Difluprednate Ophthalmic

What is difluprednate ophthalmic?

Difluprednate ophthalmic is a corticosteroid eye medication used to treat inflammation and provide pain management in the eye following surgery, injury, or in certain cases of inflammation (conjunctivitis, anterior uveitis, keratitis). It is recommended for use in all animal species except birds.

Difluprednate is used off-label in pets as there are no veterinary formulations available. Many drugs are commonly prescribed for off-label use in veterinary medicine. “Off label” means the drug is being used in a way that has not been reviewed or approved by the U.S. Food and Drug Administration (FDA) or Health Canada. In these instances, follow your veterinarian’s directions and cautions carefully, as they may be significantly different from those on the label. 

How do I give my pet difluprednate ophthalmic?

• Difluprednate ophthalmic comes in a liquid drop format to be instilled directly to the eye (topically).
• Follow your veterinarian’s instructions and give this medication exactly as directed.
• Shake the bottle well before use.
• Wash your hands before applying this medication.
• Do not allow anything to touch the dropper tip, including your hands, to avoid contamination.
• Wipe any residue of this medication from the fur of your pet’s face gently with a damp cloth.
• Wait for 5 minutes after applying this medicine before applying any other medicines to the eye.

This medication should take effect quickly, within 1–2 hours, and improvement in clinical signs should follow.

What if I miss giving my pet the medication?

If you miss a dose of difluprednate ophthalmic, give it as soon as you remember, and then continue with the regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and resume the regular dosing schedule. Do not give the pet two doses at once.

Are there any potential side effects from difluprednate ophthalmic?

Difluprednate ophthalmic may cause the following side effects:

• Burning and stinging of the eyes on application
• Drooping of the eyelid.

Serious adverse reactions may occur. If any of the following signs develop, stop giving difluprednate ophthalmic and contact your veterinarian immediately:

• Signs of an allergy (labored or noisy breathing or swelling of the throat)
• Nausea, vomiting, and loss of appetite
• Signs of an eye infection, such as an increase in ocular discharge
• Failure of eye injuries to heal
• Changes in blood or urine sugar in diabetic animals
• Development of cataracts
• An increase in the size of the eye (increased intraocular pressure)
• Dilated pupils
• Hair loss

Drug sensitivities can develop over time, with repeated exposure. Your pet may have no reaction after the first few doses but may develop a sensitivity later. It is important to watch for signs of an allergic reaction over the entire course of treatment (e.g., irregular breathing, rash, fever, puffiness and swelling around the face) and notify your veterinarian if you have any concerns. 

Other side effects may occur. If you notice anything unusual, contact your veterinarian immediately. This short-acting medication should stop working within 24 hours, although effects can be longer in pets with liver or kidney disease.

Are there any risk factors for this medication?

DO NOT USE difluprednate ophthalmic in:

• Pets with a hypersensitivity or allergy to this medication
• Birds (they are very sensitive to steroids)
• Animals suspected of having an eye infection caused by a virus (e.g., herpes)
• Pets with fungal eye infections
• Animals that have an eye ulcer

USE WITH EXTREME CAUTION in:

• Pets with an infectious disease
• Pets with chronic renal failure
• Pets with congestive heart failure
• Pets with systemic hypertension (high blood pressure)
• Pets with gastric ulceration

USE WITH CAUTION in:

• Pets that are diabetic
• Pets with glaucoma
• Pets that are prone to stomach ulcers
• Pets that are pregnant or nursing

Prolonged use of topical corticosteroids such as difluprednate ophthalmic can suppress the hypothalamic-pituitary axis (HPA), which may lead to the development of diseases of the pituitary and adrenal glands, such as Cushing’s disease (hyperadrenocorticism).

Are there any drug interactions I should be aware of?

Certain medications may interact with difluprednate ophthalmic, so be sure to tell your veterinarian about any medications (including vitamins, supplements, and herbal therapies) that your pet is taking before starting any new treatment. 

Several medications should be used with caution when given with difluprednate ophthalmic, including:

• Corticosteroids (e.g., prednisone): do not use with difluprednate ophthalmic unless instructed by your veterinarian

Is any monitoring needed with this medication?

• Your veterinarian will let you know when they want to reassess your pet to ensure the medication is working and not causing side effects.
• At home, monitor for any side effects such as those noted above. If any side effects occur, discontinue use of the medication and contact your veterinarian.

How do I store difluprednate ophthalmic?

• Store difluprednate ophthalmic at room temperature (68°F–77°F or 20°C–25°C).
• Do not freeze.
• Store upright and tightly closed in the original bottle.
• Protect from light and heat.
• Store compounded forms of this medication according to the label.
• Keep medication out of reach of children and pets.

What should I do in case of emergency?

If you suspect an overdose or an adverse reaction to the medication, call your veterinary office immediately. If they are not available, follow their directions in contacting an emergency facility. Be prepared to provide information about the product and your pet’s weight and symptoms.