- Ciprofloxacin Ophthalmic
- How does this medication work? What will it do for me?
- What form(s) does this medication come in?
- How should I use this medication?
- Who should NOT take this medication?
- What side effects are possible with this medication?
- Are there any other precautions or warnings for this medication?
- What other drugs could interact with this medication?
- Ciloxan Ophthalmic Solution
- What is Ciloxan?
- About ciprofloxacin eye preparations
- Before using ciprofloxacin eye preparations
- How to use ciprofloxacin eye preparations
- Getting the most from your treatment
- Can ciprofloxacin eye preparations cause problems?
- How to store ciprofloxacin eye preparations
- Important information about all medicines
Ophthalmic ciprofloxacin comes as a solution (liquid) and an ointment to apply to the eyes. Ciprofloxacin ophthalmic solution is usually used often, between once every 15 minutes to once every 4 hours while awake for 7 to 14 days or longer. Ciprofloxacin ophthalmic ointment is usually applied 3 times a day for 2 days and then twice a day for 5 days. Use ophthalmic ciprofloxacin at around the same times every day. Follow the directions on your prescription label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Use ophthalmic ciprofloxacin exactly as directed. Do not use more or less of it or use it more often than prescribed by your doctor.
You should expect your symptoms to improve during your treatment. Call your doctor if your symptoms do not go away or get worse, or if you develop other problems with your eyes during your treatment.
Use ophthalmic ciprofloxacin until you finish the prescription, even if you feel better. If you stop using ophthalmic ciprofloxacin too soon, your infection may not be completely cured and the bacteria may become resistant to antibiotics.
To instill the eye drops, follow these steps:
- Wash your hands thoroughly with soap and water.
- Check the dropper tip to make sure that it is not chipped or cracked.
- Avoid touching the dropper tip against your eye or anything else; eye drops and droppers must be kept clean.
- While tilting your head back, pull down the lower lid of your eye with your index finger to form a pocket.
- Hold the dropper (tip down) with the other hand, as close to the eye as possible without touching it.
- Brace the remaining fingers of that hand against your face.
- While looking up, gently squeeze the dropper so that a single drop falls into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.
- Close your eye for 2 to 3 minutes and tip your head down as though looking at the floor. Try not to blink or squeeze your eyelids.
- Place a finger on the tear duct and apply gentle pressure.
- Wipe any excess liquid from your face with a tissue.
- If you are to use more than one drop in the same eye, wait at least 5 minutes before instilling the next drop.
- Replace and tighten the cap on the dropper bottle. Do not wipe or rinse the dropper tip.
- Wash your hands to remove any medication.
To apply the eye ointment, follow these instructions:
- Wash your hands thoroughly with soap and water.
- Avoid touching the tip of the tube against your eye or anything else; the tube tip must be kept clean.
- Holding the tube between your thumb and forefinger, place it as near to your eyelid as possible without touching it.
- Brace the remaining fingers of that hand against your face.
- Tilt your head backward slightly.
- With your index finger, pull the lower eyelid down to form a pocket.
- Squeeze a 1/2-inch (1.25-centimeter) ribbon of ointment into the pocket made by the lower eyelid. Remove your index finger from the lower eyelid.
- Blink your eye slowly; then gently close your eye for 1 to 2 minutes.
- With a tissue, wipe any excess ointment from the eyelids and lashes. With another clean tissue, wipe the tip of the tube clean.
- Replace and tighten the cap right away.
- Wash your hands to remove any medication.
Follow all directions on your prescription label. Do not use this medicine in larger or smaller amounts or for longer than recommended.
While treating a corneal ulcer, you may notice a whitish buildup in your eye. This is a sign that the medication is working and is not a harmful effect. This buildup should clear within a few days or weeks of treatment.
If you wear contact lenses, remove them before applying ciprofloxacin ophthalmic. Ask your doctor if contact lenses can be reinserted after application of the medication.
Wash your hands before using eye medication.
To apply the eye drops:
- Tilt your head back slightly and pull down your lower eyelid to create a small pocket. Hold the dropper above the eye with the tip down. Look up and away from the dropper and squeeze out a drop.
- Close your eyes for 2 or 3 minutes with your head tipped down, without blinking or squinting. Gently press your finger to the inside corner of the eye for about 1 minute, to keep the liquid from draining into your tear duct.
- Use only the number of drops your doctor has prescribed. If you use more than one drop, wait about 5 minutes between drops.
