ciprofloxacin ophthalmic (Rx)

Brand and Other Names:Ciloxan

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

ophthalmic solution

  • 0.3%

ophthalmic ointment

  • 0.3%

Bacterial Conjunctivitis

Solution: 1-2 drops instilled into conjunctival sac(s) q2hr with patient awake on days 1-2, then 1-2 drops q4hr with patient awake on days 3-7

Ointment: 0.5-in. (1.25-cm) ribbon applied into conjunctival sac q8hr on days 1-2, then 0.5-in. (1.25-cm) ribbon q12hr on days 3-7

Corneal Ulcers (Keratitis)

Solution: 2 drops q15min for 6 hours, then 2 drops q30min for remainder of day 1, then 2 drops q1hr on day 2, and finally 2 drops q4hr on days 3-14

Ointment: Not indicated for keratitis

Dosage Forms & Strengths

ophthalmic solution

  • 0.3%

ophthalmic ointment

  • 0.3%

Bacterial Conjunctivitis

Solution: 1-2 drops instilled into conjunctival sac(s) q2hr with patient awake on days 1-2, then 1-2 drops q4hr with patient awake on days 3-7

Ointment: 0.5-in. (1.25-cm) ribbon applied into conjunctival sac q8hr on days 1-2, then 0.5-in. (1.25-cm) ribbon q12hr on days 3-7

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Adverse Effects

>10%

Burning

Ciprofloxacin precipitate in superficial portion of corneal defect

Stinging

1-10%

Conjunctival hyperemia

Crystals or scales on eyelashes

Foreign-body sensation

Itching

Keratopathy or keratitis

Lid margin crusting

Unpleasant taste after instillation

<1%

Corneal infiltrates

Corneal staining

Decrease in vision

Lid edema

Ocular discomfort

Photophobia

Sensitivity reactions

Tearing

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Warnings

Contraindications

Resistance to ciprofloxacin

Hypersensitivity to quinolones or any component of product

Cautions

Serious and occasionally fatal hypersensitivity (anaphylactic) reactions, some following the first dose, reported; some reactions were accompanied by cardiovascular collapse, loss of consciousness, tingling, pharyngeal or facial edema, dyspnea, urticaria, and itching

May result in overgrowth of nonsusceptible organisms, including fungi; if superinfection occurs, appropriate therapy should be initiated

Careful monitoring, including slit-lamp microscopy and fluorescein staining when appropriate, may be necessary in some patients receiving ophthalmic ciprofloxacin therapy

Discontinue therapy at first appearance of a skin rash or any other sign of hypersensitivity reaction

Do not touch dropper tip to any surface, as this may contaminate solution

Contact lenses should be removed before administration

Not for injection into the eye

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Pregnancy & Lactation

Pregnancy category: C

Lactation: Drug is distributed into milk; use with caution

Pregnancy Categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

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Pharmacology

Mechanism of Action

Bactericidal; inhibits DNA gyrase, inhibits relaxation of supercoiled DNA, and causes breakage of double-stranded DNA

Absorption

Absorbed through cornea into aqueous humor; absorption enhanced in presence of ocular inflammation or epithelial defects; some systemic absorption

Metabolism

Partially metabolized in liver to at least 4 metabolites; metabolites have less microbiologic activity than ciprofloxacin, but their activity may be similar to or greater than that of other quinolones

Enzymes inhibited: Hepatic CYP1A2

Elimination

Half-life: 3-5 hr

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Images

No images available for this drug.
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Patient Handout

A Patient Handout is not currently available for this monograph.
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Formulary

FormularyPatient Discounts

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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

Tier Description
1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
NC NOT COVERED – Drugs that are not covered by the plan.
Code Definition
PA Prior Authorization
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
ST Step Therapy
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.