Generic name: loteprednol etabonate
Brand names: Lotemax, Lotemax SM
Dosage form: eye gel, eye ointment, eye (suspension) drops
Drug class: Ophthalmic steroids

Medically reviewed by Philip Thornton, DipPharm. Last updated on Apr 4, 2023.

What is Lotemax?

Lotemax and Lotemax SM (loteprednol etabonate) are corticosteroid medications used to help treat swelling (edema) and inflammation of the eyes.

They works by blocking your body's inflammatory response, which helps reduce symptoms such as pain, swelling and redness.

Lotemax comes as an eye gel, eye ointment and eye drops.

Lotemax SM also comes as an eye gel, but it contains extra ingredients that help to stabilize particles smaller than a micron - submicron (SM) particles. This helps you to absorb more of the medication because Lotemax SM is made to spread better and stay on your eyes for longer.

What is Lotemax used for?

Lotemax eye drops are used to decrease swelling and inflammation caused by conditions such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis and selected infective conjunctivitides.

Lotemax eye drops are also used to treat post-operative inflammation after ocular surgery.

Lotemax gel and ointment, and Lotemax SM are also used to treat post-operative inflammation and pain after ocular surgery.

Important information

Lotemax and Lotemax SM may cause serious side effects.

• Intraocular pressure (IOP) increase
  • Prolonged use of corticosteroids may result in glaucoma with damage to the optic nerve, defects in visual acuity and fields of vision. Steroids should be used with caution in the presence of glaucoma. If Lotemax and Lotemax SM are used for 10 days or longer, IOP should be monitored.
• Cataracts
  • Use of corticosteroids may result in posterior subcapsular cataract formation.
• Delayed healing
  • The use of steroids after cataract surgery may delay healing and increase the incidence of bleb formation. In those with diseases causing thinning of the cornea or sclera, perforations have been known to occur with the use of topical steroids. The initial prescription and renewal of the medication order should be made by a physician only after examination of the patient with the aid of magnification such as slit lamp biomicroscopy and, where appropriate, fluorescein staining.
• Viral infections
  • Ophthalmic corticosteroids should not be used in most viral diseases of the cornea and conjunctiva including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella.
  • Employment of a corticosteroid medication in the treatment of patients with a history of herpes simplex requires great caution. Use of ocular steroids may prolong the course and may exacerbate the severity of many viral infections of the eye (including herpes simplex).
• Bacterial infections
  • Ophthalmic corticosteroids, should not be used in mycobacterial infection of the eye. Prolonged use of corticosteroids may suppress the host response and thus increase the hazard of secondary ocular infections. In acute purulent conditions, steroids may mask infection or enhance existing infections.
• Fungal infections
  • Fungal infections of the cornea are particularly prone to develop coincidentally with long-term local steroid application. Fungus invasion must be considered in any persistent corneal ulceration where a steroid has been used or is in use. Fungal cultures should be taken when appropriate.

Contact lenses should not be worn when the eyes are inflamed.

Who should not use Lotemax?

Do not use Lotemax or Lotemax SM if you are allergic to loteprednol etabonate or any of the ingredients in Lotemax or Lotemax SM. See below for a complete list of ingredients in Lotemax and Lotemax SM.

What should I tell my doctor before using Lotemax?

Before using Lotemax or Lotemax SM, tell your healthcare provider about all your medical conditions, including if your have or had:

• Glaucoma
• Cataracts or cataract surgery

How should I use Lotemax?

Wash your hands before applying Lotemax and Lotemax SM

Use Lotemax and Lotemax SM exactly as your healthcare provider tells you to.

