Adult: As 0.05% emulsion: Instill 1 drop into the conjunctival sac of the affected eye(s) 4 times daily, starting 24 hours after surgery, continue for 2 weeks. Then, decrease to bid for 1 week then taper based on response.
Ophthalmic Anterior uveitis
Adult: As 0.05% emulsion: Instill 1 drop into the conjunctival sac of the affected eye(s) 4 times daily for 14 days, then taper as clinically indicated. Child: ≥2 years Same as adult dose.
Adult: As 0.05% cream/ointment: Apply once daily or bid to the affected area(s).
Contraindications
Active viral diseases of the cornea and conjunctiva (e.g. epithelial herpes simplex keratitis, vaccinia, varicella), mycobacterial infection and fungal disease of the eye. Bacterial, viral, fungal or parasitic skin infections, ulcerated lesions, acne, rosacea.
Special Precautions
Patients with glaucoma, history of ocular herpes simplex, diseases which may cause thinning of cornea or sclera, acute purulent conditions. Pregnancy.
Adverse Reactions
Significant: Ophthalmic: Reduced visual acuity, posterior subcapsular cataract formation, increased intraocular pressure, corneal perforation, delayed healing, immunosuppression (e.g. increased risk for bacterial, viral and fungal infection), exacerbation of infections. Topical: Cortico-induced and paradoxically cortico-sensitive dermatitis, and cushingoid syndrome (prolonged use), slowing of growth in children. Eye disorders: Ciliary, conjunctival and limbal hyperaemia; eye pain, photophobia, posterior capsule opacification, anterior chamber cells, anterior chamber flare, corneal and conjunctival oedema, blepharitis, punctate keratitis, eye inflammation, iritis, blurred vision, eye irritation, uveitis, dry eye, iridocyclitis. Nervous system disorders: Headache. Skin and subcutaneous tissue disorders: Skin atrophy, stretch marks, secondary ecchymotic purpura, cutaneous fragility, acneiform or pustular eruptions, hypertrichosis, depigmentation, allergic contact dermatoses. Vascular disorders: Telangiectasia.
Patient Counseling Information
Ophthalmic: Remove contact lenses prior instillation and reinsert after 10 minutes. Topical: Avoid contact with the eyes.
Monitoring Parameters
Monitor intraocular pressure for prolonged use (≥10 days). Perform periodic examination of eye lens (prolonged use >28 days).
Action
Description: Mechanism of Action: Difluprednate is a corticosteroid with glucocorticoid activity. It acts by inhibiting the inflammatory responses including oedema, capillary dilation, leukocyte migration, and scar formation. It penetrates cells and induces production of lipocortins, a protein that modulates the activity of prostaglandins and leukotrienes. Pharmacokinetics: Metabolism: Metabolised via deacetylation to 9-difluroprednisolone 17-butyrate (DFB).
Chemical Structure
Source: National Center for Biotechnology Information. PubChem Database. Difluprednate, CID=443936, https://pubchem.ncbi.nlm.nih.gov/compound/Difluprednate (accessed on Jan. 21, 2020)
Storage
Ophthalmic: Store between 15-25°C. Protect from light. Topical cream/ointment: Store below 25°C.
D07AC19 - difluprednate ; Belongs to the class of potent (group III) corticosteroids. Used in the treatment of dermatological diseases.
References
Anon. Difluprednate. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 29/03/2019.Anon. Difluprednate. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 29/03/2019.Buckingham R (ed). Difluprednate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 29/03/2019.Durezol (Alcon Laboratories, Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 22/05/2018.
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