- Wait at least 10 minutes before using any other eye drops your doctor has prescribed.
To apply the ointment:
- Tilt your head back slightly and pull down your lower eyelid to create a small pocket. Hold the ointment tube with the tip pointing toward this pocket. Look up and away from the tip.
- Squeeze out a ribbon of ointment into the lower eyelid pocket without touching the tip of the tube to your eye. Blink your eye gently and then keep it closed for 1 or 2 minutes.
- Use a tissue to wipe excess ointment from your eyelashes.
- After opening your eyes, you may have blurred vision for a short time. Avoid driving or doing anything that requires you to be able to see clearly.
Do not touch the tip of the eye dropper or ointment tube or place it directly on your eye. A contaminated tip can infect your eye, which could lead to serious vision problems.
Ciprofloxacin ophthalmic is most often used for 5 to 14 days in a row. Use this medicine for the full prescribed length of time. Your symptoms may improve before the infection is completely cleared.
Do not use the eye drops if the liquid has changed colors or has particles in it. Call your pharmacist for new medicine.
Store at room temperature away from moisture, heat, and light. Do not freeze. Keep the bottle or tube tightly closed when not in use.
An overdose of ciprofloxacin ophthalmic is not expected to be dangerous. Seek emergency medical attention or call the Poison Help line at 1-800-222-1222 if anyone has accidentally swallowed the medication.
Use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.
Copyright 1996-2020 Cerner Multum, Inc.
Latest Update: 11/9/2018, Version: 6.02
How does this medication work? What will it do for me?
Ciprofloxacin is an antibiotic that belongs to the family of medications known as quinolones. Ciprofloxacin ointment or solution is used for the treatment of infections of the eye caused by certain types of bacteria.
This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.
Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are using this medication, speak to your doctor. Do not stop using this medication without consulting your doctor.
Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to use this medication if their doctor has not prescribed it.
What form(s) does this medication come in?
Each gram of ophthalmic ointment contains 3 mg of ciprofloxacin. Nonmedicinal ingredients: mineral oil and white petrolatum.
Each mL of ophthalmic solution contains 3 mg of ciprofloxacin. It also contains benzalkonium chloride 0.006% as preservative. Nonmedicinal ingredients: acetic acid, edetate disodium, hydrochloric acid and/or sodium hydroxide, mannitol, purified water, and sodium acetate.
How should I use this medication?
Ointment: Apply a 1.25 cm (half-inch) ribbon of ointment into the inside of the lower eyelid as directed by your doctor. (The directions will vary according to the condition being treated.) Avoid touching the tip of the tube to anything, as this can cause contamination.
Drops: Use 1 or 2 drops in the affected eye(s) as directed by your doctor for conjunctivitis or corneal ulcer. Avoid touching the tip of the bottle to anything, as this can cause contamination.
Many things can affect the dose of a medication that a person needs, such as age, body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are using the medication without consulting your doctor.
It is important to apply this medication exactly as prescribed by your doctor. If you miss a dose, apply it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not apply a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.
Store this medication at room temperature and keep it out of the reach of children.
Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.
Who should NOT take this medication?
Do not use this medication if you:
- are allergic to ciprofloxacin or any ingredients of the medication
- are allergic to nalidixic acid or other quinolones (e.g., norfloxacin, levofloxacin, and ofloxacin)
What side effects are possible with this medication?
Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.
The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.
The following side effects have been reported by at least 1% of people using this medication. Many of these side effects can be managed, and some may go away on their own over time.
Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.
- crystals in the corner of the eye
- noticeable taste or change in taste
- stinging, burning, irritation of the eye
Although most of these side effects listed below don’t happen very often, they could lead to serious problems if you do not seek medical attention.
Check with your doctor as soon as possible if any of the following side effects occur:
- crusting at the lid margin
- increased sensitivity of eyes to light
- swelling of the eye
Stop using the medication and seek immediate medical attention if any of the following occur:
- allergic reaction (skin rash, hives, itching)
- reduced vision
- worsening headache or eye pain
Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are using this medication.
Are there any other precautions or warnings for this medication?
Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.
Allergy: Stop using ciprofloxacin at the first sign of allergy (e.g., a skin rash) and contact your doctor.
Blurred Vision: This medication may cause a temporary blurring of vision. If your vison becomes blurred, do not drive or operate machinery until your vision has cleared.
