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Topical fluoroquinolone antibiotic (ophthalmic) Pregnancy: There are no adequate data from the use of Ciloxan in pregnant women. Animal studies do not indicate direct harmful effects with respect to reproductive toxicity, and systemic exposure to ciprofloxacin after topical use is expected to be low. As a precautionary measure, it is preferable to avoid the use of Ciloxan during pregnancy unless the therapeutic benefit is expected to outweigh the potential risk to the fetus. Breastfeeding: orally administered ciprofloxacin is excreted in human milk; it is unknown whether ciprofloxacin is excreted in human breast milk following topical ocular or otic administration, and a risk to the suckling child cannot be excluded — caution should be exercised in nursing women. Fertility: studies have not been performed in humans to evaluate the effect of topical ciprofloxacin on fertility; oral administration in animals does not indicate direct harmful effects.

Ciprofloxacin 0.3% Eye Drops/Ointment (Ciloxan)

Brand names: Ciloxan

Ciprofloxacin 0.3% eye drops and ointment (Ciloxan) are a topical fluoroquinolone antibacterial used for bacterial eye infections, including corneal ulcers and bacterial conjunctivitis.

Adult dose

Dose: SCOPE — the regimens below are for CILOXAN 0.3% w/v EYE DROPS SOLUTION only. The eye OINTMENT named in this page's title is a separate presentation with its own SPC and is NOT covered by this source; do not apply these drop schedules to the ointment. SUPERFICIAL OCULAR INFECTION (the usual indication): one or two drops in the affected eye(s) four times a day. In severe infections, the dosage for the first two days may be one or two drops every two hours during waking hours. CORNEAL ULCERS: Ciloxan must be administered at the following intervals, even during night time — on the first day, instil 2 drops into the affected eye every 15 minutes for the first six hours and then 2 drops into the affected eye every 30 minutes for the remainder of the day; on the second day, instil 2 drops in the affected eye hourly; on the third through the fourteenth day, place two drops in the affected eye every 4 hours. If the patient needs to be treated longer than 14 days, the dosing regimen is at the discretion of the attending physician.
Route: Ophthalmic — instilled into the affected eye(s). For ocular use only.
Frequency: Superficial ocular infection: four times a day (or one to two drops every two hours during waking hours for the first two days in severe infection). Corneal ulcer: intensive round-the-clock tapering schedule over 14 days — see dose.
Max: Maximum duration of therapy: 21 days is recommended for either indication. This SPC states no maximum number of drops per day — the corneal-ulcer day-one schedule (2 drops every 15 minutes for the first six hours) is the most intensive regimen it licenses.
The SPC gives a single posology for adults, newborn infants (0-27 days), infants and toddlers (28 days to 23 months), children (2-11 years) and adolescents (12-16 years); the dosage in children above the age of 1 year is the same as for adults. For either indication a maximum duration of therapy of 21 days is recommended. Contact lens wear is not recommended during treatment of an ocular infection; this medicine contains 0.3 mg benzalkonium chloride in each 5 ml (equivalent to 0.06 mg/ml), which may be absorbed by soft contact lenses and may change their colour — remove contact lenses before use and put them back 15 minutes afterwards. In patients with corneal ulcer receiving frequent administration, white topical ocular precipitates (medication residue) have been observed, with onset within 24 hours to 7 days of starting therapy and resolution from immediately to 13 days after therapy commencing; the precipitate does not preclude continued application and does not adversely affect recovery. No studies have been performed using Ciloxan Eye Drops in patients with kidney or liver problems. SOURCE LIMITS: the §4.4 warnings and §4.8 adverse-effects sections in this bundle were truncated at the source-fetch limit, so the safety lists below are not complete; the §4.2 posology itself was captured in full. The §4.1 indications section was not fetched, so the licensed indication wording is taken from the posology headings themselves.

