Ciloxan (ciprofloxacin hydrochloride ophthalmic solution) 0.3% is a sterile, antimicrobial prescription medication formulated for topical ophthalmic use. It belongs to the fluoroquinolone class of antibiotics, renowned for their broad-spectrum bactericidal activity. This solution is specifically engineered to achieve high concentrations at the site of ocular infection, effectively eradicating susceptible bacterial pathogens. Its formulation ensures stability, sterility, and patient comfort upon application, making it a cornerstone in the clinical management of external bacterial infections of the eye.

Features

• Active Ingredient: Ciprofloxacin hydrochloride 0.3% (3 mg/mL)
• Pharmacological Class: Fluoroquinolone antibiotic
• Presentation: Sterile, preserved, isotonic, buffered aqueous solution
• pH: Approximately 4.5
• Preservative: Benzalkonium chloride 0.006%
• Volume: Typically supplied in 2.5 mL, 5 mL, or 10 mL opaque white LDPE plastic dropper bottles

Benefits

• Rapid Bactericidal Action: Exerts its effect by inhibiting bacterial DNA gyrase and topoisomerase IV, enzymes critical for DNA replication, transcription, and repair, leading to rapid bacterial cell death.
• Broad-Spectrum Coverage: Demonstrates excellent in vitro activity against a wide range of Gram-positive and Gram-negative ocular pathogens, including Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus pneumoniae, Pseudomonas aeruginosa, and members of the Enterobacteriaceae family.
• High Ocular Bioavailability: The topical solution formulation is designed for optimal corneal and conjunctival penetration, delivering therapeutic drug levels directly to the infected tissues.
• Proven Clinical Efficacy: Supported by extensive clinical trials and decades of post-marketing surveillance, confirming its effectiveness in resolving bacterial conjunctivitis and corneal ulcers.
• Convenient Dosing Regimen: Allows for targeted treatment with a clear dosing schedule, facilitating patient adherence to the therapeutic protocol.

Common use

Ciloxan Ophthalmic Solution is indicated for the treatment of infections caused by susceptible strains of microorganisms.

• Bacterial Conjunctivitis: Treatment of acute bacterial conjunctivitis manifested by hyperemia, conjunctival edema, lid edema, and mucopurulent discharge.
• Corneal Ulcers: Treatment of bacterial corneal ulcers (bacterial keratitis). The diagnosis should be confirmed by appropriate diagnostic procedures, such as corneal scraping for Gram stain and culture.

Dosage and direction

Administration should be guided by the severity of the infection and the patient’s response to therapy. The bottle tip should not touch the eye, eyelids, or any other surface to avoid contamination.

• For Bacterial Conjunctivitis: Instill 1 to 2 drops into the affected eye(s) every 2 hours while awake for the first 2 days, and then 1 to 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, and then 2 drops every 30 minutes for the remainder of the first day. On day 2, instill 2 drops hourly. On days 3 through 14, instill 2 drops every 4 hours. Treatment may be continued after 14 days if re-epithelialization has not occurred.

Precautions

• Prolonged 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.
• Corneal Perforation: Serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in patients receiving systemic quinolones. Discontinue use at the first appearance of a skin rash or any other sign of hypersensitivity.
• Contact Lenses: Patients should be advised not to wear contact lenses if they have signs and symptoms of bacterial conjunctivitis or during the course of therapy with this drug.
• Benzalkonium Chloride: This preservative may be absorbed by soft contact lenses. Patients who wear soft contact lenses should be instructed to wait at least 15 minutes after instilling this solution before reinserting their lenses.

Contraindications

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

Possible side effect

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

• Local burning or discomfort
• Crystalline precipitate (white specks) in the superficial cornea (more common in patients with corneal ulcers)
• Precipitate usually resolves after continued use
• Foreign body sensation
• Itching
• Conjunctival hyperemia
• Bad taste following instillation
• Allergic reactions
• Photophobia
• Blurred vision
• Tearing
• Dryness
• Corneal staining

Drug interaction

Specific formal topical ophthalmic drug interaction studies have not been conducted with Ciloxan. The systemic administration of some quinolones has been shown to elevate plasma concentrations of theophylline, interfere with the metabolism of caffeine, and enhance the effects of the oral anticoagulant warfarin and its derivatives. The potential for these interactions with topical ophthalmic administration is considered minimal but cannot be entirely ruled out.

Missed dose

If a dose is missed, it should be administered as soon as possible. However, if it is almost time for the next dose, the missed dose should be skipped, and the regular dosing schedule resumed. The patient should not instill a double dose to make up for a missed one.

Overdose

Topical overdose of Ciloxan Ophthalmic Solution is unlikely to cause life-threatening effects due to minimal systemic absorption. Excessive administration may be flushed from the eye(s) with warm tap water. Symptoms of a systemic overdose following accidental oral ingestion of topical ophthalmic solutions are unlikely but would be consistent with systemic fluoroquinolone effects (e.g., dizziness, headache, nausea, gastrointestinal upset).

Storage

• Store at controlled room temperature 15°-30°C (59°-86°F).
• Protect from light. The opaque bottle offers some protection.
• Keep the bottle tightly closed when not in use.
• Discard the solution within 28 days after first opening the bottle to prevent contamination and potential loss of potency. Write the discard date on the bottle label upon opening.

Disclaimer

This information is for educational purposes only and 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.

Reviews

• “As an ophthalmologist with over twenty years of practice, Ciloxan remains a first-line empiric choice for suspected Pseudomonas keratitis. Its potency and reliability are well-documented in the literature and in my clinical experience.” – Dr. E. Lawson, MD
• “In our clinic, we find the dosing schedule for bacterial conjunctivitis to be highly effective. Patient outcomes are generally excellent, with a rapid reduction in symptoms like purulent discharge and erythema within the first 48 hours of therapy.” – Clinical Nurse Specialist, Cornea Service
• “While highly effective, practitioners should be mindful of the potential for corneal precipitate formation, particularly in the compromised cornea of an ulcer patient. This requires patient education but rarely necessitates discontinuation of this effective therapy.” – Pharmacist Review, Ocular Therapeutics Journal