Contact lenses: Avoid wearing contact lenses while you have signs and symptoms of an eye infection. The preservative in this medication can also cause discolouration of soft contact lenses.
Overgrowth of organisms: Prolonged use of ciprofloxacin eye solution or ointment may result in overgrowth of organisms not killed by the medication, including fungi.
Pregnancy: There are no adequate and well-controlled studies of the use of ciprofloxacin eye solution or ointment by pregnant women. It should be used by pregnant women only if, in the doctor’s opinion, the benefit clearly outweighs any potential unknown risks.
Breast-feeding: It is not known if ciprofloxacin eye solution or ointment passes into breast milk. If you are a breast-feeding mother and are taking this medication, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.
Children: The safety and effectiveness of using this medication have not been established for children under one year of age.
What other drugs could interact with this medication?
It is not known specifically whether ciprofloxacin eye ointment or solution will interact with other medications. However, when taken by mouth or intravenously (i.e. injected into a vein), there may be an interaction between ciprofloxacin and any of the following:
If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:
- stop taking one of the medications,
- change one of the medications to another,
- change how you are taking one or both of the medications, or
- leave everything as is.
An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.
Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.
All material copyright MediResource Inc. 1996 – 2020. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/drug/getdrug/Ciloxan
- Sambursky R, Trattler W, Tauber S, et al. Sensitivity and specificity of the AdenoPlus test for diagnosing adenoviral conjunctivitis. JAMA Ophthalmol. 2013;131(1):17-22.
Comment: A prospective, multicenter clinical trial demonstrated that AdenoPlus is a rapid, sensitive and specific in-office test for detecting adenoviral conjunctivitis when compared to traditional tests (PCR and CC-IFA).
- Sheikh A, Hurwitz B, van Schayck CP, et al. Antibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev. 2012.
Comment: Though usually self-limiting, review of 11 RCTs with 3673 patients finds some faster clinical improvement with the use of topical antibacterials.
- Utine CA. Update and critical appraisal of the use of topical azithromycin ophthalmic 1% (AzaSite) solution in the treatment of ocular infections. Clin Ophthalmol. 2011;5:801-9.
Comment: A review of the use of topical azithromycin in the treatment of ocular infections including conjunctivitis. Summarizes the available RCTs.
- Annan NT, Boag FC. Outpatient management of severe gonococcal ophthalmia without genital infection. Int J STD AIDS. 2008;19(8):573-4.
Comment: A case report of HIV-positive patient treated for severe gonococcal conjunctivitis w/ daily ceftriaxone 1 g IM for 10 days.
- Siegel JD, Rhinehart E, Jackson M, et al. 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings. Am J Infect Control. 2007;35(10 Suppl 2):S65-164.
Comment: Document outlines recommendations for control and environmental recommendations for adenovirus.
- Centers for Disease Control and Prevention (CDC). Acute hemorrhagic conjunctivitis outbreak caused by Coxsackievirus A24–Puerto Rico, 2003. MMWR Morb Mortal Wkly Rep. 2004;53(28):632-4.
Comment: Acute hemorrhagic conjunctivitis (AHC) is an epidemic form of highly contagious conjunctivitis characterized by sudden onset of painful, swollen, red eyes, w/ conjunctival hemorrhage and excessive tearing. The report summarizes outbreak in Puerto Rico; 490K persons were affected; school-aged children and those living in crowded urban areas were at highest risk. To control outbreaks, prevention methods (e.g., frequent hand washing and avoidance of sharing towels and bedding) should be targeted to groups at highest risk.
- Schwab IR, Friedlaender M, McCulley J, et al. A phase III clinical trial of 0.5% levofloxacin ophthalmic solution versus 0.3% ofloxacin ophthalmic solution for the treatment of bacterial conjunctivitis. Ophthalmology. 2003;110(3):457-65.
Comment: A prospective, randomized-controlled, double-masked, multicenter study comparing the efficacy and safety of 0.5% levofloxacin ophthalmic solution with 0.3% ofloxacin ophthalmic solution for the treatment of bacterial conjunctivitis. Although clinical cure rates in the 0.5% levofloxacin and 0.3% ofloxacin treatment groups were similar, a 5-day treatment regimen with 0.5% levofloxacin achieved microbial eradication rates that were statistically superior to those attained with 0.3% ofloxacin. There was no difference in the incidence of treatment-related adverse events.
