Alrex (loteprednol) is a prescription corticosteroid eye drop used short-term to treat adults with seasonal eye allergies, or allergic conjunctivitis. It works by reducing redness, itching, and swelling in the eyes. You typically apply it directly to the affected eye four times a day for 2 weeks. Common side effects include blurry vision, dry eyes, and a burning feeling right after using the drops.
Seasonal eye allergies (allergic conjunctivitis)
Alrex (loteprednol) is a corticosteroid. While the exact way it works in the eye isn't fully known, the medication is thought to block certain chemicals that cause inflammation. This helps lower inflammation in the eye to relieve symptoms like swelling, itchiness, and redness.
Source: DailyMed
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur:
More common
Blurred vision or other change in vision
redness or swelling of the eye
sensitivity of the eyes to light
swelling of the membrane covering the white part of the eye
Less common
Decreased vision
discharge from the eye
eye discomfort, irritation, or pain
redness of the eyelid or inner lining of the eyelid
tiny bumps on the inner lining of the eyelid
Incidence not known
Blindness
gradual blurring or loss of vision
loss of vision
slow wound healing
tearing
vomiting
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
More common
Burning feeling when medicine is applied
feeling of something in the eye
headache
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Starts working within 2 hours
Specifically approved for seasonal eye allergies
Applied directly where the pain or inflammation is
Needs to be used four times per day
Slows healing and raises your risk of eye infection
Might be difficult for some people to use correctly
Alrex (loteprednol) is an eye drop medication that you should place only on the surface of your eye. Don’t put it in your mouth, nose, ears, or on your skin.
Don’t let the tip of the Alrex (loteprednol) bottle touch your eye, fingers, or any surface. This can contaminate the drops and cause an infection. If your eye redness or itching gets worse, talk to your prescriber.
If you wear soft contact lenses, take them out before using Alrex (loteprednol). Wait at least 10 minutes after using Alrex (loteprednol) before putting your contacts back in. It’s best not to wear contact lenses at all if your eye is red.
Let your prescriber know if your eye symptoms don't start to get better after 2 days of using Alrex (loteprednol). They might consider a different medication to help relieve your symptoms.
Store Alrex (loteprednol) at room temperature. Keep the bottle in its box to protect it from light.
Shake the bottle well before each use because it's a suspension. This helps mix the medicine evenly.
Tilt your head back, look up, and gently pull your lower eyelid down to make a small pocket. Hold the bottle upside down right above your eye.
Squeeze out one drop into the pocket. Close your eye and gently press the inner corner for about a minute to keep the medication in your eye.
Alrex (loteprednol) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Using Alrex (loteprednol) for a long time | History of glaucoma
Using Alrex (loteprednol) for a long time can lead to serious eye problems like glaucoma or cataracts. This could lead to vision loss or blind spots. Your prescriber will likely monitor your eye pressure if you use the medication for more than 10 days. Tell your prescriber if you have any vision changes using these eye drops.
Risk factors: Using Alrex (loteprednol) for a long time | History of eye infections | Certain eye conditions
Using Alrex (loteprednol) for a long time can make it harder for your body to fight eye infections. This can raise the chance of getting a new infection or making an existing one worse. Let your prescriber know if you have symptoms of an eye infection, like worsening redness, itching, swelling, or discharge.
Steroid eye drops like Alrex (loteprednol) can make viral infections, like herpes simplex, worse or last longer. Fungal infections in the eye can also happen with long-term steroid use. If you've had an eye infection in the past, let your prescriber know before using this eye drop.
Alrex (loteprednol) contains a preservative that absorbs into soft contact lenses and damages them. If your prescriber says it's okay to wear contacts during treatment, take them out before using the drops. Wait at least 10 minutes after using Alrex (loteprednol) before putting your contact lenses back in.
The typical dose is 1 drop into the affected eye(s) four times per day.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Bacterial, viral, or fungal infection in the eye
Seasonal eye allergies (allergic conjunctivitis)
Eye injury
Swelling or allergies in the eye
Temporary relief of allergy eye symptoms, such as itching and redness
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American Academy of Allergy, Asthma & Immunology. (2024). Tips for administering eye drops.
Bausch & Lomb Incorporated. (2022). Alrex- loteprednol etabonate suspension/ drops [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2025). What causes HSV (herpes simplex virus) keratitis.
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