What to Know About Durezol (Difluprednate)

Topical Corticosteroid for Ocular Pain, Swelling, and Redness

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Durezol, known generically as difluprednate, is a topical emulsion that is used for treating eye-related pain, redness and swelling. This corticosteroid drop tamps down on the inflammatory response of many agents that would otherwise interfere with healing. It also works to inhibit inflammatory-related scar formation.

Man takes eyedrop to soothe pain, redness and swelling.
 ​ljubaphoto / E+ / Getty Images

Uses

This emulsion, approved in 2008, has the distinction of being the first steroid specifically approved for ocular pain management. It has also been approved for treating ocular inflammation related to:

  • Recent ocular surgery
  • Uveitis at the front of the eye.

Durezol is often prescribed right after common eye surgery such as cataract procedures.

Before Taking

As with any medication, this is not for everyone. Before prescribing this medication or renewing it, the doctor will first make sure there is no thinning of the clear or the white part of the eye.

Prior to beginning, you should be sure to alert your doctor about any prior reactions to Durezol, other corticosteroids, or other medications. Also, mention any sensitivities to possible components such as preservatives, dyes, foods, or even animals.

In addition, tell your doctor about any other medications you are currently taking, as well as any supplements and vitamins that might interfere or cause unwanted interactions with Durezol.

While some drugs pose minor interaction risks, others may outright contraindicate use or prompt careful consideration as to whether the pros of treatment outweigh the cons in your case.

Precautions and Contraindications

Durezol cannot be taken in certain cases. In particular, this is contraindicated for those who have viral and other eye diseases such as:

  • Epithelial herpes simplex keratitis
  • Vaccinia
  • Varicella
  • Mycobacterial infection
  • Ocular fungal disease
  • Those who have glaucoma should use any steroid carefully since this may cause an eye pressure rise.

Also, take care if you take the medication for a prolonged period of 10 days or longer since over time Durezol usage can sometimes have unintended consequences.

Prolonged use of a steroid such as Durezol can also cause:

  • Glaucoma to occur for the first time
  • Cataract formation
  • Delayed wound healing with possible perforation of the globe
  • Rise of bacterial infections due to immune response suppression
  • Increased severity of viral infections such as herpes simplex, which should only be given with caution
  •  Fungal infections to arise

Be sure to discuss any concerns you have with your doctor, particularly if you are on this medication for an extended period.

Other Ophthalmic Steroids

Durezol is not the only steroid used to combat pain and inflammation of the eye. Others in this class commonly also used here include:

  • AK‐Pred, Inflamase Forte (prednisolone sodium phosphate 1%)
  • AK‐Tate, Econopred Plus, Pred Forte (prednisolone acetate 1%)
  • Alrex, Lotemax (loteprednol etabonate 0.5%)
  • Decadron, Maxidex (dexamethasone sodium phosphate 0.1%)
  • Dexadron (dexamethasone sodium phosphate ointment 0.05%)
  • Econopred, Pred Mild (prednisolone acetate 0.12%)
  • Flarex (fluorometholone acetate 0.1%)
  • FML Forte, FML, FML Liquifilm (fluorometholone alcohol 0.1% or 0.25% suspension)
  • FML S.O.P. (fluorometholone ointment 0.1%)
  • HMS (medrysone 1% suspension)
  • Prednisolone Minims (prednisolone sodium phosphate 0.5%)

Dosage

The Durezol ophthalmic emulsion contains 0.05% difluprednate.

When Durezol is used to treat the inflammation and pain that occurs after eye surgery, the manufacturer recommends starting the drops 24 hours after the procedure and then using one drop four times a day for the first two weeks. Then usage is dropped to two times a day for one week and tapered depending upon the response.

For those with endogenous anterior uveitis, use of 1 drop is recommended, 4 times a day for two weeks. After that, the dosage should be tapered, as instructed by the practitioner.

All listed dosages are according to the drug manufacturer. Check your prescription and talk to your doctor to make sure you are taking the right dose for you.

Modifications

While Durezol is a topical eye medication with minimal systemic absorption, its use in pregnant individuals has not been assessed. This should be kept in mind and the medication only used in those cases where the advantages are determined to outweigh the risks to the developing fetus.

Likewise, the effect when breastfeeding remains in question, although when taken systemically, steroids have been found to inhibit growth and so caution here is urged.

When Durezol is used to treat inflammation in children, the doctor should determine the dosage. Older patients can use the medication in the same manner as other adults.

Those who wear contact lenses should make sure to remove these before using the medication. They can be reinserted 10 minutes after using the medication.

How to Take and Store

This emulsion is supplied in an opaque drop bottle, which should be stored at 68 to 77 degrees Fahrenheit, although if taken on a brief trip a temperature range of 59 degrees to 86 degrees F is acceptable.

Before putting Durezol drops in the eye, first wash your hands. Then pull away the lower eyelid gently with your fingers to make room for the drop and with your head tipped back, squeeze this in. Release the lower lid, close the eye taking care not to blink, and use your fingers to apply pressure to the inner corner of the eye for one to two minutes.

If you think you may have missed the eye, instill another drop. Then once again clean your hands and replace the cap on the bottle. Throughout this take care not to inadvertently contaminate the tip of the bottle.

If you are using this medication after surgery and have had the procedure in both eyes, be sure to use a separate bottle for each. Keep in mind that since Durezol is an emulsion there is no need to shake the bottle first.

Side Effects

While Durezol is generally well tolerated, some may occasionally experience adverse reactions. Common side effects that impact up to 15% of people can include:

  • Blepharitis (eyelid inflammation)
  • Blurred vision
  • Corneal edema
  • Eye irritation
  • Headache
  • Increase in eye pressure
  • Infection
  • Iritis
  • Pain
  • Redness
  • Sensitivity to light
  • Swelling of the clear part of the eye

Somewhat less commonly seen are side effects such as:

  • Dry eye
  • Foreign body sensation
  • Itching
  • Tearing
  • Reduced vision

Be sure to tell your doctor if these or any other issues arise while you are taking this medication. 

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Article Sources
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