• Lotemax eye gel
  • Invert closed bottle of Lotemax gel and shake ones to fill tip before putting the gel drops in your eye(s).
  • Apply 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 post-operative period.
• Lotemax eye ointment
  • Apply a small amount (approximately ½ 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 eye drops
  • Shake bottle vigorously before using.
  • Steroid-Responsive Disease Treatment: Apply one to two drops of Lotemax eye drops into the conjunctival sac of the affected eye four times daily. During the initial treatment within the first week, the dosing may be increased, up to 1 drop every hour, if necessary. Care should be taken not to stop therapy to early.
  • Post-Operative Inflammation: Apply one to two drops of Lotemax eye drops into the conjunctival sac of the operated eye four times daily beginning 24 hours after surgery and continuing throughout the first 2 weeks of the post-operative period.
• Lotemax SM
  • Invert closed bottle and shake once to fill tip before instilling drops. Apply one drop of Lotemax SM into the conjunctival sac of the affected eye three times daily beginning the day after surgery and continuing throughout the first 2 weeks of the post-operative period.

What should I avoid while using Lotemax?

• Avoid wearing contact lenses while your eyes are inflamed.

What are the side effects of Lotemax?

Adverse reactions associated with ophthalmic steroids include elevated IOP, which may be associated with infrequent optic nerve damage, visual acuity and field defects, posterior subcapsular cataract formation, delayed wound healing and secondary ocular infection from pathogens including herpes simplex, and perforation of the globe where there is thinning of the cornea or sclera.

• Lotemax eye gel
  • The most common adverse drug reactions (2-5%) were anterior chamber inflammation, eye pain, and foreign body sensation.
• Lotemax eye ointment
  • The most common ocular adverse event, reported in approximately 25% of subjects in clinical studies, is anterior chamber inflammation. Other common adverse events, with an incidence of 4-5%, are conjunctival hyperemia, corneal edema, and eye pain.
• Lotemax eye drops
  • The most common ocular adverse reactions occurring in 5%-15% of patients in clinical studies included abnormal vision/blurring, burning on instillation, chemosis, discharge, dry eyes, epiphora, foreign body sensation, itching, injection, and photophobia.
• Lotemax SM
  • There were no treatment-emergent adverse drug reactions that occurred in more than 1% of subjects in clinical studies in the three times daily group compared to vehicle.​​​​​​

Interactions

Tell your healthcare provider about all the medicines that you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.

Pregnancy and breastfeeding

Tell your doctor if you are pregnant or plan to become pregnant. Lotemax and Lotemax SM should only be used during pregnancy if the benefit outweighs the risk to the fetus.

Tell your doctor if you are breastfeeding or plan to breastfeed. It is not known if Lotemax and Lotemax SM passes into your breast milk. Talk to your doctor about the best way to feed your baby if you use Lotemax or Lotemax SM.

Storage

• Lotemax eye gel: Store upright at 15º to 25º C (59º to 77º F).
• Lotemax eye ointment: Store between 15°C to 25°C (59°F to 77°F). After opening, it can be used until the expiration date on the tube. Do not use if tamper-evident skirt is visible on bottom of cap.
• Lotemax eye drops: Store upright between 15° to 25°C (59° to 77°F). Do not freeze. Do not use if neckband imprinted with. 'Protective Seal' and yellow mortar and pestle image is not intact.
• Lotemax SM: Store upright at 15º to 25ºC (59º to 77ºF). After opening, Lotemax SM can be used until the expiration date on the bottle. Use only if imprinted neckband is intact.
• Keep out of reach of children.

What are the ingredients in Lotemax and Lotemax SM?

Active ingredients: loteprednol etabonate

Inactive ingredients:

Lotemax eye gel: boric acid, edetate disodium, glycerin, polycarbophil, propylene glycol, sodium chloride, tyloxapol, water, sodium hydroxide, benzalkonium chloride

Lotemax eye ointment: mineral oil, petrolatum

Lotemax eye drops: benzalkonium chloride, edetate disodium, glycerin, water, tyloxapol, hydrochloride acid, sodium hydroxide, unspecified povidone

Lotemax SM: boric acid, edetate disodium, glycerin, unspecified hypromellose, poloxamer 407, polycarbophil, propylene glycol, sodium chloride, water, sodium hydroxide, benzalkonium chloride

Lotemax and Lotemax SM are manufactured by Bausch & Lomb Incorporated Tampa, FL 33637 USA.

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Further information

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