Dosing and uses of Ciloxan (ciprofloxacin ophthalmic)
Adult dosage forms and 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
Pediatric dosage forms and strengths
ophthalmic solution
- 0.3%
ophthalmic ointment
- 0.3%
Bacterial Conjunctivitis
<1 year: Safety and efficacy not established
>1 year (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
>2 years (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
Ciloxan (ciprofloxacin ophthalmic) adverse (side) 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
Warnings
Contraindications
Resistance to ciprofloxacin
Hypersensitivity to quinolones or any component of product
Cautions
May result in overgrowth of nonsusceptible organisms, including fungi
Careful monitoring, including slit-lamp microscopy and fluorescein staining when appropriate, may be necessary in some patients receiving ophthalmic ciprofloxacin therapy
Contact lenses should be removed before administration
Pregnancy and 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.
Pharmacology of Ciloxan (ciprofloxacin ophthalmic)
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
