sulfacetamide / prednisolone
Sulfacetamide / prednisolone is a combination eye drop used in adults and children ages 6 years and older to treat inflammatory eye conditions, including certain eye infections. Sulfacetamide is a sulfa antibiotic that kills bacteria and prednisolone is a corticosteroid that treats eye inflammation (e.g., redness, swelling, itching). The dosage is typically two drops in the affected eye(s) every 4 hours. This medication is only available as a lower-cost generic as the brand name Blephamide has been discontinued. Side effects include eye irritation and allergic reactions.
What is Sulfacetamide / prednisolone?
What is Sulfacetamide / prednisolone used for?
Eye inflammation caused by a bacterial infection
Eye inflammation with a risk of bacterial infection
How Sulfacetamide / prednisolone works
Sulfacetamide / prednisolone is a combination eye drop containing two medications:
Sulfacetamide is a sulfa antibiotic that prevents bacteria from making folic acid, which is a nutrient they need to survive.
Prednisolone is a corticosteroid. It lessens inflammation in the eye to help relieve eye itching, swelling, pain, and redness.
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What are the side effects of Sulfacetamide / prednisolone?
Common Side Effects
- Eye irritation
Other Side Effects
- High eye pressure
- Vision changes
- Slow wound healing
- Cataracts
Serious Side Effects
- Severe allergic reactions: hives, rash, blisters, fever, swelling of the lips or tongue, difficulty breathing
Source: DailyMed
The following side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Aplastic anemia—unusual weakness or fatigue, dizziness, headache, trouble breathing, increased bleeding or bruising
- Eye pain, change in vision, vision loss
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- New or worsening eye pain, redness, irritation, or discharge
- Redness, blistering, peeling, or loosening of the skin, including inside the mouth
Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):
- Blurry vision
- Eye irritation or itching
- Eyelid drooping
Pros and cons of Sulfacetamide / prednisolone
Pros
Useful for treating eye inflammation and a bacterial eye infection at the same time
Conveniently combines two medications into a single eye drop product
Applied directly to the eyes, which should have fewer side effects than medications taken by mouth
Cons
Needs to be taken every 4 hours, including at night
Might be difficult for some people to use properly
Might not be the best choice for people who are allergic to sulfa medications
Pharmacist tips for Sulfacetamide / prednisolone
Take sulfacetamide / prednisolone exactly as prescribed. Don't change your dose or stop treatment early, even if your eye starts to get better. Stopping the medication too soon can cause your infection to come back and be harder to treat.
Let your prescriber know if your eye symptoms don't start to improve after you've used sulfacetamide / prednisolone for 2 days. They might consider a different medication to help relieve your symptoms and treat your infection better.
Don't wear contact lenses while you're using sulfacetamide / prednisolone. In general, it's best not to wear contacts while you have an eye infection, since this can affect how quickly your symptoms improve.
Wash your hands before and after using sulfacetamide / prednisolone drops. Avoid letting the dropper tip touch your eye, any surface, or your hands. This helps prevent contaminating the medication with germs.
If you need to use other eye drop medications in addition to sulfacetamide / prednisolone, wait 5 minutes between using each medication. This helps give your eye time to fully absorb each medication.
Sulfacetamide / prednisolone can raise your eye pressure, especially if you use it for more than 10 days. Your prescriber might check this pressure regularly to make sure it's still safe for you to take this medication.
Store the sulfacetamide / prednisolone bottle at room temperature and keep it away from heat and light. It's normal for the eye drops to turn slightly yellow, but don't use it if they become darker. If this happens, contact your care team for a new bottle.
You don't need to shake the sulfacetamide / prednisolone bottle before putting the drops into your eyes.
Tilt your head back and look up. Gently pull down your lower eyelid to create a small pocket. Then, hold the eye drop bottle upside down above your eye and squeeze out 1 drop into the pocket. Avoid blinking, close your eye, and press the inner corner for a minute to help the medication stay.
For a full dose, wait 3 to 4 minutes before applying another drop to the same eye as above.
Frequently asked questions about Sulfacetamide / prednisolone
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What are the risks and warnings for Sulfacetamide / prednisolone?
Sulfacetamide / prednisolone 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.
Eye problems
Risk factors: Long-term use | History of glaucoma or cataracts | History of viral infections in the eye | Recent eye surgery
Long-term use of sulfacetamide / prednisolone can raise your risk of developing new or worsening eye problems, including eye infections. It also raises your risk for glaucoma, cataracts, high eye pressure, and vision problems. If you need to take sulfacetamide / prednisolone for a long time (10 days or longer), you'll need regular eye exams to check the health of your eyes. Let your prescriber know if you have any vision changes, eye pain, or new symptoms of an eye infection while you're using this medication.
Possible eye injury or damage
Risk factors: Using steroids in the eye for a long time
Steroid eye drops like sulfacetamide / prednisolone can lead to eye injury or damage, including thinning of the cornea (the outer layer of your eye). Call your prescriber right away if you notice changes in vision, eye pain, or watery eyes. You might need to get your eyes checked for injury.
Allergic reaction
Risk factors: Allergy to sulfa antibiotics
Let your prescriber know if you're allergic to sulfa antibiotics like sulfamethoxazole / trimethoprim (Bactrim). It's possible that you might be allergic to sulfacetamide / prednisolone too. Serious allergic reactions can be life-threatening, and they can include reactions like body rashes, blisters, and facial swelling. Get medical help right away if you notice hives, rash, swelling of the lips or tongue, or trouble breathing after you use sulfacetamide / prednisolone.
Sulfacetamide / prednisolone dosage forms
Typical dosing for Sulfacetamide / prednisolone
This medication contains 10% of sulfacetamide and 0.23% of prednisolone
The typical dose is 2 drops in the affected eye(s) every 4 hours.
Sulfacetamide / prednisolone contraindications
What are alternatives to Sulfacetamide / prednisolone?
Eye inflammation caused by a bacterial infection
Eye inflammation with a risk of bacterial infection
Inflamed eyes that have a bacterial infection
Inflamed eyes that could become infected with bacteria
Eye inflammation from a bacterial infection in the eye
Eye inflammation when there's a risk for a bacterial infection in the eye
Sulfacetamide / prednisolone images
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References
Best studies we foundAmerican Academy of Allergy, Asthma & Immunology. (2024). Tips for administering eye drops.
Bausch & Lomb Incorporated. (2023). Sulfacetamide sodium and prednisolone sodium phosphate- sulfacetamide sodium and prednisolone sodium phosphate solution/ drops [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2024). Fungal eye infections basics.
Drugs@FDA: FDA-Approved Drugs. (n.d.). Blephamide. U.S. Food and Drug Administration.
Drugs@FDA: FDA-Approved Drugs. (n.d.). Blephamide S.O.P. U.S. Food and Drug Administration.
Hoffman, J., et al. (2020). Viral diseases of the eye. Community Eye Health.
Kheir, W. J., et al. (2015). Nontuberculous mycobacterial ocular infections: A systematic review of the literature. BioMed Research International.
SafeMedication. (n.d.). How to use eye drops.
U.S. Food and Drug Administration. (2018). Contact lens risks.
Valentini, C., et al. (2021). Price differences between otic and ophthalmic drops. Otology & Neurotology.
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