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A steroid WITHOUT BAK!! FML Ointment 0.1%

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  • A steroid WITHOUT BAK!! FML Ointment 0.1%

    Hi, Guys, so I am on a quest to find things without BAK in them. I don't know for sure that I am sensitive to BAK, but so far EVERYTHING that has BAK makes me worse (Azasite, Tobradex, Lotemax, Pataday, etc. etc.) and everything that doesn't have BAK seems to make me better (preservative free OTC drops and medicines that have some preservative OTHER than BAK.

    My doctor (Dr. Brad Spagnolo of the Baltimore Washington Eye institute) prescribed a steroid on my first visit to him that made my eyes feel like heaven. I wake up in the morning and my eyes have been calm and moist all night. I wake up ready to make it through the day.

    Of course the steroid I am talking about is FML s.o.p. ophthalmic ointment 0.1 % (ask for this exactly). It is a little purple tube. It is pretty expensive actually (highest copay for my insurance).

    When you use it, you are supposed to put 1/4 inch or 1/2 inch in your eyes, 1 - 3 times a day. I just use it once at night because you can't see after you put it in your eyes. It is goopy and messy and inconvenient. But like I said - heaven.

    Now, just to point something out - regular FML (the drops) have BAK. FML FORTE drops also have BAK. Make sure you tell your doctor you want the OINTMENT and not the drops.

    The ointment has a preservative called PMA (phenylmercuric acetate) which is a mercury compound like Thimerasol. I have read articles that say bad things about PMA, but all I can say is - it isn't BAK and it feels great.

    So, FML ointment isn't preservative free but at least it doesn't have BAK in it. (BAK is used in animal experiments to induce dry eye - it only takes a week or so and the animals have horrible dry eye).

    Any others?

  • #2
    Leiters in San Jose do PF steroid drops. See Many members here have used Leiters for years.
    Rebecca Petris
    The Dry Eye Foundation


    • #3
      Thanks, Rebecca. I have used Leiter's for the preservative free cromolyn sodium eye drops.

      Here are the preservative free steroids on Leiter's website:

      Dexamethasone Na Phos Injection 4-24mg/ml PF varies
      Dexamethasone Sodium Phosphate Preservative Free Solutions
      Dexamethasone 0.05% Ophthalmic Ointment
      Dexamethasone 0.05% Lanolin Free Ophthalmic Ointment
      Loteprednol 0.25% PF** Opthalmic Solution
      Methylprednisolone Na Succinate Preservative Free Ophthalmic Solution
      Prednisolone Acetate Preservative Free Ophthalmic Suspension
      Prednisolone Sod Phos Preservative Free Ophthalmic Solution
      Rimexolone 0.5% Cmpd PF ** Ophthalmic Solution
      Triamcinolone 80mg/ml Preservative Free Compound Injection

      I don't like these options for a couple reasons - most of them are the older steroids with higher risk of side effects - for example, dexamethasone, methylprednisolone, prednisolone, and triamcinolone.

      Also, Loteprednol is the same steroid in Lotemax and Alrex - which is extremely drying and irritating for me.

      FML is a newer steroid with fewer side effects and doesn't cause the irritation of Lotemax. This is why I wanted everyone to know about FML ointment - and especially because it doesn't have BAK.

      Does anyone know of any other topical steroids that don't have BAK?