- Kowalski RP, Sundar-Raj CV, Romanowski EG, et al. The disinfection of contact lenses contaminated with adenovirus. Am J Ophthalmol. 2001;132(5):777-9.
Comment: Patients with adenoviral conjunctivitis need to dispose of unclean contact lenses as adenovirus survives chemical and hydrogen peroxide disinfection.
- Graves A, Henry M, O’Brien TP, et al. In vitro susceptibilities of bacterial ocular isolates to fluoroquinolones. Cornea. 2001;20(3):301-5.
Comment: The in vitro antimicrobial susceptibilities of ocular isolates to levofloxacin, ofloxacin, and ciprofloxacin were determined. Levofloxacin demonstrated superior in vitro activity against human bacterial conjunctival isolates compared with either ofloxacin or ciprofloxacin (levofloxacin > ofloxacin > ciprofloxacin).
- Tabbara KF, El-Sheikh HF, Aabed B. Extended wear contact lens related bacterial keratitis. Br J Ophthalmol. 2000;84(3):327-8.
Comment: The predominant organism from the corneal scrapings of 11 contact lens wearers with bacterial keratitis was Pseudomonas aeruginosa.
- Raizman MB, Rothman JS, Maroun F, et al. Effect of eye rubbing on signs and symptoms of allergic conjunctivitis in cat-sensitive individuals. Ophthalmology. 2000;107(12):2158-61.
Comment: In patients with allergic conjunctivitis, eye rubbing causes increased ocular itching, chemosis, and hyperemia.
- Cheng KH, Leung SL, Hoekman HW, et al. Incidence of contact-lens-associated microbial keratitis and its related morbidity. Lancet. 1999;354(9174):181-5.
Comment: Contact lens wearers are at risk for the development of bacterial keratitis. The bacteria most commonly isolated in this study were Serratia spp and Pseudomonas aeruginosa.
- Azar MJ, Dhaliwal DK, Bower KS, et al. Possible consequences of shaking hands with your patients with epidemic keratoconjunctivitis. Am J Ophthalmol. 1996;121(6):711-2.
Comment: 12/26 patients with epidemic keratoconjunctivitis had positive adenovirus hand cultures.
- Gwon A. Ofloxacin vs tobramycin for the treatment of external ocular infection. Ofloxacin Study Group II. Arch Ophthalmol. 1992;110(9):1234-7.
Comment: A multicenter, double-masked, randomized trial was conducted comparing 0.3% ofloxacin and 0.3% tobramycin for topical treatment of external ocular infection. Ofloxacin was found as effective, safe, and comfortable as tobramycin.
- Gwon A. Topical ofloxacin compared with gentamicin in the treatment of external ocular infection. Ofloxacin Study Group. Br J Ophthalmol. 1992;76(12):714-8.
Comment: In a double-masked, randomized-controlled study the effectiveness and safety of 0.3% ofloxacin solution were compared with those of 0.3% gentamicin ophthalmic solution in treating external bacterial ocular infections. The two treatments were found to be equally effective.
- Leibowitz HM. Antibacterial effectiveness of ciprofloxacin 0.3% ophthalmic solution in the treatment of bacterial conjunctivitis. Am J Ophthalmol. 1991;112(4 Suppl):29S-33S.
Comment: In two multicentered, randomized, prospective clinical studies, ciprofloxacin 0.3% ophthalmic solution was compared to placebo and to tobramycin 0.3% respectively. In both trials cipro was approximately 94% effective. Although cipro was significantly more effective than placebo, there was no difference in efficacy between ciprofloxacin and tobramycin.
- Haimovici R, Roussel TJ. Treatment of gonococcal conjunctivitis with single-dose intramuscular ceftriaxone. Am J Ophthalmol. 1989;107(5):511-4.
Comment: This small study of 12 patients remains the only study examing conjunctival GC. A single 1g IM injection of ceftriaxone in these 12 patients, all responded.
- Fitch CP, Rapoza PA, Owens S, et al. Epidemiology and diagnosis of acute conjunctivitis at an inner-city hospital. Ophthalmology. 1989;96(8):1215-20.
Comment: Johns Hopkins study examined epidemiology of acute conjunctivitis in an inner city population. Out of 45 patients, viral conjunctivitis was diagnosed in 36%, bacterial in 40%, while 24% of cases remained undiagnosed.
- Lohr JA, Austin RD, Grossman M, et al. Comparison of three topical antimicrobials for acute bacterial conjunctivitis. Pediatr Infect Dis J. 1988;7(9):626-9.
