroids inhibit the inflammatory response to a variety of inciting agents that may delay or slow healing. They inhibit edema, fibrin deposition, capillary dilation, leukocyte migration, capillary proliferation, fibroblast proliferation, deposition of collagen, and scar formation associated with inflammation.
  • Dosage: One drop into the conjunctival sac of the affected eye(s) 4 times daily beginning 24 hours after surgery and continuing throughout the first 2 weeks of the postoperative period, followed by 2 times daily for a week and then a taper based on the response.

Durezol (difluprednate ophthalmic emulsion) 0.05% is a topical corticosteroid that is indicated for the treatment of inflammation and pain associated with ocular surgery.

Yes

Not specified

Difluprednate

Topical

Prescription

0.5%

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  • Mechanism of Action: Prednisolone acetate is a glucocorticoid that, on the basis of weight, has 3 to 5 times the antiinflammatory potency of hydrocortisone. Glucocorticoids inhibit the edema, fibrin deposition, capillary dilation, and phagocytic migration of the acute inflammatory response, as well ascapillary proliferation, deposition of collagen, and scar formation.
  • Dosage: One to two drops into the conjunctival sac two to four times daily. During the initial 24 to 48 hours, the dosing frequency may be increased if necessary.

Pred Forte (prednisolone acetate ophthalmic suspension, USP) 1% is indicated for the treatment of steroid-responsive inflammation of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe.

Yes

Not specified

Prednisolone acetate

Topical

Prescription

1%

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  • Mechanism of Action: 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. While glucocorticoids are known to bind to and activate the glucocorticoid receptor, the molecular mechanisms involved in glucocorticoid/glucocorticoid receptor-dependent modulation of inflammation are not clearly established. However, corticosteroids are thought to inhibit prostaglandin production through several independent mechanisms.
  • Dosage: One to two drops of LOTEMAX into the conjunctival sac of the affected eye four times daily beginning the day after surgery and continuing throughout the first 2 weeks of the postoperative period.

Lotemax (loteprednol etabonate ophthalmic gel) 0.5% is a corticosteroid in a gel formulation indicated for the treatment of postoperative inflammation and pain following ocular surgery.

Yes

Not specified

Loteprednol etabonate

Topical

Prescription

0.5%

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  • Mechanism of Action: 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. While glucocorticoids are known to bind to and activate the glucocorticod receptor, themolecular mechanisms involved in glucocorticoid/glucocorticoid receptordependent modulation of inflammation are not clearly established. However, corticosteroids are thought to inhibit prostaglandin production through several independent mechanisms.
  • Dosage: Apply a small amount (approximately ? inch ribbon) into the conjunctival sac(s) four times daily beginning 24 hours after surgery and continuing throughout the first 2 weeks of the post-operative period.

Lotemax (loteprednol etabonate ophthalmic ointment) 0.5% is a corticosteroid in an oinment formulation indicated for the treatment of postoperative inflammation and pain following ocular surgery.

Yes

Not specified

Loteprednol etabonate

Topical

Prescription

0.5%

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  • Dropless formulations are available from Imprimis' 503B outsourcing facility
  • Formulations include:
    • Tri-Moxi (Triamcinolone acetonide and moxifloxacin hydrochloride)
    • Dex-Moxi (Dexamethasone and moxifloxacin hydrochloride)
    • Dex-Moxi-Ketor (Dexamethasone, moxifloxacin hydrochloride and ketorolac)
    • Moxifloxacin
    • Hyaluronidase
    • Lidocaine/Epinephrine in BSS (PF/SF)
    • Phenylephrine/Lidocaine (PF/SF)

Dropless formulations are compounded combinations of steroid, antibiotic, and NSAID intended for use as an intracameral injection at the time of cataract surgery to minimize or eliminate the need for postoperative drops.

No (compounded formulation)

No

Formulation dependent

Injectable

Prescription

Formulation dependent

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  • Dosage: hydrogel insert designed to release a tapered dose of dexamethasone

Dextenza (dexamethazone insert) 0.4mg is a corticosteroid intracanalicular insert placed through the punctum into the canaliculus and is designed to deliver dexamethasone to the ocular surface for up to 30 days without preservatives.  Following treatment, Dextenza is intended to resorb and exit the nasolacrimal system without the need for removal.

Dextenza has completed Phase 3 evaluation for the treatment of ocular pain and inflammation following ophthalmic surgery. DEXTENZA is also being studied for allergic conjunctivitis.

Under investigation

No

Dexamethasone

Intracanalicular insertion

Prescription

0.4 mg