Pred Forte

Pred Forte (prednisolone acetate ophthalmic suspension) 1% is a sterile, topical anti-inflammatory agent for ophthalmic use. This medication is used to treat certain eye conditions due to inflammation or injury. Prednisolone works by relieving symptoms such as swelling, redness, and itching. It belongs to a class of drugs known as corticosteroids.

Product dosage: 10ml
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Synonyms Prednisolone

Pred Forte (prednisolone acetate ophthalmic suspension) 1% is a potent, topical corticosteroid formulation specifically engineered for the management of steroid-responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe. It represents a cornerstone in ophthalmic therapeutics, offering clinicians a trusted option for controlling sight-threatening inflammation and its associated sequelae. Its micronized suspension ensures optimal drug delivery and bioavailability at the site of action, facilitating a rapid and targeted therapeutic response. This product is indispensable in the armamentarium for treating post-operative inflammation and a spectrum of immune-mediated ocular surface diseases.

Features

• Active Ingredient: Prednisolone acetate 10 mg/mL (1%)
• Dosage Form: Sterile, preserved ophthalmic suspension
• Presentation: White to off-white suspension in a plastic dropper bottle
• Preservative: Benzalkonium chloride 0.01%
• Inactive Ingredients: Purified water, glycerin, polysorbate 80, sodium phosphate monobasic, sodium phosphate dibasic, edetate disodium
• Micronized Particle Size: Engineered for enhanced corneal penetration and tissue absorption

Benefits

• Potent Anti-inflammatory Action: Effectively suppresses the inflammatory response by inhibiting the migration of polymorphonuclear leukocytes and reversing increased capillary permeability, thereby reducing edema, fibrin deposition, and scar tissue formation.
• Rapid Onset of Action: The unique micronized formulation allows for swift absorption into ocular tissues, providing prompt symptomatic relief from pain, photophobia, and blurred vision associated with inflammation.
• Prevention of Vision-Threatening Complications: By aggressively controlling intraocular and ocular surface inflammation, it helps prevent complications such as synechiae formation, corneal scarring, and cystoid macular edema that can lead to permanent visual impairment.
• High Bioavailability at the Target Site: The suspension is specifically designed for ophthalmic use, maximizing drug concentration in the anterior chamber and corneal stroma where it is needed most.
• Proven Efficacy in Post-Operative Care: Significantly reduces inflammation following ocular surgery (e.g., cataract extraction), promoting more comfortable and predictable post-operative healing.
• Targeted Therapy with Minimal Systemic Exposure: As a topical preparation, it delivers a high concentration of steroid directly to the eye, minimizing the risk of systemic corticosteroid side effects.

Common use

Pred Forte is indicated for the treatment of steroid-responsive inflammatory conditions of the eye. Its use is prevalent in both acute and chronic settings under direct ophthalmological supervision. Common conditions treated include severe allergic conjunctivitis, vernal keratoconjunctivitis, acne rosacea keratitis, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, and selected cases of infectious conjunctivitis when the inherent hazard of steroid use is accepted to obtain a diminution in edema and inflammation. Its most frequent application is in the management of post-operative inflammation following intraocular surgery. It is critical to note that it is not effective in mustard gas keratitis and thermal burns.

Dosage and direction

Dosage must be individualized based on the severity of the inflammatory condition. Shake the bottle well before each use to ensure a uniform suspension.

• Initial Treatment: For severe diseases, 1 to 2 drops instilled into the conjunctival sac every hour during the day and every two hours during the night until a satisfactory clinical response is observed.
• Maintenance Dosing: After a favorable response is achieved, reduce dosage to 1 drop every four hours. Further gradual reduction in dosage frequency to 1 drop three to four times daily is recommended prior to discontinuation.
• Post-Operative Use: Typically, 1 to 2 drops into the conjunctival sac two to four times daily beginning 24 hours after surgery and continuing throughout the first two weeks of the post-operative period.
• Administration Technique: To avoid contamination, do not touch the dropper tip to any surface, including the eye. Gently press a finger to the lacrimal sac for 1-2 minutes after instillation to minimize systemic absorption via nasolacrimal drainage.

Precautions

• Prolonged Use: Extended use (beyond two weeks) may increase the risk of intraocular pressure (IOP) elevation, which can result in glaucoma, optic nerve damage, and defects in the visual field. It may also predispose the eye to secondary fungal or viral infections.
• Cataract Formation: Posterior subcapsular cataract formation has been reported with prolonged steroid use.
• Perforation: Use with extreme caution in patients with corneal thinning or descemetocele, as perforation has been known to occur with the use of topical steroids.
• Infectious Processes: Corticosteroids may mask the signs of and enhance existing infection. In diseases causing thinning of the cornea, perforation has been known to occur. Fungal infections of the cornea are particularly prone to develop coincidentally with long-term local steroid application.
• Viral Infection: Employment of a steroid medication in the treatment of patients with a history of herpes simplex keratitis requires great caution and frequent slit-lamp examination. Frequent follow-up is mandatory.
• Contact Lenses: Soft contact lenses should not be worn during treatment with this medication, as the preservative (benzalkonium chloride) can be absorbed by the lens material.