Comment: 158 patients, 21 years of age or less, presenting with culture-positive (Haemophilus influenzae or Streptococcus pneumoniae) conjunctivitis were treated with trimethoprim-polymyxin B,gentamicin sulfate or sodium sulfacetamide ophthalmic solution for 10 days. Clinical response at 3 to 6 days after start of therapy was similar for all test agents. Clinical response at 2 to 7 days after completion of therapy was also similar, as was bacteriologic response.
- Wan WL, Farkas GC, May WN, et al. The clinical characteristics and course of adult gonococcal conjunctivitis. Am J Ophthalmol. 1986;102(5):575-83.
Comment: Review of 21 cases of gonococcal conjunctivitis between 1972 and 1986. Keratitis, anterior chamber inflammation, periocular edema and tenderness, gaze restriction and preauricular adenopathy were common findings. All patients were hospitalized and received parenteral antibiotics. Only 2/21 patients had a poor outcome.
- Leibowitz HM, Hyndiuk RA, Smolin GR, et al. Tobramycin in external eye disease: a double-masked study vs. gentamicin. Curr Eye Res. 1981;1(5):259-66.
Comment: A double-masked randomized study was conducted at four centers to compare the efficacy and safety of tobramycin and gentamicin ophthalmic ointment in the treatment of superficial external eye disease. The results indicate that tobramycin is safe, effective and comparable to gentamicin. There was a trend towards better efficacy, safety and fewer adverse reactions in the tobramycin-treated group, but the differences were not statistically significant.
- Wagner RS. Results of a survey of children with acute bacterial conjunctivitis treated with trimethoprim-polymyxin B ophthalmic solution. Clin Ther. 1995;17(5):875-81.
Comment: Trimethoprim-Polymyxin B is safe and well tolerated for the treatment of bacterial conjunctivitis in children. It is effective against both gram-positive and gram-negative organisms including S pneumoniae and H influenzae, the most prevalent pathogens in pediatric patients.
- Raizman MB. Results of a survey of patients with ocular allergy treated with topical ketorolac tromethamine. Clin Ther. 1995;17(5):882-90.
Comment: 84% of responders rated ketorolac as good to excellent in relieving their overall symptoms of ocular allergy and 86% felt that the drug produced good to excellent relief of their ocular itching within minutes to 1 hour of administration.
Ciloxan Ophthalmic Solution
As with other antibacterial preparations, prolonged use of ciprofloxacin may result in overgrowth of nonsusceptible organisms, including fungi. If superinfection occurs, appropriate therapy should be initiated. Whenever clinical judgment dictates, the patient should be examined with the aid of magnification, such as slit lamp biomicroscopy and, where appropriate, fluorescein staining.
Ciprofloxacin should be discontinued at the first appearance of a skin rash or any other sign of hypersensitivity reaction. In clinical studies of patients with bacterial corneal ulcer, a white crystalline precipitate located in the superficial portion of the corneal defect was observed in 35 (16.6%) of 210 patients. The onset of the precipitate was within 24 hours to 7 days after starting therapy. In one patient, the precipitate was immediately irrigated out upon its appearance. In 17 patients, resolution of the precipitate was seen in 1 to 8 days (seven within the first 24-72 hours), in five patients, resolution was noted in 10-13 days. In nine patients, exact resolution days were unavailable; however, at follow-up examinations, 18-44 days after onset of the event, complete resolution of the precipitate was noted. In three patients, outcome information was unavailable. The precipitate did not preclude continued use of ciprofloxacin, nor did it adversely affect the clinical course of the ulcer or visual outcome. (see ADVERSE REACTIONS).
Carcinogenesis, Mutagenesis, Impairment Of Fertility
Eight in vitro mutagenicity tests have been conducted with ciprofloxacin and the test results are listed below:
Salmonella/Microsome Test (Negative)
E. coli DNA Repair Assay (Negative)
Mouse Lymphoma Cell Forward Mutation Assay (Positive)
Chinese Hamster V79 Cell HGPRT Test (Negative)
Syrian Hamster Embryo Cell Transformation Assay (Negative)
Saccharomyces cerevisiae Point Mutation Assay (Negative)
Saccharomyces cerevisiae Mitotic Crossover and Gene Conversion Assay (Negative)
Rat Hepatocyte DNA Repair Assay (Positive)
Thus, two of the eight tests were positive, but the results of the following three in vivo test systems gave negative results:
Rat Hepatocyte DNA Repair Assay
Micronucleus Test (Mice)
Dominant Lethal Test (Mice)
Long term carcinogenicity studies in mice and rats have been completed. After daily oral dosing for up to two years, there is no evidence that ciprofloxacin had any carcinogenic or tumorigenic effects in these species.
