Zylet Eye Drops (Loteprednol and Tobramycin) - Uses, Dose, Brands

Zylet eye drops contain Loteprednol and tobramycin. It is a combination of a topical corticosteroid (loteprednol) and an aminoglycoside (tobramycin). It is used to treat ocular inflammatory conditions where the risk of bacterial infection exists.

Loteprednol and tobramycin (Zylet eye drops) Uses:

Ocular inflammatory conditions:
- It is indicated for the treatment of steroid-responsive inflammatory conditions of the eyes where a risk of a superficial bacterial infection exists.
- It may be used in patients with:
  - inflammation of the palpebral and bulbar conjunctiva, cornea, and the anterior segment of the eyeglobe
  - allergic conjunctivitis,
  - acne rosacea,
  - herpes zoster keratitis,
  - iritis,
  - superficial punctate keratitis,
  - cyclitis,
  - chronic anterior uveitis;
  - corneal injury from chemical,
  - radiation or thermal burns;
  - penetration of foreign bodies.
  - where the inherent risk of steroid use may result in a reduction in the edema and inflammation of the eye.

Loteprednol and tobramycin (Zylet eye drops) Dose in Adults:

Loteprednol and tobramycin (Zylet eye drops) Dose in the treatment of Ocular inflammatory conditions:

Ophthalmic:
- Instill 1 - 2 drops into the affected eye every 4 to 6 hourly;
- The dosing frequency may be increased during the first 24 to 48 hours to every 1 to 2 hours.
- The dosing frequency should be reduced if the clinical signs and symptoms improve.
- Patients should be evaluated if greater than 20 ml of the drug has been used.

Use in Children:

Refer to adults dosing.

Pregnancy Risk Category: C

Talk to individual agents.
The drug has not yet been tested in pregnancy studies with humans or animals.

Breastfeeding: Loteprednol or tobramycin

The systemic absorption of topical applications is very minimal.
It is unknown whether breastmilk contains sufficient drug to detect its presence.
However, the manufacturer recommends that breastfeeding mothers use the drug with caution.
Talk to individual agents.

Dose in Kidney Disease:

Dosage adjustments have not been provided in the manufacturer's labeling.
However, since the drug has minimal systemic absorption, dosage adjustment is unlikely in patients with kidney disease.

Dose in Liver Disease:

Dosage adjustments have not been provided in the manufacturer's labeling.
However, since the drug has minimal systemic absorption, dosage adjustment is unlikely in patients with liver disease.

Common Side Effects of Loteprednol and tobramycin (Zylet eye drops):

Central nervous system:
- Headache
Ophthalmic:
- Eye redness
- Superficial punctate keratitis

Less Common Side Effects of Loteprednol and tobramycin (Zylet eye drops):

Ophthalmic:
- Intraocular pressure increased
- Eye discomfort
- Stinging of eyes
- Corneal deposits
- Disease of the lacrimal apparatus
- Eye discharge
- Eye disease
- Eyelid disease
- Eye pruritus

Contraindications to Loteprednol and tobramycin (Zylet eye drops):

Allergy reactions to loteprednol, tobramycin, and other corticosteroids or any component of this formulation
Viral infections of the cornea, conjunctiva and eye including epithelial and conjunctival herpes simplex, vaccinia and varicella
Mycobacterial infections in the eye
Fungal infections in the eye and surrounding structures.

Warnings and precautions

Immunosuppression:
- Long-term use of corticosteroids, including topical ocular corticosteroids, may cause immunosuppression.
- This can lead to secondary ocular infections and fungal infections.
- It can also mask symptoms of acute ocular infection and may worsen the infective process.
- Patients with persistent corneal ulceration and who are taking topical ocular steroids should be examined for fungal infections.
Ocular effects
- Long-term use of the drug can lead to ocular hypertension and glaucoma.
- Ocular steroids should be used with caution in patients with glaucoma as they can cause an increase in intraocular pressure.
- Steroids can cause corneal or scleral tears if used in conditions that thin the cornea and sclera.
- Steroids can also slow down wound healing and increase the likelihood of bleb formation.
- Patients who have been taking the drug for longer than ten days must have intraocular pressure measured.
Sensitivity reactions
- Tobramycin may cause sensitivity in some patients. If sensitivity reactions develop, treatment may be stopped.
- Cross-sensitivity reactions may occur to other aminoglycoside antimicrobials.
Ocular herpes simplex
- Patients with ocular herpes complex infection should avoid it.
- Patients who have had a history of ocular hispes simplex infections should be warned.

Loteprednol and tobramycin: Drug Interaction

Risk Factor C (Monitor therapy)
Ritodrine	Corticosteroids may enhance the adverse/toxic effect of Ritodrine.

Monitoring parameters:

Patients who have persistent signs and symptoms after 48 hours of initiating treatment may need re-evaluation.
If the treatment is prolonged beyond 10 days, the intraocular pressure should be assessed.
Patients on long term treatment may need evaluation for fungal infections if they have persistent eye swelling and discharge.
After the cumulative dose exceeds 20 ml, the patient should be re-examined. Eye examination must include magnification and fluoroscein staining.

How to administer Loteprednol and tobramycin (Zylet eye drops)?

During treatment, remove contact lenses.
Shake the eye solution before instilling it.
Tilt the head back and instill the suspension in the conjunctival sac and close the eyes.
Avoid touching the tip of the dropper to eyes or other surfaces.
Following instillation, apply a light pressure on the lacrimal sac for one minute.

Mechanism of action of Loteprednol and tobramycin (Zylet eye drops):

Zylet eye drops are made with loteprednol, tobramycin and a combination of both.
Loteprednol acts as an anti-inflammatory drug and a corticosteroid.
It decreases ocular swelling, edema and capillary dilation.
Loteprdenol, which is very fat-soluble, penetrates cells easily to induce the production of lipocortins.
Lipocortins, proteins that regulate the activity of prostaglandins and leukotrienes, are also known as lipocortins.
Tobramycin, an aminoglycoside antibiotic, interferes with bacterial protein production by inducing the 30-S subunit of the ribosomal ribosomal ribosomal.
This causes a deficient bacterial cell membrane, and the death of the bacteria.
Refer to individual agents (Loteprednol, Tobramycin).