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Overview: Sulfacetamide/prednisolone is an eye drop used for eye infections and inflammation caused by certain bacteria. It combines an antibiotic, sulfacetamide, to stop bacterial growth, and a steroid, prednisolone, to relieve swelling. Common side effects include eye or eyelid irritation. Serious side effects are rare, but may include infections with other germs and severe allergic reactions. Contact your healthcare provider if your eye condition does not improve with use.

Uses

What is sulfacetamide/prednisolone used for?

Sulfacetamide/prednisolone is commonly used for eye infections caused by certain bacteria, and to help relieve eye inflammation and swelling from the infection.

Sulfacetamide/prednisolone may not be appropriate for some eye infections, depending on which germs are causing the infection. Some bacteria may have developed resistance to sulfacetamide/prednisolone, which will make it less effective.

Sulfacetamide/prednisolone may also be used for other conditions as determined by your healthcare provider.

How does sulfacetamide/prednisolone work (mechanism of action)?

This medicine combines two active ingredients: sulfacetamide, which is an antibiotic, and prednisolone, which is a steroid. Sulfacetamide works by stopping certain bacteria from making an acid they need to grow. Prednisolone works by calming (suppressing) the immune system to reduce swelling and inflammation in the eye.

How is sulfacetamide/prednisolone supplied (dosage forms)?

Brands and other names

  • Blephamide
  • Isopto Cetapred
  • Metimyd
  • Predamide
  • Predsulfair
  • Sulphrin
  • Sulster
  • Vasocidin

Dosage forms and strengths

  • 10%/0.23% ophthalmic solution (eye drops)

How should I store sulfacetamide/prednisolone?

Sulfacetamide/prednisolone should be stored at room temperature, between 59 F to 77 F (15 C to 25 C). Keep the lid tightly closed on the bottle between uses, which helps protect it from light. Do not freeze, and avoid keeping it in direct sunlight. The eye drops may darken over time and should be thrown away if this happens.

Side Effects

What are the most common side effects of sulfacetamide/prednisolone?

The most common side effects of sulfacetamide/prednisolone are listed below. Tell your healthcare provider if you have any of these side effects that bother you.

  • Eye irritation or redness
  • Allergic reactions (see below)
  • Eyelid itching or swelling

There may be other side effects of sulfacetamide/prednisolone that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of sulfacetamide/prednisolone?

While less common, the most serious side effects of sulfacetamide/prednisolone are described below, along with what to do if they happen.

Severe Allergic Reactions. Sulfacetamide/prednisolone may cause allergic reactions, which can be serious. Stop using sulfacetamide/prednisolone and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Another Infection and Delayed Healing. Using sulfacetamide/prednisolone may lead to an infection with other types of germs, such as fungi. Sulfacetamide/prednisolone may also hide or worsen an active infection and slow healing. Do not use it for longer than prescribed. Keep all appointments to have your eyes checked. Call your healthcare provider if your eye infection does not improve after two days or if the following symptoms of an eye infection come back or get worse.

  • Pink or itchy eye
  • Blurry vision
  • Increased pus or eye discharge
  • Swollen eyelids
  • Fever
  • Eye pain

Severe Eye Problems With Prolonged Use. Using sulfacetamide/prednisolone for a long time (ten days or more) may cause increased pressure in the eye, which can lead to nerve damage and gradual vision loss (glaucoma). Prolonged use may cause other severe eye problems, including vision changes, cataracts, and thinning or a hole (perforation) in part of the eye. Follow your healthcare provider’s instructions carefully and keep all appointments to have your eyes checked. Do not use sulfacetamide/prednisolone for longer than prescribed. Tell your healthcare provider right away if you have any eye pain or vision changes. 

Severe Skin Reactions. Sulfacetamide/prednisolone may cause severe skin reactions, called Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), that can lead to death if not treated. If you develop a rash, stop sulfacetamide/prednisolone and call your healthcare provider right away. Get emergency help if you have any of the following symptoms of SJS or TEN.

  • Painful, peeling skin that may look red, purple, or discolored
  • Flat rash or blisters on your skin, mouth, nose, and genitals
  • Red, painful, watery eyes

Liver Damage. Liver damage, also called hepatotoxicity, can happen when using sulfacetamide/prednisolone. Call your healthcare provider right away if you have any of the following symptoms of liver damage.

