Corticosteroid eye drops

Prolonged use or extensive use should be avoided during pregnancy or lactation in human beings since safety for use in pregnancy and lactation has not been established. There is inadequate evidence of safety in human pregnancy. Topical administration of corticosteroids to pregnant animals can cause abnormalities of foetal development including cleft palate and intrauterine growth retardation. There may therefore be a very small risk of such effects in the human foetus. There is a risk of foetal ototoxicity if aminoglycoside antibiotic preparations are administered during pregnancy.

Uveitis : Controlled clinical studies of patients with uveitis demonstrated that LOTEMAX (loteprednol etabonate ophthalmic suspension) was less effective than prednisolone acetate 1%. Overall, 72% of patients treated with LOTEMAX (loteprednol etabonate ophthalmic suspension) experienced resolution of anterior chamber cell by day 28, compared to 87% of patients treated with 1% prednisolone acetate. The incidence of patients with clinically significant increases in IOP ( ≥ 10 mmHg) was 1% with LOTEMAX (loteprednol etabonate ophthalmic suspension) and 6% with prednisolone acetate 1%.

Corticosteroids have been used as drug treatment for some time. Lewis Sarett of Merck & Co. was the first to synthesize cortisone, using a complicated 36-step process that started with deoxycholic acid, which was extracted from ox bile . [43] The low efficiency of converting deoxycholic acid into cortisone led to a cost of US $200 per gram. Russell Marker , at Syntex , discovered a much cheaper and more convenient starting material, diosgenin from wild Mexican yams . His conversion of diosgenin into progesterone by a four-step process now known as Marker degradation was an important step in mass production of all steroidal hormones, including cortisone and chemicals used in hormonal contraception . [44] In 1952, . Peterson and . Murray of Upjohn developed a process that used Rhizopus mold to oxidize progesterone into a compound that was readily converted to cortisone. [45] The ability to cheaply synthesize large quantities of cortisone from the diosgenin in yams resulted in a rapid drop in price to US $6 per gram, falling to $ per gram by 1980. Percy Julian's research also aided progress in the field. [46] The exact nature of cortisone's anti-inflammatory action remained a mystery for years after, however, until the leukocyte adhesion cascade and the role of phospholipase A2 in the production of prostaglandins and leukotrienes was fully understood in the early 1980s.

Corticosteroid eye drops

corticosteroid eye drops

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