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 (inflammation of the uvea) 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, Durezol 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 starting to take this medication, you should be sure to alert your doctor about any prior reactions you may have had to Durezol, other corticosteroids, or other medications. In addition, mention any sensitivities to its possible components, such as preservatives, dyes, foods, or even animals, and tell your doctor about any other medications, supplements, and vitamins you are currently taking. This information will help your doctor identify anything that might interfere with or cause unwanted interactions with Durezol.

If you have taken steroid eye drops before and had an increase in eye pressure, you may be a "steroid responder" and be at risk of developing glaucoma when taking this drop. Be sure to discuss any concerns you have with your doctor, particularly if you are on this medication for an extended period.

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 medication is contraindicated for those who have viral and other eye diseases, such as:

  • Epithelial herpes simplex keratitis
  • Vaccinia
  • Varicella
  • Mycobacterial infection
  • Ocular fungal disease
  • Glaucoma (those with this condition should use any steroid carefully, since steroids may raise pressure in the eye)

Also, take care if you take this medication for a prolonged period (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 (due to increased eye pressure)
  • 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
  • Fungal infections

Other Ophthalmic Steroids

Durezol is not the only steroid used to combat pain and inflammation of the eye. Other drugs in this class 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 one drop is recommended, four times a day for two weeks. After that, the dosage should be tapered, as instructed by your practitioner.

Note that all dosages listed 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 medication should only be used in 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 infant growth. As a result, caution here is urged.

When Durezol is used to treat inflammation in children, your doctor should determine the dosage. Older patients can use the medication according to their doctor's instructions.

Those who wear contact lenses should make sure to remove them 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 Fahrenhei. If you need to take it 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 the bottle gently to release one drop into the eye. Release the lower lid and close the eye, then 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 process, take care not to inadvertently contaminate the tip of the bottle.

If you are using this medication after surgery and had the procedure in both eyes, be sure to use a separate bottle for each eye. 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 individuals may occasionally experience adverse reactions. Common side effects that impact up to 15% of people 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 include:

  • 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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