Pred-G Side Effects: What to Expect and When to Call Your Doctor

Pred-G (gentamicin/prednisolone ophthalmic suspension) is an effective treatment for inflammatory eye conditions and bacterial infections, but like all prescription medications, it carries a risk of side effects. Knowing which side effects are expected, which are concerning, and when to contact your provider can protect your vision and help you use Pred-G safely.

Common Side Effects of Pred-G (Usually Mild and Temporary)

The following side effects are the most commonly reported with Pred-G. They often improve as your eyes adjust to the medication:

• Burning or stinging upon instillation: A brief, mild burning or stinging sensation when the drops are first applied is very common. It usually lasts only a few seconds.
• Temporary blurred vision: Vision may blur immediately after using the drops. Do not drive or operate machinery until your vision clears.
• Eye irritation or redness: Some patients experience mild eye redness or irritation, particularly in the first few days of treatment. This often subsides as the medication controls the underlying inflammation.
• Light sensitivity (photophobia): Mild sensitivity to bright light is possible. Wearing sunglasses outdoors may help.
• Watery eyes: Increased tearing is sometimes reported after application.

Serious Side Effects: Know the Warning Signs

The more serious side effects of Pred-G are primarily associated with the corticosteroid (prednisolone) component and typically occur with prolonged use. These require prompt attention from your eye care provider:

• Elevated intraocular pressure (IOP) / steroid-induced glaucoma: Corticosteroid eye drops can raise eye pressure, especially with prolonged use. Up to one-third of the general population may experience some degree of IOP elevation with topical steroids. Elevated pressure can lead to glaucoma if untreated. Your provider should measure IOP regularly if you use Pred-G for 10 days or longer.
• Posterior subcapsular cataracts: Long-term use of corticosteroid eye drops is associated with formation of cataracts at the posterior capsule of the lens. This is primarily a risk with extended courses of therapy.
• Corneal or scleral thinning: Pred-G's steroid component can thin the cornea (the clear front of the eye) or sclera (the white part). In severe cases, thinning can progress to perforation. This risk is higher in patients who already have thin corneas or sclera and in those using the medication for extended periods. Call your provider immediately if you experience sudden eye pain, increased tearing, or worsening vision.
• Delayed wound healing: Corticosteroids suppress healing responses. For patients using Pred-G after eye surgery, the steroid component may slow surgical healing if used improperly. Follow your surgeon's tapering instructions carefully.
• Superinfection: The immunosuppressive effect of prednisolone can allow secondary fungal or bacterial infections to develop, particularly with prolonged use. If your symptoms worsen or new symptoms appear after the initial improvement, contact your provider.
• Bacterial keratitis from contamination: Touching the dropper tip to your eye or another surface can contaminate the bottle and introduce bacteria into your eye. Always follow proper application technique.

When to Call Your Doctor Right Away

Contact your ophthalmologist or optometrist promptly if you experience any of the following:

• Sudden or worsening eye pain
• Vision getting worse or significant blurring beyond what's expected
• Symptoms that are not improving after 2 days of use or are getting worse
• Signs of an allergic reaction: severe itching, rash, swelling around the eye
• Unusual tearing or discharge
• New sensitivity to light that wasn't present before

How to Minimize Side Effects

Follow these best practices to reduce your risk of side effects while using Pred-G:

1. Use the lowest effective dose for the shortest time necessary, as directed by your prescriber.
2. Wash your hands before and after applying the drops.
3. Never touch the dropper tip to your eye, hands, or any surface.
4. Shake the bottle well before each use.
5. Attend all scheduled follow-up eye exams so your provider can monitor intraocular pressure and eye health.

The Bottom Line

Most people use Pred-G for a short course without significant problems. The key is following your prescriber's instructions, attending follow-up visits, and knowing when to escalate. For information about drug interactions, see Pred-G drug interactions.