  • Nausea or vomiting
  • Stomach or belly pain
  • Fever
  • Weakness or unusual tiredness
  • Itching
  • Loss of appetite
  • Light-colored poop
  • Dark-colored pee
  • Your skin or the whites of your eyes turning yellowish in color (jaundice)

Blood Disorders. Sulfacetamide/prednisolone may cause blood disorders, such as agranulocytosis, aplastic anemia, low platelet levels (thrombocytopenia), and low white blood cell levels (leukopenia). Stop using sulfacetamide/prednisolone and get help right away if you have any of the following symptoms of blood disorders.

  • Fever
  • Shortness of breath
  • Pale or yellowish skin
  • Easy bruising or bleeding
  • Frequent infection
  • Unusual weakness or tiredness
  • Dizziness, lightheadedness, or feeling like you are about to pass out
  • Fast or abnormal heartbeat

Warnings & Precautions

Who should not use sulfacetamide/prednisolone?

Allergies to Ingredients. People who are allergic to any of the following should not use sulfacetamide/prednisolone.

  • Sulfacetamide
  • Prednisolone
  • Blephamide
  • Isopto Cetapred
  • Metimyd
  • Predamide
  • Predsulfair
  • Sulphrin
  • Sulster
  • Vasocidin
  • Any other sulfonamides, also known as sulfa medicines
  • Any other medicine known as a corticosteroid
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific sulfacetamide/prednisolone products they stock.

Certain Types of Infections. People with the following types of infections should not use sulfacetamide/prednisolone, as it could make these conditions worse.

  • Herpes simplex keratitis, which is an eye infection caused by herpes simplex virus
  • Most types of active viral infections of the eye, such as those caused by chickenpox (varicella) or poxvirus (vaccinia)
  • Mycobacterial infections of the eye, such as an infection from tuberculosis 
  • Fungal infection of the eye

What should I know about sulfacetamide/prednisolone before using it?

Do not use sulfacetamide/prednisolone unless it has been prescribed to you by a healthcare provider. Use it as prescribed. Make sure that you or a caregiver knows how to properly administer eye drops. 

Do not share sulfacetamide/prednisolone with other people, even if they have the same condition as you. It may harm them.

Keep sulfacetamide/prednisolone out of the reach of children.

To help prevent germs from contaminating the sulfacetamide/prednisolone bottle, be careful not to let the tip touch your eye, fingers, or any other surfaces. Wash your hands before each use. Tell your healthcare provider if your eye symptoms get worse, do not improve, or if you have new eye problems, eye pain, or vision changes.

What should I tell my healthcare provider before using sulfacetamide/prednisolone?

Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if sulfacetamide/prednisolone is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.

  • Glaucoma
  • A condition that causes thinning of the outer layer (cornea) or white of your eye
  • Allergic or sensitive to thimerosal or mercury

Planned Eye Surgery. Using sulfacetamide/prednisolone may raise the risk of eye problems after cataract surgery. Tell your healthcare provider if you are planning to have eye surgery. 

Other Medicines and Supplements. Sulfacetamide/prednisolone may interact with other medicines and supplements. Before using sulfacetamide/prednisolone, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.

Pregnancy. It is not known if or how sulfacetamide/prednisolone could affect pregnancy or harm an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. 

Breastfeeding. It is not known if sulfacetamide/prednisolone passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should stop breastfeeding or stop sulfacetamide/prednisolone.

Interactions

Does sulfacetamide/prednisolone interact with foods or drinks?

There are no known interactions between sulfacetamide/prednisolone and foods or drinks.

It is unknown if drinking alcohol will affect sulfacetamide/prednisolone, but heavy drinking can slow your immune response and make it harder for your body to fight infection.

Does sulfacetamide/prednisolone interact with other medicines (drug interactions)?

Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.

​​In particular, make sure that you discuss if you are using local anesthetic for the eye, such as lidocaine (Akten), proparacaine (Alcaine), or tetracaine before using sulfacetamide/prednisolone. 

This may not be a complete list of medicines that can interact with sulfacetamide/prednisolone. Always check with your healthcare provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much sulfacetamide/prednisolone?

If you or someone else has used too much sulfacetamide/prednisolone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of sulfacetamide/prednisolone?

If you miss a dose, use it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only use the next dose. Do not use double or extra doses.

It is important to complete your prescribed course of sulfacetamide/prednisolone, even if your symptoms get better or go away. This will reduce the risk that future infections are resistant to sulfacetamide/prednisolone or other similar medicines.