Ciloxan (ciprofloxacin hydrochloride ophthalmic solution) 0.3% is a sterile, antimicrobial topical solution formulated for the treatment of ocular infections caused by susceptible strains of bacteria. As a fluoroquinolone antibiotic, it offers a potent bactericidal mechanism of action, effectively inhibiting bacterial DNA gyrase and topoisomerase IV. This prescription medication is indicated for corneal ulcers and bacterial conjunctivitis, providing targeted therapy with a well-established efficacy and safety profile. Its formulation is designed for optimal ocular penetration and patient tolerance, making it a first-line choice for ophthalmologists and optometrists in managing sight-threatening conditions.

Features

• Contains 0.3% ciprofloxacin hydrochloride as the active pharmaceutical ingredient.
• Preservative-free formulation in single-use containers minimizes risk of contamination and preservative-induced toxicity.
• Sterile, isotonic solution with a pH approximating that of tears for enhanced comfort upon instillation.
• Presented in either 2.5 mL or 5 mL opaque white LDPE plastic bottles with a controlled-drop tip or in individual single-use dropperettes.
• Exhibits a broad spectrum of in vitro activity against gram-positive and gram-negative ocular pathogens.

Benefits

• Rapid bactericidal action eradicates causative pathogens, reducing bacterial load and facilitating swift clinical improvement.
• High corneal penetration ensures effective drug concentration at the site of infection, even for deeper stromal involvement in corneal ulcers.
• Low incidence of resistance development among susceptible organisms when used as directed for appropriate indications.
• Convenient dosing regimen supports patient adherence, which is critical for treatment success and preventing recurrence.
• Well-tolerated formulation minimizes stinging and burning upon application compared to some other antibiotic classes.

Common use

Ciloxan Ophthalmic Solution is primarily prescribed for the treatment of infections caused by susceptible strains of microorganisms. Its two main FDA-approved indications are for bacterial conjunctivitis and corneal ulcers. For bacterial conjunctivitis, it is used to treat the inflammation of the conjunctiva characterized by redness, discharge, and irritation. For corneal ulcers, it is a critical treatment for this more serious, sight-threatening infection involving a defect in the corneal epithelium with underlying inflammation, often associated with contact lens wear, trauma, or pre-existing ocular surface disease. The causative organisms typically include Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Pseudomonas aeruginosa, and members of the Enterobacteriaceae family.

Dosage and direction

Administration is strictly by topical instillation into the affected eye(s). The dosage is indication-specific and must be prescribed by a qualified eye care professional.

• For Bacterial Conjunctivitis: Instill 1 to 2 drops into the affected eye(s) every 2 hours while awake for the first two days. For days 3 through 7, instill 1 to 2 drops into the affected eye(s) every 4 hours while awake.
• For Corneal Ulcers: Instill 2 drops into the affected eye every 15 minutes for the first six hours, then 2 drops into the affected eye every 30 minutes for the remainder of the first day. On day two, instill 2 drops into the affected eye hourly. For days 3 through 14, instill 2 drops into the affected eye every 4 hours.
• Therapy may be continued after 14 days based on clinical assessment.
• Administration Instructions: Wash hands thoroughly before use. Avoid touching the dropper tip to any surface, including the eye, to prevent contamination. Tilt the head back, pull down the lower eyelid to create a pouch, and instill the prescribed number of drops. Close the eye gently and apply light pressure to the tear duct (nasolacrimal occlusion) for 1-2 minutes to minimize systemic absorption. If more than one topical ophthalmic drug is being used, administer them at least 5 minutes apart.

Precautions

• This product is for topical ophthalmic use only. It is not for injection or oral use.
• As with other antibacterial preparations, prolonged use may result in overgrowth of non-susceptible organisms, including fungi. If superinfection occurs, discontinue use and institute alternative therapy.
• Patients should be advised not to wear contact lenses if they have signs and symptoms of ocular infection.
• Systemic quinolones, including ciprofloxacin, have been associated with rare but serious events such as tendonitis, tendon rupture, and peripheral neuropathy. While the systemic exposure from topical ocular administration is significantly lower, these potential risks should be considered.
• Use with caution in patients with a history of hypersensitivity to ciprofloxacin or other quinolone antibiotics.

Contraindications

Ciloxan Ophthalmic Solution is contraindicated in patients with a known history of hypersensitivity to ciprofloxacin, to other quinolones, or to any of the components in this formulation.

Possible side effect

The most frequently reported adverse reactions occurred in 1-4% of patients and are primarily ocular. These include:

• Local ocular burning and discomfort
• Crystalline precipitates (white deposits) in the superficial cornea (typically associated with corneal ulcer treatment; usually resolve upon discontinuation)
• Foreign body sensation
• Itching
• Conjunctival hyperemia (redness)
• Bad taste following instillation
• Allergic reactions, including lid edema, tearing, itching, and photophobia
• Corneal staining
• Keratitis
• Nausea
• Rare events: superinfection, corneal infiltrates

Drug interaction

Formal drug interaction studies have not been conducted with the topical ophthalmic formulation. However, the potential for elevated systemic ciprofloxacin levels exists if used concurrently with drugs that compete for the same metabolic pathway. The minimal systemic absorption makes clinically significant interactions unlikely but not impossible. Inform your physician of all medications you are taking.

Missed dose

If a dose is missed, it should be administered as soon as possible. However, if it is almost time for the next scheduled dose, skip the missed dose and resume the usual dosing schedule. Do not instill a double dose to make up for a missed one.

Overdose

Topical ocular overdose of Ciloxan is unlikely to produce life-threatening effects. Excessive administration may be flushed from the eye(s) with warm tap water. Symptoms of a topical overdose would be consistent with the side effects listed above. Oral ingestion of the contents of a bottle, while unlikely, could lead to systemic effects seen with oral ciprofloxacin overdose (e.g., nausea, vomiting, diarrhea, headache, dizziness). In case of accidental ingestion, seek medical attention or contact a poison control center.

Storage

• Store at controlled room temperature, 15°-25°C (59°-77°F).
• Protect from light. The opaque bottle provides some protection.
• Do not freeze.
• Keep the bottle tightly closed when not in use.
• Discard the multi-dose bottle 28 days after first opening to prevent contamination.
• Single-use containers should be used immediately after opening and any remaining solution discarded. They are for single use only.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read here. The full official prescribing information should be consulted before initiating treatment.

Reviews

• “As a corneal specialist, Ciloxan remains a workhorse in my arsenal for managing bacterial keratitis. Its efficacy against Pseudomonas is particularly valuable. The crystalline precipitates can be concerning for patients but are typically benign and resolve.” – Ophthalmologist, 15 years experience
• “We see excellent clinical outcomes with Ciloxan for severe bacterial conjunctivitis in our practice. The dosing schedule is intensive initially, but patient compliance is generally good due to the rapid symptom relief it provides.” – Optometrist, Hospital-based practice
• “I was prescribed Ciloxan for a corneal abrasion that became infected. The drops stung a bit at first, but the redness and pain improved significantly within 48 hours. The instructions were clear, and the infection cleared up completely.” – Patient T.M.
• “From a pharmacy perspective, it’s a commonly dispensed and well-tolerated ophthalmic antibiotic. We counsel patients strictly on the administration technique and the importance of completing the full course, even if symptoms improve.” – Pharmacist, Retail setting