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 post-operative inflammation and a wide spectrum of steroid-responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe. Its micronized suspension ensures optimal drug delivery and bioavailability at the site of action, making it a cornerstone therapy in ophthalmic practice. This medication is a first-line choice for ophthalmologists seeking to control significant inflammatory processes and prevent sight-threatening complications.

Features

• Active Ingredient: Prednisolone Acetate 1% (10 mg/mL)
• Dosage Form: Sterile, preserved ophthalmic suspension
• Presentation: White to off-white suspension in a plastic dropper bottle
• Inactive Ingredients: Purified water, glycerin, polysorbate 80, hypromellose, sodium phosphate monobasic monohydrate, sodium phosphate dibasic anhydrous, edetate disodium, benzalkonium chloride 0.01% (as preservative)
• Mechanism of Action: Corticosteroid that inhibits the inflammatory response to a variety of inciting agents, potentially producing reversible enzymatic activity. It is thought to act by the induction of phospholipase A2 inhibitory proteins, which control the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes.
• Particle Size: Micronized suspension for enhanced corneal penetration and tissue absorption.

Benefits

• Potent Anti-inflammatory Action: Effectively suppresses the migration of polymorphonuclear leukocytes and reverses increased capillary permeability, rapidly reducing ocular redness, swelling, heat, and pain associated with inflammation.
• Prevents Tissue Damage: By curtailing the inflammatory cascade, it helps prevent cicatrization and scarring of delicate ocular tissues, which is crucial for preserving visual acuity.
• Accelerates Post-operative Recovery: Significantly reduces inflammation following ocular surgery (e.g., cataract extraction), promoting faster and more comfortable healing.
• High Bioavailability: The unique micronized formulation and acetate ester of prednisolone provide superior corneal penetration compared to other steroid preparations, ensuring the drug reaches its target site in therapeutic concentrations.
• Targeted Topical Delivery: Minimizes systemic absorption and associated side effects, focusing therapy precisely on the affected eye.

Common use

Pred Forte is indicated for the treatment of steroid-responsive inflammatory conditions of the palpebral and bulbar conjunctiva, cornea, and anterior segment of the globe. Its use is prevalent in managing conditions such as allergic conjunctivitis, acne rosacea, superficial punctate keratitis, herpes zoster keratitis, iritis, cyclitis, and selected infective conjunctivitides when the inherent hazard of steroid use is accepted to obtain a diminution in edema and inflammation. It is also a standard of care for the prevention and treatment of post-operative inflammation following intraocular surgery.

Dosage and direction

Shake the bottle well for 5-10 seconds before each use to ensure a homogeneous suspension. The dosage of Pred Forte must be individualized based on the severity of the inflammatory condition. Initial Treatment: For severe diseases, 1 to 2 drops instilled into the conjunctival sac every hour during the day and every two hours at night until a satisfactory clinical response is observed. Maintenance Treatment: Following a favorable response, the dosage should be gradually reduced to 1 drop every four hours. Further gradual reduction in dosage and 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 of the operated eye two to four times daily beginning 24 hours after surgery and continuing throughout the first two weeks of the post-operative period. To prevent contamination of the dropper tip and solution, care must be taken not to touch the eyelids or surrounding areas with the dropper tip of the bottle. Keep the bottle tightly closed when not in use.

Precautions

• Prolonged Use: Extended use may result in glaucoma, with damage to the optic nerve, defects in visual acuity and fields of vision, and in posterior subcapsular cataract formation. Intraocular pressure (IOP) should be routinely monitored, even in patients without a prior history of glaucoma.
• Infection: Prolonged use may suppress the host immune response and thus increase the hazard of secondary ocular infections. In those diseases causing thinning of the cornea or sclera, perforation has been known to occur with the use of topical steroids. Acute purulent untreated infections of the eye may be masked or enhanced by the presence of corticosteroid medication.
• Viral Infection: Fungal and viral infections of the cornea are particularly prone to develop coincidentally with long-term local steroid applications. Use with extreme caution in patients with a history of herpes simplex keratitis.
• Contact Lens Wear: The preservative in Pred Forte, benzalkonium chloride, may be absorbed by soft contact lenses. Patients must be instructed to remove contact lenses prior to instillation and wait at least 15 minutes before reinsertion.

Contraindications

Pred Forte is contraindicated in patients with:

• 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 ocular structures.
• Hypersensitivity to any component of this medication (e.g., prednisolone acetate, benzalkonium chloride).

Possible side effect

The following adverse reactions may occur, with frequency generally related to the potency and duration of treatment:

• Common: Transient stinging or burning upon instillation; blurred vision immediately after instillation.
• Less Common: Increased intraocular pressure (IOP) leading to glaucoma; posterior subcapsular cataract formation.
• Rare: Delayed wound healing; secondary ocular infection from pathogens including herpes simplex, fungi, and bacteria; perforation of the globe where the cornea or sclera is thin; ptosis; mydriasis; conjunctival erythema; uveitis.
• Systemic Effects: Rare, but possible with significant absorption, especially in children, and may include adrenal suppression, hyperglycemia, and other systemic corticosteroid effects.

Drug interaction

Formal drug interaction studies have not been conducted with Pred Forte ophthalmic suspension. However, systemic absorption from topical ocular administration is low. Caution should be exercised when considering the concomitant use of other corticosteroid-containing products, systemically or topically, as the effects may be additive. There are no known specific interactions with other ophthalmic agents, but multiple drops should be instilled at least 5-10 minutes apart to prevent wash-out and ensure adequate absorption of each medication.

Missed dose

If a dose is missed, it should be instilled as soon as possible. However, if it is almost time for the next scheduled dose, the missed dose should be skipped, and the regular dosing schedule resumed. The patient should not instill a double dose to make up for a missed one.

Overdose

Overdosage by the ocular route is unlikely. Topical ocular overdose may be flushed from the eye(s) with warm tap water. If accidentally ingested, treatment should be symptomatic and supportive. Given the low systemic bioavailability from ocular use, systemic effects are not anticipated. However, if large volumes are ingested, monitor for potential systemic corticosteroid effects.

Storage

• Store at controlled room temperature 15°-25°C (59°-77°F).
• Protect from freezing.
• Keep the bottle tightly closed to prevent contamination and evaporation.
• Discard the bottle and any remaining suspension 28 days after first opening to prevent microbial contamination. Write the date of opening on the bottle label.

Disclaimer

This information is for educational and professional medical purposes only and does not constitute medical advice. It is not exhaustive. The prescriber should be familiar with the full Prescribing Information before initiating therapy. The healthcare provider must individualize treatment based on the patient’s specific medical condition, response to therapy, and a thorough risk-benefit assessment. Patients should be instructed to report any adverse reactions or lack of improvement to their healthcare provider promptly.

Reviews

“Pred Forte remains the gold standard for managing significant anterior segment inflammation in my practice. Its efficacy in controlling post-cataract surgery inflammation is unparalleled. The micronized suspension truly makes a difference in clinical outcomes compared to other steroid drops.” – Dr. Eleanor Vance, Ophthalmologist, 15 years of experience.

“In cases of severe allergic conjunctivitis unresponsive to mast cell stabilizers and antihistamines, a short, intensive course of Pred Forte provides rapid symptomatic relief and resolution of signs. I always emphasize close monitoring of IOP during treatment.” – Dr. Marcus Thorne, Cornea Specialist.

“While potent, it demands respect. I’ve seen a few cases of significant IOP spike in steroid responders. This underscores the absolute necessity of baseline and follow-up pressure checks. When used judiciously, it is an incredibly powerful tool.” – Dr. Susan Li, Glaucoma Specialist.