safety of lotemax long term?? what do your docs say??

[jenny2008]

Ok so i used to use prednisolone preservative free off and on for years.. both my eye specialists (who retired) were fine with it...

now my new eye doc is saying even lotemax ointment (which i can use because there is no preservative) is not to be used long term and is even dangerous in small amounts..he is saying i for sure will get cataracts very early (40s or early 50s) which will make my eyes drier for about 3 months.. and possibly glaucoma..

i just spoke with another dry eye friend on the phone and she said her doc told her lotemax was safe to use daily and that there was even a study done on it with people using it 4x a day for 2 years without problems..

can anybody offer any insight?? Rebecca do you have any knowledge of this?? thanks!!!

i dont want to harm myself but i dont want to be miserable daily.

[pbeinetti]

Here are a couple of articles that indicate Lotemax is safe -- and that the ointment can be a better therapy than the drops.

http://www.optometricmanagement.com/...ticleID=106684

http://www.mastereyeassociates.com/e...oid-eye-drops/

[Faith1989]

I agree it shouldn't be used everyday forever but my doctor said three times a week is fine, when I have a flare up I can use it more. Some doctors are trying to cover their own ass and not get sued. I agree with Pbeinetti and think its relatively safe to use, I've been using it on and off for a year now and my pressures have not gone up ever and have not developed a cataract. I just use it in my right eye when I am having lid problems..I'm gunna ask my doctor for the ointment next week.

[No tears in ATL]

Jenny, my doc says it is ok to use for flareups as well. I don't use lotemax but durezol, which is pretty much the same thing in a different preservative. In fact, I'm in the middle of a huge flareup right now and have been using it once a day for 5 days. Beyond that, I'd say I might use it about 5 times a month (one drop) on those mornings when I wake up and eyes feel sore.

[Mawsky]

Interesting, while at my visit with the specialist last week, when I told him my right eye gets really bad and red sometimes and I have a old bottle of lotemax I put a drop or two in it, he said "it's not OK to use that all the time" I wonder if they have been told to say this now, because I was told before that it was OK especially seeing as I only use it occasionally. I was going to ask him for a new RX for it but it kinda made me not ask for it. I think I will ask him for one the next visit in August. my poor right eye has been acting up lately.

[spmcc]

My assumption is that doctors believe that if you're having a lot of flare-ups that require steroids, then you're not on the best preventive treatments. For example, with my asthma, if I'm using my rescue inhaler too much, my doctor says "we need to find better meds to prevent your symptoms so you don't use your rescue inhaler".

[Faith1989]

I am having a flare up in my right eye only. My specialist told me to stop using any over the counter lid products and just water to clean. she said she thinks I'm having a reaction to something..SPCC what r u using to prevent your flares if u don't mind me asking.

[spmcc]

My diagosis is ocular rosacea. I've found over 15 years that it is best to put as little as possible on my sick eye surfaces (and leave my lids alone - i.e., no compresses, no expression, no touching!). However - recently I tried Freshkote and woke up with extremely painful, devil-red eyes. So I used Lotemax for 2 days - and kicked myself. So, as much as I minimize my flare-ups, I also do stupid things. Here's what I do "normally" to avoid flare-ups:

1) Muro 128 solution (cornea specialist said okay to use as often as I want) or PF saline
2) all four puncta cauterized
3) Wiley X during the day
4) seal eyes at night (tape, Glad, Tranquileyes, Onyix) -- I still wake after 2-3 hours and have to reapply drops
5) when things are really bad during the day, I will tape my eye into a tarsorraphy and/or close my eyes and try to nap

Doing these things generally keeps my eyes in a steady state of dryness (zero Schirmers, MGD). I used to use Lotemax every 3-4 weeks when the pain would build up until I couldn't stand it. Now I don't have those periods of increasing pain... just a steady dryness (still no fun - but at least no acute dramas).

[spmcc]

Here's what I do "normally" to avoid flare-ups:

1) Muro 128 solution (cornea specialist said okay to use as often as I want) or PF saline
2) all four puncta cauterized
3) Wiley X during the day
4) seal eyes at night (tape, Glad, Tranquileyes, Onyix) -- I still wake after 2-3 hours and have to reapply drops
5) when things are really bad during the day, I will tape my eye into a tarsorraphy and/or close my eyes and try to nap

Oh shoot! I made this sound so simple. But I forgot the "lifestyle changes" I've made...

1) control my environment - no heated air, no a/c, no moving/circulating/blowing air, no fluorescent lights (iow, no malls, no offices, no travel... no life), increase humidity.

2) avoid rosacea triggers, use shampoos for seb derm, etc. (I have skin from hell - rosacea, seb derm, eczema, allergies)

3) minimize use of eyes e.g., computer, reading, TV (also keep screens low, below eye level + use computer programs to help eyes)

There are probably more things...

[kitty]

I used Lotemax drops daily for about 2 years. The medication gave me steroid induced glaucoma, not to mention cataracts. Do not use it for more than a month or two at a time. It is not worth the loss of sight.

[jenny2008]

wow thanks for the info Kitty... so appreciate it... i already used prednisol for years daily.. nothing i can do to change the past but now moving forward i won't use steriods unless for very short periods... did the cataracts and/or glaucoma make your eyes even drier??? Did you doc say it was safe to use Lotemax daily? Im asking because i have a friend who has dry eyes but not so bad where she needs 4 plugs or anything and shes been using lotemax 1x daily for about 6 years and says her doc says it completely safe???

just curious if your doc told you the same ? also did you have pressure spikes??? sorry for so many ?s... if you want private message me.. )) thanks..Jenny

[browneyesblu]

My doc tests my pressure and its low enough says Lotemax is OK. The thing is, one of the adverse effects of glaucoma meds is ocular surface damage. So if you have OSD you may not be able to take them. Don't risk your sight!

[Nikki]

why not try Alrex to see if that works instead of Lotemax? it's a lower concentration of the same active steroid (0.2% vs 0.5%) -

[jenny2008]

ive tried FML which in preservative free alrex i believe..its not strong enough-does nothing at all.i feel like its a rewetting drop..unfortunalety.. ive tried the .1% and .25% and neither helped..

[jenny2008]

i dont think i have osd..they always so my corneas and surface look great -even tho my eye (right one for now)is bone dry!!thanks