Loteprednol: Difference between revisions

Loteprednol etabonate
Clinical data
Trade names	Lotemax
Other names	HGP 1
AHFS/Drugs.com	Micromedex Detailed Consumer Information
MedlinePlus	a606003
Routes of; administration	Eye drops
ATC code	S01BA14 (WHO) ;
Legal status
Legal status	US: ℞-only;
Identifiers
	IUPAC name Chloromethyl 17-ethoxycarbonyloxy-11-hydroxy-10,13-dimethyl-3-oxo-7,8,9,11,12,14,15,16-octahydro-6H-cyclopenta[a]phenanthrene-17-carboxylate;
CAS Number	82034-46-6 ;
PubChem CID	444025;
IUPHAR/BPS	7085;
DrugBank	DB00873 ;
ChemSpider	392049 ;
UNII	Z8CBU6KR16;
KEGG	D01689 ;
ChEBI	CHEBI:31784;
ChEMBL	ChEMBL1201389 ;
CompTox Dashboard (EPA)	DTXSID2046468 ;
ECHA InfoCard	100.167.120
Chemical and physical data
Formula	C24H31ClO7
Molar mass	466.951 g/mol g·mol−1
3D model (JSmol)	Interactive image;
	SMILES CCOC(=O)O[C@@]1(CC[C@@H]2[C@@]1(C[C@@H]([C@H]3[C@H]2CCC4=CC(=O)C=C[C@]34C)O)C)C(=O)OCCl;
	InChI InChI=1S/C24H31ClO7/c1-4-30-21(29)32-24(20(28)31-13-25)10-8-17-16-6-5-14-11-15(26)7-9-22(14,2)19(16)18(27)12-23(17,24)3/h7,9,11,16-19,27H,4-6,8,10,12-13H2,1-3H3/t16-,17-,18-,19+,22-,23-,24-/m0/s1; Key:DMKSVUSAATWOCU-HROMYWEYSA-N;
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Revision as of 07:25, 15 June 2016

Loteprednol (as the ester loteprednol etabonate) is a corticosteroid used to treat inflammations of the eye. It is marketed by Bausch and Lomb as Lotemax.^[1]

Medical uses

Ocular applications for this drug include the treatment of inflammation of the eye due to allergies, as well as chronic forms of keratitis (e.g. adenoviral and Thygeson's keratitis), vernal keratoconjunctivitis,^[2] pingueculitis, and episcleritis.^{[citation needed]}

Contraindications

As corticosteroids are immunosuppressive, loteprednol is contraindicated in patients with viral or fungal infections of the eye.^[1]^[2]

Adverse effects

Common adverse effects include foreign body sensation in the eye, dry eye and epiphora (overflow of tears), chemosis (swelling of the conjunctiva), headache, and itching. Increased intraocular pressure, a side effect typical of corticosteroids, occurs in about 2% of patients.^[1]^[2]

Interactions

The effect of drugs lowering intraocular pressure may be reduced. Loteprednol is not detectable in the bloodstream; so interactions with systemic drugs are highly unlikely.^[1]

Pharmacology

Mechanism of action

Pharmacokinetics

Neither loteprednol not its metabolite are detectable in the bloodstream, even after oral administration. A study with patients receiving loteprednol eye drops over 42 days showed no adrenal suppression, which would be a sign of the drug reaching the bloodstream to a clinically relevant extent.^[1]

Physical and chemical properties

Chemical synthesis

^[3]

References

^ ^a ^b ^c ^d ^e Haberfeld, H, ed. (2015). Austria-Codex (in German). Vienna: Österreichischer Apothekerverlag.
^ ^a ^b ^c Loteprednol Professional Drug Facts.
^ Druzgala, P.; Hochhaus, G.; Bodor, N. (1991). "Soft drugs—10. Blanching activity and receptor binding affinity of a new type of glucocorticoid: Loteprednol etabonate". J. Steroid Biochem. Mol. Biol. 38 (2): 149–54. doi:10.1016/0960-0760(91)90120-T. PMID 2004037.{{cite journal}}: CS1 maint: multiple names: authors list (link)

@@ Line 65: / Line 65: @@
 ==Interactions==
 The effect of drugs lowering intraocular pressure may be reduced. Loteprednol is not detectable in the bloodstream; so interactions with systemic drugs are highly unlikely.<ref name="AC" />
+==Pharmacology==
+===Mechanism of action===
+{{main|Glucocorticoid#Mechanism of action}}
+===Pharmacokinetics===
+Neither loteprednol not its [[metabolite]] are detectable in the bloodstream, even after [[oral administration]]. A study with patients receiving loteprednol eye drops over 42 days showed no [[adrenal suppression]], which would be a sign of the drug reaching the bloodstream to a clinically relevant extent.<ref name="AC" />
 ==Physical and chemical properties==