From the Guidelines
Prescription strength allergy eye drops, such as Lotemax (loteprednol etabonate) and Bepreve (bepotastine besilate), are effective treatments for allergic conjunctivitis, with Lotemax being reserved for more severe symptoms due to its potential side effects 1. When considering treatment options, it's essential to weigh the benefits and risks of each medication.
- Lotemax (loteprednol etabonate) is a corticosteroid that can provide rapid relief of symptoms, but its use should be limited to 1-2 weeks for acute conditions due to the risk of increased intraocular pressure and other vision-threatening side effects 1.
- Bepreve (bepotastine besilate) is an antihistamine that can be used for longer periods, typically dosed as one drop twice daily, and has fewer side effects than steroids 1. Other prescription options include:
- Pataday (olopatadine)
- Lastacaft (alcaftadine)
- Pazeo (olopatadine 0.7%) These medications work by blocking histamine receptors or stabilizing mast cells to prevent the release of inflammatory mediators 1. It's crucial for patients to follow proper administration techniques, such as applying gentle pressure to the inner corner of the eye after administration to prevent systemic absorption, and being aware of potential temporary stinging or burning upon application 1. If symptoms persist beyond two weeks of treatment, patients should follow up with their eye care provider to reassess their treatment plan 1.
From the FDA Drug Label
Bepotastine besilate ophthalmic solution 1.5% is a histamine H1 receptor antagonist indicated for the treatment of itching associated with signs and symptoms of allergic conjunctivitis. Loteprednol etabonate is not mentioned in the provided drug labels, however, bepotastine besilate (Bepreve) is mentioned as a prescription strength allergy eye drop.
Prescription strength allergy eye drops mentioned in the drug labels include:
Bepotastine besilate (Bepreve) 1.5% ophthalmic solution, a histamine H1 receptor antagonist.
The dosage for bepotastine besilate (Bepreve) is:
Instill one drop into the affected eye(s) twice a day [2] [3].
Key points to consider when using bepotastine besilate (Bepreve) include:
- Remove contact lenses prior to instillation of bepotastine besilate ophthalmic solution [2] [3].
- Bepotastine besilate ophthalmic solution should not be used to treat contact lens-related irritation [2] [3].
From the Research
Prescription Strength Allergy Eye Drops
- Lotemax (loteprednol etabonate) is a corticosteroid designed using the "soft drug" concept, available as a 0.5% or 0.2% suspension, effective in reducing signs and symptoms of giant papillary conjunctivitis, acute anterior uveitis, and inflammation following cataract extraction 4.
- Bepreve (bepotastine besilate) is a second-generation H1-antihistamine, approved in the United States for the treatment of allergic conjunctivitis, and also used for the treatment of perennial allergic rhinitis, chronic urticaria, and pruritus associated with skin conditions 5, 6.
Efficacy and Safety
- Loteprednol etabonate has been shown to be effective in treating allergic conjunctivitis, with a superior safety profile compared to other steroids, due to its "soft drug" characteristics 4, 7.
- Bepotastine besilate has been found to be effective and well-tolerated in the treatment of allergic rhinitis, with infrequent side effects in patients without kidney or liver disease 5, 6.
- Loteprednol etabonate is associated with a higher incidence of clinically significant intraocular pressure (IOP) elevation compared to placebo and other treatments, and should be used with caution 7.
Formulations and Indications
- Loteprednol etabonate is available in various formulations, including Eysuvis (0.25% ophthalmic suspension) for the short-term treatment of dry eye disease 8.
- Bepotastine besilate is available as an oral formulation for the treatment of allergic disorders, including allergic rhinitis, chronic urticaria, and pruritus associated with skin conditions 6.