Pregnancy Category C: Reproduction studies have been performed in rats and mice at doses up to six times the usual daily human oral dose and have revealed no evidence of impaired fertility or harm to the fetus due to ciprofloxacin. In rabbits, as with most antimicrobial agents, ciprofloxacin (30 and 100 mg/kg orally) produced gastrointestinal disturbances resulting in maternal weight loss and an increased incidence of abortion. No teratogenicity was observed at either dose. After intravenous administration, at doses up to 20 mg/kg, no maternal toxicity was produced and no embryotoxicity or teratogenicity was observed. There are no adequate and well controlled studies in pregnant women. CILOXAN® Ophthalmic Solution should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.
It is not known whether topically applied ciprofloxacin is excreted in human milk; however, it is known that orally administered ciprofloxacin is excreted in the milk of lactating rats and oral ciprofloxacin has been reported in human breast milk after a single 500 mg dose. Caution should be exercised when CILOXAN Ophthalmic Solution is administered to a nursing mother.
Safety and effectiveness in pediatric patients below the age of 1 year have not been established. Although ciprofloxacin and other quinolones cause arthropathy in immature animals after oral administration, topical ocular administration of ciprofloxacin to immature animals did not cause any arthropathy and there is no evidence that the ophthalmic dosage form has any effect on the weight bearing joints.
No overall differences in safety or effectiveness have been observed between elderly and younger patients.
What is Ciloxan?
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aripiprazole Lauroxil
- Arsenic Trioxide
- Cholera Vaccine, Live
- Doxorubicin Hydrochloride Liposome
- Inotuzumab Ozogamicin
- Insulin Aspart, Recombinant
- Insulin Bovine
- Insulin Degludec
- Insulin Detemir
- Insulin Glargine, Recombinant
- Insulin Glulisine
- Insulin Lispro, Recombinant
- Mycophenolate Mofetil
- Sodium Phosphate
- Sodium Phosphate, Dibasic
- Sodium Phosphate, Monobasic
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
- Aminolevulinic Acid
- Lanthanum Carbonate
About ciprofloxacin eye preparations
|Type of medicine||Antibacterial eye preparation|
|Used for||Eye infections in adults and children|
|Available as||Eye drops and eye ointment|
Ciprofloxacin eye drops and ointment are used to treat bacterial eye infections. They work by helping to kill the germs (bacteria) which are causing the infection. Eye infections are a common cause of conjunctivitis. In conjunctivitis, your eye becomes inflamed, feels gritty, and may water more than usual. The white of your eye may look red, and your eyelids may become swollen and stuck together with a discharge when you wake up in the morning. Only one eye may be infected to begin with, but it often spreads to both eyes. Most cases of infective conjunctivitis clear within a week or so without treatment. For more severe infections, or for infections which do not clear on their own, an antibiotic eye drop such as ciprofloxacin is used.
Ciprofloxacin is also prescribed to treat corneal ulcers. A corneal ulcer is one which forms on the delicate layer covering the surface of your eye.
Before using ciprofloxacin eye preparations
Some medicines are not suitable for people with certain conditions, and sometimes a medicine may only be used if extra care is taken. For these reasons, before you start using ciprofloxacin it is important that your doctor or pharmacist knows:
- If you are pregnant or breastfeeding.
- If you have ever had an allergic reaction to ciprofloxacin or any other antibiotic, or to any other eye drops.
- If you are taking or using any other medicines. This includes any medicines you are taking which are available to buy without a prescription, as well as herbal and complementary medicines.
How to use ciprofloxacin eye preparations
Before you start this treatment, read the manufacturer’s printed information leaflet from the pack. The leaflet will give you more information about the drops or ointment, and a full list of possible side-effects. If your eyes have an obvious discharge or ‘crust’, it can help if you bathe them with cool clean water before using ciprofloxacin.
How to use eye drops
- Wash your hands well before you use the drops.
- Remove the cap.
- Tilt your head back a little and pull the lower lid of your eye downwards to form a pocket.
- Hold the bottle upside down near to your eye. Try not to touch your eye as you do this.
