Flarex (Fluorometholone Acetate 0.1%) Dosing
For routine postoperative inflammation, instill one drop into the conjunctival sac two to four times daily, with the option to increase dosing to every four hours during the initial 24-48 hours for more severe inflammation. 1
Standard Adult Dosing Schedule
- Initial dosing: Apply 1 drop to the affected eye(s) 2-4 times daily for routine postoperative inflammation 1
- Severe inflammation (first 24-48 hours): Increase frequency to 1 drop every 4 hours if marked inflammation is present 1
- Duration: Continue treatment for at least 2 days before considering discontinuation; if no improvement occurs after 2 days, re-evaluate the patient 1
Tapering Strategy
- Gradual reduction: Once inflammation is controlled, reduce the frequency of applications rather than abruptly stopping treatment 1
- Chronic conditions: Withdraw treatment by gradually decreasing application frequency to prevent rebound inflammation 1
- Critical warning: Do not discontinue therapy prematurely, as this commonly leads to recurrence of inflammation 1
Severe Postoperative Inflammation Protocol
- Loading phase: For severe postoperative inflammation with marked chemosis, lid swelling, or epithelial involvement, use the every-4-hour dosing schedule during the first 24-48 hours 1
- Maintenance phase: After initial control, taper to 2-4 times daily and continue until inflammation resolves 1
- Monitoring requirements: Measure intraocular pressure periodically during treatment, perform pupillary dilation to evaluate for cataract formation, and re-evaluate within 1 week for severe cases 2, 3
Clinical Context and Advantages
- Fluorometholone is preferred for long-term postoperative inflammation control because it suppresses inflammation without inducing significant increases in intraocular pressure, unlike prednisolone or dexamethasone 4
- Fluorometholone 0.1% acetate demonstrates equivalent efficacy to fluorometholone 0.2% for postoperative inflammation after procedures like photorefractive keratectomy 5
- This agent is considered the steroid of choice for extended postoperative inflammation management due to its favorable safety profile regarding IOP elevation 4
Important Safety Considerations
- IOP monitoring: Although fluorometholone has a lower risk of IOP elevation compared to other steroids, periodic measurement remains essential, especially in children under 7 years of age who show increased susceptibility to steroid-induced ocular hypertension 6
- Cataract surveillance: Perform periodic pupillary dilation to screen for cataract formation during prolonged use 2, 3
- Avoid premature discontinuation: Gradual tapering is mandatory in chronic conditions to prevent inflammation recurrence 1