Ciprofloxacin Ophthalmic

You should not wear contact lenses while you still have active symptoms of the eye infection you are treating.

Do not use other eye drops or medications during treatment unless otherwise directed by your doctor.

Avoid caffeine while you are using ciprofloxacin, because the medication can make the effects of caffeine stronger.

Ciprofloxacin ophthalmic can cause blurred vision. Be careful if you drive or do anything that requires you to be able to see clearly.

It is not likely that other drugs you take orally or inject will have an effect on ciprofloxacin used in the eyes. But many drugs can interact with each other. Tell your doctor about all other medications you use, especially:

• theophylline (Elixophyllin, Theo-24, Uniphyl);
• a blood thinner such as warfarin (Coumadin); or
• cyclosporine used in the eyes (Restasis) or taken by mouth (Neoral, Sandimmune, Gengraf).

This list is not complete and there may be other drugs that can interact with ciprofloxacin ophthalmic. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

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

Ciprofloxacin eye drops and eye ointment are used to treat infections of the eye, such as bacterial conjunctivitis. Ciprofloxacin eye drops is also used to treat corneal ulcers of the eye. Ciprofloxacin belongs to a group of medicines called fluoroquinolone antibiotics. It works by killing bacteria that cause conjunctivitis.

ciprofloxacin is available only with your doctor's prescription.

• Ciprofloxacin HCl
• Ciprofloxacin Hydrochloride

Bacterial conjunctivitis: Ophthalmic:

Solution: Instill 1 to 2 drops into the conjunctival sac every 2 hours while awake for 2 days and 1 to 2 drops every 4 hours while awake for the next 5 days

Ointment: Apply a 1/2 inch ribbon into the conjunctival sac 3 times/day for the first 2 days, followed by a 1/2 inch ribbon applied twice daily for the next 5 days

Corneal ulcer: Ophthalmic:

Solution: Instill 2 drops into affected eye every 15 minutes for the first 6 hours, then 2 drops into the affected eye every 30 minutes for the remainder of the first day. On day 2, instill 2 drops into the affected eye hourly. On days 3-14, instill 2 drops into affected eye every 4 hours. Treatment may continue after day 14 if re-epithelialization has not occurred.

Ointment (off-label): Apply 1/2 inch ribbon into the conjunctival sac every 1 to 2 hours around the clock on the first 2 days, then apply 1/2 inch ribbon every 4 hours for up to 12 days. Treatment may continue after day 12 if re-epithelialization has not occurred (Ciloxan Canadian product labeling 2016).

Frequency not always defined.

>10%: Ophthalmic: Crystalline eye deposits (solution:17%; white crystalline precipitate in superficial portion of corneal defect in those with corneal ulcer; reversible after completion of therapy)

1% to 10%:

Gastrointestinal: Unpleasant taste (immediately after instillation)

Ophthalmic: Corneal disease (ointment: 2%), burning sensation of eyes, conjunctival hyperemia, crusting of eyelid, eye discomfort, eye pruritus, foreign body sensation of eye

<1% (Limited to important or life-threatening): Blurred vision, corneal infiltrates, corneal staining, dermatitis, epitheliopathy, eye pain, eye irritation, eyelid edema, keratitis, keratoconjunctivitis, lacrimation, nausea, photophobia, vision loss, xerophthalmia

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Patient may experience blurred vision, eye redness, crusting of eyelid, foreign body sensation in eye, or bad taste. Have patient report immediately to prescriber vision changes, eye pain, severe eye irritation, eye or eyelid edema, joint pain, joint edema, or crystalline eye deposits (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

Ciprofloxacin is a fluoroquinolone (flor-o-KWIN-o-lone) antibiotic that fights bacteria in the body.

Ciprofloxacin ophthalmic (for use in the eyes) is used to treat bacterial infections of the eyes.

Ciprofloxacin ophthalmic is also used to treat an ulcer in the cornea of the eye.

Ciprofloxacin will not treat a viral or fungal infection of the eye. This medicine is for use in treating only bacterial infections.

Ciprofloxacin ophthalmic may also be used for purposes not listed in this medication guide.

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.

Solution:
-Day 1: Instill 2 drops into the affected eye(s) every 15 minutes for the first 6 hours and then 2 drops into the affected eye(s) every 30 minutes for the remainder of the day.
-Day 2: Instill 2 drops into the affected eye(s) every hour.
-Days 3 through 14: Instill 2 drops into the affected eye(s) every 4 hours.

Comments: May continue treatment after 14 days if corneal reepithelialization has not occurred

Use: For the treatment of corneal ulcers due to susceptible strains of Pseudomonas aeruginosa, Serratia marcescens, S aureus, S epidermidis, S pneumoniae, Streptococcus (viridans group)

Safety and efficacy have not been established in patients younger than 2 years (ointment) or 1 year (solution).

Consult WARNINGS section for additional precautions.

Administration advice:
-For topical ophthalmic use only (not for injection into the eye)

Storage requirements:
-Store at 2C to 25C (36F to 77F).
-Solution: Protect from light.

Patient advice:
-Do not wear contact lenses if you have signs/symptoms of bacterial conjunctivitis or during therapy.
-Avoid contaminating the applicator tip with material from the eye, fingers, or any other source; do not touch the applicator tip to any surface.
-Stop this drug at first sign of skin rash or any other sign of hypersensitivity.