- Gently press on the base of the bottle to release one drop into your eye.
- Close your eye for a minute or two, and press gently on the side of your nose where the corner of your eye meets your nose. This helps to stop the drop from draining away and keeps it in your eye.
- Repeat the process in your other eye if you have been told to use the drops in both eyes.
- Replace the cap.
How to use eye ointment
- First wash your hands.
- Remove the cap from the tube.
- Pull the lower lid of your eye downwards to form a pocket.
- Hold the tube upside down near to your eye.
- Squeeze the tube to release a thin line of ointment along the inside of your lower eyelid. Try not to touch your eye with the end of the tube as you do this.
- Blink a few times to spread the ointment around the inside of your eye.
- Repeat the process in your other eye if you have been told to use it in both eyes.
- Replace the cap on the tube.
Getting the most from your treatment
- If you have a corneal ulcer, you will need to use ciprofloxacin eye drops regularly, day and night, for the first two days. Your doctor will tell you how often to use them – this is often every 15 minutes to begin with, then every 30 minutes, then every hour. On day three, it is likely that you will be able to reduce the frequency to every four hours. Try not to miss putting the drops in but, if you do forget, put them in as soon as you remember.
- For other infections, use the drops regularly exactly as your doctor tells you to. If the infection is severe, this is likely to be every two hours for the first two days. (Just use the drops while you are awake – you do not need to wake yourself up during the night to put them in.) On day three, reduce the frequency down to four times a day.
- Ciprofloxacin eye ointment is frequently prescribed to use at night. If you are using eye drops during the day, you are unlikely to need to use the ointment during the day as well. Sometimes only the eye ointment is prescribed, in which case you may be asked to use it 3-4 times during the day, as well as at bedtime.
- If your symptoms do not improve within a few days, or if they become worse, speak again with your doctor.
- When you first put the drops or ointment into your eye, it may cause blurred vision. This should quickly clear, but make sure you can see clearly again before you drive and before using machines or tools.
- Take care to avoid spreading the infection from one eye to the other, and to other members of your family. Washing your hands regularly (particularly after touching your eyes) and not sharing towels or pillows will help to prevent the infection from spreading.
- If the tip of the tube/bottle touches your eye(s) when putting the drops in, it is a good idea to squeeze out two or three drops straightaway on to some tissue and rinse the tip with salt water.
- Eye infections can cause your eyes to become more sensitive to sunlight than usual. Wearing sunglasses may help to prevent this.
- If you are using any other eye drops or eye ointments, leave 5-10 minutes between applying each preparation.
- Even when your eye appears normal again, there may still be some germs (bacteria) present. It is important to continue to use ciprofloxacin for a further 48 hours once your eye appears normal. This will help to make sure that all the bacteria have been killed. It is likely that you may need to use ciprofloxacin for about a week. You should not use it for longer than three weeks.
- Do not wear contact lenses until your symptoms have completely gone. Wait for 24 hours after the last dose of eye drops before using your lenses again.
Can ciprofloxacin eye preparations cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them. These usually improve as your body adjusts to the new medicine, but speak with your doctor or pharmacist if any of the following side-effects continue or become troublesome.
|Common ciprofloxacin eye drop/ointment side-effects||What can I do if I experience this?|
|Blurred vision||If this happens, do not drive until you can see clearly again|
|Feeling sick (nausea)||This is usually mild and does not last for long|
|Burning and itching, crusting, eye redness and puffiness, watery eyes, metallic taste||These are usually mild and do not last for long|
|Occasional allergic skin reactions||Let your doctor know straightaway if you think you have an allergic reaction|
Whilst using ciprofloxacin eye drops or ointment, if you feel any pain or swelling of the tendons (tough fibres that attach your muscles to bone – for example, the Achilles heel), stop treatment and let your doctor know straightaway.
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store ciprofloxacin eye preparations
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
- Throw away the bottle or tube after you have finished the course of treatment, even if there is some left. Never keep opened eye drops or ointments to use later.
Important information about all medicines
This preparation is for use in your eyes only. If someone swallows some of it, go to the accident and emergency department of your local hospital. Take the container with you, even if it is empty.
This medicine is for you. Never give it to other people even if their condition appears to be the same as yours.
Do not keep out-of-date or unwanted medicines. Take them to your local pharmacy which will dispose of them for you.
If you have any questions about this medicine ask your pharmacist.