Can't find Alrex or it's too expensive? Explore the best alternatives to Alrex for seasonal allergic conjunctivitis, including generics and OTC options.
If you've been prescribed Alrex (Loteprednol Etabonate 0.2%) for seasonal allergic conjunctivitis but can't find it at your pharmacy — or the cost is too high — you're not stuck. There are several effective alternatives that your doctor might recommend, ranging from generic versions of the same ingredient to completely different classes of eye drops.
In this guide, we'll explain how Alrex works, then walk through the most common alternatives so you can have an informed conversation with your eye doctor.
Alrex is a brand-name prescription eye drop containing Loteprednol Etabonate 0.2%, an ophthalmic corticosteroid manufactured by Bausch + Lomb. It's FDA-approved to treat the signs and symptoms of seasonal allergic conjunctivitis (SAC) — including itching, redness, swelling, and watery eyes during allergy season.
Loteprednol works by reducing inflammation in the eye. When you're exposed to allergens like pollen, dust, or pet dander, your immune system triggers an inflammatory response in the conjunctiva (the clear membrane covering the white of your eye). This leads to swelling, redness, and itching. Alrex suppresses this inflammatory cascade by inhibiting the release of chemicals like prostaglandins and leukotrienes.
What makes Alrex special compared to older corticosteroid eye drops is that it's a "soft steroid." After it reduces inflammation, it's designed to break down into inactive metabolites. This means it's less likely to cause elevated intraocular pressure (IOP) — a common and potentially serious side effect of traditional steroid eye drops. For more details, read our deep dive into how Alrex works.
The standard dosing is 1 drop in the affected eye(s) four times daily during allergy flare-ups. It's meant for short-term use and comes in 5 mL and 10 mL bottles.
There are several reasons you may be looking for an alternative to Alrex:
The closest alternative to Alrex is its own generic — Loteprednol Etabonate Ophthalmic Suspension 0.2%. This is the exact same active ingredient at the same concentration, made by a different manufacturer.
Key facts:
If your only issue is finding or affording brand-name Alrex, the generic is almost always the easiest solution. Ask your pharmacist if they can substitute it.
Lotemax is another Bausch + Lomb product that contains the same active ingredient — Loteprednol Etabonate — but at a higher concentration of 0.5%. It comes in several formulations: suspension, gel, and ointment.
Key facts:
Your doctor might switch you to Lotemax if your allergic conjunctivitis symptoms are more severe than what Alrex 0.2% can control.
If you'd prefer to avoid steroids entirely, Pataday (Olopatadine) is one of the most popular alternatives. It's an antihistamine and mast cell stabilizer eye drop that's now available over the counter.
Key facts:
Pataday is often the first-line treatment that insurance companies require patients to try before covering a steroid like Alrex. Many patients find that Pataday alone is enough to manage their symptoms.
Zaditor (Ketotifen) is another OTC antihistamine eye drop for allergic conjunctivitis. It works similarly to Pataday.
Key facts:
Zaditor is one of the most budget-friendly options for eye allergy relief. It's not as potent as a corticosteroid like Alrex, but it works well for many patients with mild to moderate symptoms.
For more severe cases where a stronger anti-inflammatory is needed, your doctor might prescribe Pred Forte (Prednisolone Acetate 1%). This is a traditional ophthalmic corticosteroid that's been used for decades.
Key facts:
Pred Forte is a good option when you need strong anti-inflammatory power, but it comes with more side effect risks. Your doctor will likely want to monitor your eye pressure if you use it.
The best alternative depends on your specific situation:
Always talk to your eye doctor before switching medications. They can help you weigh the benefits and risks based on your eye health history. Need help finding a doctor who can prescribe Alrex or its alternatives? We have a guide for that too.
Not being able to fill your Alrex prescription is frustrating, but there are plenty of effective alternatives. Start with the generic version of Loteprednol — it's the same medication at a fraction of the cost. If you want to avoid steroids altogether, OTC options like Pataday and Zaditor work well for many patients.
Whatever you choose, make sure to discuss it with your doctor. And if you're still looking for Alrex specifically, Medfinder can help you find it in stock near you.
Related reading:
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