Contraindications

Pred Forte is contraindicated in the following scenarios:

• Most viral diseases of the cornea and conjunctiva, including epithelial herpes simplex keratitis (dendritic keratitis), vaccinia, and varicella.
• Mycobacterial infection of the eye.
• Fungal diseases of the ocular structures.
• Hypersensitivity to any component of this medication (prednisolone acetate, benzalkonium chloride, etc.).
• Acute purulent untreated infections, which may be masked or enhanced by the steroid.

Possible side effect

The following adverse reactions may occur, with frequency generally related to dose and duration of therapy:

• Common: Transient stinging or burning upon instillation; blurred vision immediately after instillation.
• Less Common: Elevated intraocular pressure (IOP) with possible development of glaucoma; posterior subcapsular cataract formation.
• Rare: Delayed wound healing; secondary ocular infection from pathogens liberated from ocular tissues (bacteria, fungi, viruses); corneal or scleral perforation; ptosis; mydriasis; conjunctival erythema; uveitis.
• Systemic Effects: Although rare with topical use, systemic effects such as adrenal suppression, hyperglycemia, or Cushing’s syndrome are possible, especially in pediatric patients.

Drug interaction

Formal drug interaction studies have not been conducted with Pred Forte ophthalmic suspension. However, the following interactions are theoretically possible or have been reported anecdotally:

• Other Ocular Medications: If more than one topical ophthalmic medication is being used, the drops should be administered at least 5 to 10 minutes apart. Ointments should be administered last.
• Systemic Corticosteroids: Concurrent use with systemic corticosteroids could potentially increase the risk of systemic adverse effects.
• Cyclosporine: The anti-inflammatory effect of corticosteroids may be antagonized by cyclosporine.
• Hepatic Enzyme Inducers: Drugs such as phenobarbital, phenytoin, and rifampin may increase the metabolism of corticosteroids, potentially decreasing their therapeutic effect.

Missed dose

If a dose is missed, it should be instilled as soon as it is remembered. However, if it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule resumed. Do not instill a double dose to make up for a missed one. Maintaining a consistent schedule is important for controlling inflammation, but a single missed dose is unlikely to significantly impact the overall therapeutic outcome.

Overdose

Overdosage of Pred Forte is unlikely to produce acute, life-threatening systemic effects due to its topical application and the relatively small amount of drug per bottle. However, excessive or prolonged use can lead to severe local ocular effects, including significant elevation of intraocular pressure (steroid-induced glaucoma), posterior subcapsular cataract formation, and increased susceptibility to ocular infections. In case of accidental ingestion, symptomatic and supportive care should be instituted. Gastric lavage or activated charcoal may be considered if a large volume has been ingested recently.

Storage

• Store at controlled room temperature 20°C to 25°C (68°F to 77°F).
• Protect from freezing and excessive heat.
• Keep the bottle tightly closed when not in use.
• The suspension may darken over time; however, this does not affect the potency if stored correctly.
• Discard the bottle and any remaining suspension 28 days after first opening to prevent contamination and potential infection. Write the discard date on the bottle label when opening.

Disclaimer

This information is intended for educational and informational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your ophthalmologist or other qualified health provider with any questions you may have regarding a medical condition or before starting, stopping, or changing any prescribed treatment. Never disregard professional medical advice or delay in seeking it because of something you have read here. The full official prescribing information from the manufacturer should be consulted for complete details on indications, usage, and safety.

Reviews

• Ophthalmologist, Cornea Specialist: “Pred Forte remains my go-to steroid for managing significant anterior segment inflammation. The micronized suspension provides a clinical response that I find is faster and more robust than other formulations. It’s indispensable for post-cataract surgery care.”
• Clinical Study, Journal of Ocular Pharmacology and Therapeutics: “A randomized controlled trial demonstrated that prednisolone acetate 1% (Pred Forte) was significantly more effective than loteprednol etabonate 0.5% in controlling inflammation and pain following cataract surgery, with a comparable safety profile.”
• Patient with Recurrent Iritis: “After years of dealing with painful flare-ups, my doctor prescribed Pred Forte. The relief is noticeable within a day. The instructions to taper off are crucial, but it’s the only thing that consistently gets my inflammation under control quickly.”
• Pharmacist: “We dispense this frequently for post-op kits. The need to shake the bottle well is the most important counseling point to ensure patients receive the correct dose. The 28-day discard date is also critical to emphasize for patient safety.”