PRECAUTIONS
General
The initial prescription and renewal of the medication order beyond 20 milliliters of PRED
FORTE® suspension should be made by a physician only after examination of the patient with
the aid of magnification, such as slit lamp biomicroscopy, and, where appropriate, fluorescein
staining. If signs and symptoms fail to improve after 2 days, the patient should be re-evaluated.
As fungal infections of the cornea are particularly prone to develop coincidentally with longterm
local corticosteroid applications, fungal invasion should be suspected in any persistent
corneal ulceration where a corticosteroid has been used or is in use. Fungal cultures should be
taken when appropriate.
Carcinogenesis, Mutagenesis, Impairment Of Fertility
No studies have been conducted in animals or in humans to evaluate the potential of these
effects.
Pregnancy
Prednisolone has been shown to be teratogenic in mice when given in doses 1-10 times the
human dose. Dexamethasone, hydrocortisone, and prednisolone were ocularly applied to both
eyes of pregnant mice five times per day on days 10 through 13 of gestation. A significant
increase in the incidence of cleft palate was observed in the fetuses of the treated mice. There are
no adequate well-controlled studies in pregnant women. Prednisolone should be used during
pregnancy only if the potential benefit justifies the potential risk to the fetus.
Nursing Mothers
It is not known whether topical ophthalmic administration of corticosteroids could result in
sufficient systemic absorption to produce detectable quantities in breast milk. Systemically
administered corticosteroids appear in human milk and could suppress growth, interfere with
endogenous corticosteroid production, or cause other untoward effects. Because of the potential
for serious adverse reactions in nursing infants from prednisolone, a decision should be made
whether to discontinue nursing or to discontinue the drug, taking into account the importance of
the drug to the mother.
Pediatric Use
The safety and effectiveness in pediatric patients have been established. Use in pediatric patients
is supported by evidence from adequate and well-controlled studies of prednisolone acetate
ophthalmic suspension in adults with additional data in pediatric patients.
Geriatric Use
No overall differences in safety or effectiveness have been observed between elderly and
younger patients.