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Ciloxan Side Effects

Generic Name: ciprofloxacin ophthalmic

Note: This document contains side effect information about ciprofloxacin ophthalmic. Some of the dosage forms listed on this page may not apply to the brand name Ciloxan.

For the Consumer

Applies to ciprofloxacin ophthalmic: ophthalmic ointment, ophthalmic solution

Along with its needed effects, ciprofloxacin ophthalmic (the active ingredient contained in Ciloxan) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking ciprofloxacin ophthalmic:

Rare
  • Blurred vision or other change in vision
  • eye pain
  • irritation (severe) or redness of the eye
  • nausea
  • skin rash, hives, or itching

Some side effects of ciprofloxacin ophthalmic may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common
  • Burning or other discomfort of the eye
  • crusting or crystals in corner of the eye
Less common
  • Bad taste following use in the eye
  • feeling of something in the eye
  • itching of the eye
  • redness of the lining of the eyelids
Rare
  • Difficulty seeing at night
  • dryness of the eye
  • increased sensitivity of the eyes to light
  • swelling of the eyelid
  • tearing of the eye

For Healthcare Professionals

Applies to ciprofloxacin ophthalmic: ophthalmic ointment, ophthalmic solution

General

The most common side effects were ocular discomfort, local burning/discomfort, dysgeusia, corneal deposits, and white crystalline precipitates.[Ref]

Ocular

White topical ocular precipitates have been observed in patients with corneal ulcer and frequent dosing of this drug which resolved after continued application of this drug. Precipitate did not preclude continued use of this drug and did not adversely affect the clinical course of recovery. Onset was within 1 to 7 days after starting therapy and resolution varied from immediately to 13 days after starting therapy.[Ref]

Very common (10% or more): White crystalline precipitates (medication residue; up to 17%)
Common (1% to 10%): Corneal deposits, ocular discomfort, ocular hyperemia/erythema/redness, local burning/discomfort, eyelid margin crusting, crystals/scales, foreign body sensation, itching, conjunctival hyperemia, keratopathy
Uncommon (0.1% to 1%): Punctate keratitis, eyelid edema, lacrimation increased/tearing, photophobia, corneal infiltrates, decreased visual acuity/decreased vision, blurred vision, dry eye, eye pain, eye swelling, eye pruritus, eye discharge, eyelid exfoliation, conjunctival edema, erythema of eyelid/lid margin hyperemia, corneal staining, chemosis, eye inflammation, corneal toxicity, allergy, intolerance, heavy sensation, conjunctival reaction, eye hypoesthesia/numbing sensation, conjunctivitis, punctate epithelial erosion, progression of infiltrate
Rare (0.01% to 0.1%): Ocular toxicity, keratitis/keratoconjunctivitis, corneal disorder, corneal epithelium defect, diplopia, asthenopia, eye irritation, hordeolum
Frequency not reported: Epitheliopathy[Ref]

Nervous system

Common (1% to 10%): Dysgeusia/bad taste after instillation
Uncommon (0.1% to 1%): Headache
Rare (0.01% to 0.1%): Dizziness/lightheadedness[Ref]

Gastrointestinal

Uncommon (0.1% to 1%): Nausea
Rare (0.01% to 0.1%): Diarrhea, abdominal pain[Ref]

Respiratory

Uncommon (0.1% to 1%): Paranasal sinus hypersecretion/sinus drainage
Rare (0.01% to 0.1%): Rhinitis

Hypersensitivity

Rare (0.01% to 0.1%): Hypersensitivity/allergic reactions

Systemic quinolones:
-Frequency not reported: Hypersensitivity (anaphylactic) reactions[Ref]

Serious and occasionally fatal hypersensitivity (anaphylactic) reactions (some after first dose) have been reported with systemic quinolones.[Ref]

Dermatologic

Rare (0.01% to 0.1%): Dermatitis

Systemic ciprofloxacin:
-Uncommon (0.1% to 1%): Phototoxicity

Locally-applied fluoroquinolones:
-Very rare (less than 0.01%): Generalized rash, toxic epidermolysis, exfoliative dermatitis, Stevens-Johnson syndrome, urticaria[Ref]

Moderate to severe phototoxicity has been reported in some patients exposed to direct sunlight while using oral ciprofloxacin.[Ref]

Other

Rare (0.01% to 0.1%): Ear pain, drug intolerance, abnormal laboratory test

Musculoskeletal

Ruptures of the shoulder, hand, Achilles, or other tendons (requiring surgical repair or resulting in prolonged disability) have been reported with systemic fluoroquinolones. Risk of such ruptures may be increased in patients using concomitant corticosteroids, especially geriatric patients and in tendons under high stress (including the Achilles tendon).

Postmarketing reports: Tendon disorder

Systemic fluoroquinolones:
-Frequency not reported: Tendon ruptures

Psychiatric

Frequency not reported: Acute psychosis (visual and auditory hallucinations, irrational speech, behavioral disturbances)[Ref]

At least 1 case of acute psychosis (visual and auditory hallucinations, irrational speech, and behavioral disturbances) has been reported after ocular administration. The symptoms resolved upon discontinuation.[Ref]

References

1. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0

2. Cerner Multum, Inc. "Australian Product Information." O 0

3. "Product Information. Ciloxan (ciprofloxacin ophthalmic)." Alcon Laboratories Inc, Fort Worth, TX.

4. Wilhelmus KR, Abshire RL "Corneal ciprofloxacin precipitation during bacterial keratitis." Am J Ophthalmol 136 (2003): 1032-7

5. Tripathi A, Chen SI, O'Sullivan S "Clinicopathologic reports, case reports, and small case series: acute psychosis following the use of topical ciprofloxacin." Arch Ophthalmol 120 (2002): 669-70

Some side effects of Ciloxan may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

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