Table 5.

Ophthalmic agents available in Canada and the U.S. for the treatment of allergic conjunctivitis [15]

Agents (brand name)	Availabilitya	OTC/Rx	Year of market availabilityb	Age indicationc	Dosing schedule
Topical ocular vasoconstrictors
Naphazoline hydrochloride	Both	OTC	Established		Maximum QID, short term
Tetrahydrozoline hydrochloride	Both	OTC	Established		Maximum QID, short term
Ocular antihistamines
Antazoline (only found in combination)	Both	OTC	Before 1980	N/Ad	QID
Pheniramine (only found in combination)	Both	OTC	Before 1980	N/Ad	QID
Emedastine 0.05% (Emadine®) [104]	U.S. only	Rx	1998	˃ 3 years	QID
Mast-cell stabilizers
Lodoxamide 0.1% (Alomide®) [105]	Both	Rx	1992	≥ 4 years	QID
Cromolyn sodium 2%[106, 107]	Both	OTC/Rx	1993	≥ 5 years	QID
Dual-activity agents
Olopatadine 0.1% (Patanol®)[108]	Both	Rx	1998	≥ 3 years	BID
Olopatadine 0.2% (Pataday®) [109]	Both	Rx	2011	≥ 16 years	Daily
Olopatadine 0.7% (Pazeo®) [110]	Both	Rx	2017	≥ 2 years	Daily
Ketotifen 0.025% (Zaditor®) [111, 112]	Both	Rx (OTC in U.S)	2000	˃ 3 years	BID to TID
Ketotifen 0.025% preservative free	U.S. only	OTC	2000	˃ 3 years	BID to TID
Bepotastine besilate 1.5% (Bepreve®)[113]	Both	Rx	2017	≥ 3 years	BID
Alcaftadine 0.25% (Lastacaft®) [114]	U.S. only	Rx	2014 (U.S. only)	≥ 3 years	Daily
Epinastine 0.05% (Elestat®) [115]	U.S. only	Rx	2004 (U.S. only)	≥ 3 years	BID
Azelastine 0.05% (Optivar®) [116]	U.S. only	Rx	2009 (U.S. only)	˃ 3 years	BID
Ophthalmic steroids (only some most commonly used in ocular allergy)
Fluorometholone acetate 0.1% (FML®)e [117]	Both	Rx	1972	˃ 2 years	BIDf
Prednisolone acetate 1.0% (Pred Forte®)e [118]	Both	Rx	1974	All ages	BIDf
Loteprednol etabonate 0.2% (Alrex®)[119]	Both	Rx	2009	≥ 18 years	QIDf
Loteprednol etabonate 0.5% (Lotemax® (or Lotemax gel®))e [120]	Both	Rx	2009	≥ 18 years	QIDf
NSAIDs
Diclofenac 0.1% (Voltaren Ophtha®)e [121]	Both	Rx	1991	≥ 18 years	QID
Ketorolac 0.4% (Acular LS®) and 0.5% (Acular®)e [75]	Both	Rx	1992 (0.5%) 2004 (0.4%)	≥ 18 years	QID
Nepafenac 0.1% (Nevanac®)e [122]	Both	Rx	2008	≥ 18 years	TID
Bromfenac 0.7% (Prolensa®)e [123]	Both	Rx	2015	≥ 18 years	Daily

BID twice daily, N/A not available, NSAIDs nonsteroidal anti-inflammatory drugs, OTC over-the-counter, QID four times a day, Rx prescription, TID three times a day

^a“Both” indicates the agent is available in both Canada and U.S.

^bUnless otherwise stated, the year of market availability in Canada

^cFor agents that are available in both Canada and U.S., the age indication is based on the Canadian product monograph

^dInformation not available

^eOff-label use only in Canada; short term

^fOr according to the severity of symptoms/inflammation