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 potent bactericidal activity by inhibiting bacterial DNA gyrase and topoisomerase IV, enzymes critical for DNA replication, transcription, and repair. This prescription medication is indicated for corneal ulcers and bacterial conjunctivitis, providing targeted therapy directly at the site of infection. Its formulation is designed for optimal ocular penetration and patient tolerance, making it a first-line choice for ophthalmologists and optometrists in managing bacterial eye infections.

Features

• Sterile, isotonic ophthalmic solution with a pH of 4.5
• Contains ciprofloxacin hydrochloride equivalent to 0.3% base ciprofloxacin
• Preservative: benzalkonium chloride 0.006%
• Available in 2.5 mL and 5 mL dropper bottles
• Clear, pale yellow solution
• Bactericidal activity against a broad spectrum of Gram-positive and Gram-negative bacteria

Benefits

• Rapid bactericidal action leading to quicker resolution of symptoms such as purulent discharge, redness, and eyelid edema
• High corneal penetration ensures effective drug concentration at the site of infection, even in deeper ocular structures
• Broad-spectrum coverage includes common ocular pathogens like Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Pseudomonas aeruginosa, and Haemophilus influenzae
• Convenient dosing regimen improves patient compliance and treatment adherence
• Low incidence of systemic absorption minimizes risk of systemic side effects
• Proven efficacy in both superficial and more serious ocular infections like corneal ulcers

Common use

Ciloxan ophthalmic solution is primarily prescribed for the treatment of bacterial conjunctivitis (pink eye) caused by susceptible strains of bacteria. It is also indicated for corneal ulcers caused by Pseudomonas aeruginosa, Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, and certain Serratia marcescens strains. Healthcare providers may also consider it for prophylaxis following corneal abrasions in high-risk environments or post-ocular surgery when there’s concern for bacterial contamination. The solution is suitable for adults, children, and infants aged 1 year and older, though dosage may be adjusted based on severity and patient factors.

Dosage and direction

For bacterial conjunctivitis: Instill 1-2 drops into the affected eye(s) every 2 hours while awake for the first 2 days, then 1-2 drops every 4 hours while awake for the next 5 days.

For corneal ulcers: Instill 2 drops into the affected eye every 15 minutes for the first 6 hours, then 2 drops every 30 minutes for the remainder of the first day. On day 2, instill 2 drops hourly while awake. On days 3 through 14, instill 2 drops every 4 hours while awake.

Proper administration technique: Wash hands thoroughly before use. Tilt head back, pull down lower eyelid to create a pouch, and instill prescribed number of drops. Avoid touching dropper tip to any surface to prevent contamination. If using other eye medications, wait at least 5 minutes between applications.

Precautions

• For topical ophthalmic use only; not for injection or oral use
• Contact lenses should not be worn during treatment due to potential absorption of preservatives and risk of further irritation
• Patients should not wear contact lenses if they have signs and symptoms of bacterial conjunctivitis
• May cause temporary blurred vision after instillation; avoid driving or operating machinery until vision clears
• Systemic absorption may occur with topical application, though minimal
• Use with caution in patients with history of hypersensitivity to fluoroquinolones
• Prolonged use may result in overgrowth of non-susceptible organisms, including fungi
• Not recommended for viral or fungal conjunctivitis
• Pregnancy Category C: Use only if potential benefit justifies potential risk to fetus

Contraindications

• History of hypersensitivity to ciprofloxacin, other quinolones, or any component of the formulation
• Patients with known hypersensitivity to benzalkonium chloride preservative
• Not indicated for the treatment of syphilitic or tuberculous infections of the eye
• Should not be used for prophylactic antibiotic treatment in non-infected eyes except under specific medical supervision
• Contraindicated in patients with a history of tendon disorders related to fluoroquinolone use

Possible side effect

Most common (≥1%): transient ocular burning, discomfort, itching, conjunctival hyperemia, bad taste following administration, foreign body sensation, corneal staining, keratitis, allergic reactions, eyelid edema, tearing, photophobia, corneal infiltrates, nausea, decreased vision.

Less common (<1%): corneal erosion, dizziness, corneal ulceration, ocular dryness, eye pain, rash, stye, ocular itching, congestion, increased lacrimation, ocular edema/swelling, nasal dryness, headache, fever.

Rare but serious: anaphylactic reactions, Stevens-Johnson syndrome, toxic epidermal necrolysis, crystalluria, tendon inflammation or rupture (though extremely rare with ophthalmic use).

Drug interaction

• No specific drug interaction studies have been conducted with ophthalmic ciprofloxacin
• Theophylline: concurrent use may increase theophylline serum concentrations
• Cyclosporine: elevated serum creatinine reported with concurrent intravenous ciprofloxacin
• Anticoagulants: may enhance effects of warfarin and its derivatives; monitor prothrombin time
• Probenecid: may interfere with renal tubular secretion of ciprofloxacin
• Multivalent cation-containing products (antacids, sucralfate, metal cations such as iron, zinc): may reduce absorption if administered systemically
• NSAIDs: may increase risk of CNS stimulation and convulsions

Missed dose

If a dose is missed, administer it as soon as possible. However, if it is almost time for the next dose, skip the missed dose and continue with the regular dosing schedule. Do not double the dose to make up for a missed one. Maintain as consistent a dosing schedule as possible throughout the treatment period to ensure therapeutic antibiotic levels are maintained in the ocular tissues.

Overdose

Topical overdose of Ciloxan ophthalmic solution is unlikely to cause serious systemic effects due to minimal absorption. However, excessive application may lead to increased local adverse effects such as conjunctival hyperemia, burning, discomfort, or epithelial toxicity. If accidentally ingested, gastric lavage and observation are recommended. Symptomatic and supportive treatment should be provided. Dialysis is not likely to be effective in removing ciprofloxacin due to its high protein binding and large volume of distribution.

Storage

Store at controlled room temperature 15°-30°C (59°-86°F). Protect from light. Keep bottle tightly closed when not in use. Do not freeze. Discard any unused solution 4 weeks after opening, even if some medication remains. Keep out of reach of children. Do not use if solution changes color or becomes cloudy. Store in an upright position.

Disclaimer

This information is for educational purposes only and does not constitute medical advice. Always consult with a qualified healthcare professional before starting any new medication. The prescribing physician should be consulted regarding any questions about diagnosis or treatment. Individual results may vary. Full prescribing information is available from the manufacturer.

Reviews

“Clinical studies demonstrate Ciloxan’s efficacy with 86% of bacterial conjunctivitis patients achieving clinical resolution by day 6-10 of treatment. In corneal ulcer trials, 85% of patients treated with Ciloxan showed clinical improvement with complete re-epithelialization. Ophthalmologists report satisfactory results in both routine and complex cases, noting particularly good efficacy against Pseudomonas aeruginosa. Patient satisfaction surveys indicate good tolerance with most side effects being mild and transient. The convenient dosing schedule and rapid symptom relief contribute to high treatment adherence rates.”