Paediatric dose

Route: Ophthalmic — instilled into the affected eye(s)
Frequency: Same as adults — see notes
Max: Maximum duration of therapy 21 days, as for adults
FIXED DROP DOSE, NOT WEIGHT-BASED — dosePerKg is deliberately null because this SPC expresses the paediatric dose in drops, not per kilogram. Do not derive a per-kg or per-ml figure. VERBATIM §4.2: the posology heading covers 'Adults, newborn infants (0-27 days), infants and toddlers (28 days to 23 months), children (2-11 years) and adolescents (12-16 years)', and 'The dosage in children above the age of 1 year is the same as for adults.' The corneal-ulcer and superficial-ocular-infection schedules in adultDose therefore apply unchanged to children above 1 year. 'Safety and effectiveness of CILOXAN Eye Drops were determined in 230 children between the ages of 0 and 12 years of age. No serious adverse drug reaction was reported in this group of patients.' CAUTION UNDER 1 YEAR, verbatim §4.4: 'The clinical experience in children less than one year old, particularly in neonates is very limited. The use of CILOXAN eye drops in neonates with ophthalmia neonatorum of gonococcal or chalamydial origin is not recommended as it has not been evaluated in such patients. Neonates with ophthalmia neonatorum should receive appropriate treatment for their condition.' Verify all under-18 use against a children's formulary and current prescribing references.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via the eMC — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Hypersensitivity to the active substance or to any of the excipients listed in Section 6.1
  • Hypersensitivity to quinolones

Side effects

  • Most frequently reported in clinical trials: ocular discomfort (approximately 6%), dysgeusia (approximately 3%) and corneal deposits (approximately 3%)
  • Common — corneal deposits, ocular discomfort, ocular hyperaemia, dysgeusia
  • Uncommon — keratopathy, punctate keratitis, corneal infiltrates, photophobia, visual acuity reduced, eyelid oedema, blurred vision, eye pain, dry eye, eye swelling, eye pruritus, lacrimation increased, eye discharge, eyelid margin crusting, eyelid exfoliation, conjunctival oedema, erythema of eyelid, headache, nausea
  • Rare — hypersensitivity, dizziness, ocular toxicity, keratitis, conjunctivitis, corneal epithelium defect, diplopia, hypoaesthesia eye, asthenopia, eye irritation, eye inflammation, hordeolum, ear pain, paranasal sinus hypersecretion, rhinitis, diarrhoea, abdominal pain, dermatitis
  • Not known — tendon disorder
  • Very rare with locally applied fluoroquinolones — (generalized) rash, toxic epidermolysis, dermatitis exfoliative, Stevens-Johnson syndrome and urticaria
  • Serious and occasionally fatal hypersensitivity (anaphylactic) reactions, some following the first dose, have been reported with systemic quinolone therapy — sometimes with cardiovascular collapse, loss of consciousness, tingling, pharyngeal or facial oedema, dyspnoea, urticaria and itching
  • Tendon rupture (shoulder, hand, Achilles or other) requiring surgical repair or causing prolonged disability has been reported with systemic fluoroquinolones; risk may be increased with corticosteroids, in geriatric patients and in tendons under high stress
  • NOTE: the §4.8 adverse-reactions section was truncated in this source capture — this list is not complete; consult the SPC

Monitoring

  • Discontinue Ciloxan at the first appearance of skin rash or any other sign of hypersensitivity; serious acute hypersensitivity reactions may require immediate emergency treatment, with oxygen and airway management where clinically indicated
  • Discontinue at the first sign of tendon inflammation — tendon inflammation and rupture may occur with fluoroquinolones, particularly in elderly patients and those treated concurrently with corticosteroids
  • Watch for superinfection — as with all antibacterial preparations, prolonged use may lead to overgrowth of non-susceptible bacterial strains or fungi; if superinfection occurs, appropriate therapy should be initiated
  • In corneal ulcer patients on frequent dosing, expect possible white ocular precipitates (medication residue); these resolve on continued application and do not require stopping treatment
  • Review the need to continue beyond the recommended maximum 21 days of therapy; beyond 14 days in corneal ulcer the regimen is at the discretion of the attending physician

Clinical monograph

How it works

Ciprofloxacin inhibits bacterial DNA gyrase and topoisomerase IV, preventing DNA replication and producing a bactericidal effect against a broad range of Gram-negative and many Gram-positive organisms.

Prescribing in practice

  • White corneal precipitates of the drug can form in patients with corneal ulcers; these are reversible and do not usually require stopping treatment.
  • Reserve for likely bacterial infection and consider local resistance patterns and the risk of selecting resistant organisms.
  • Avoid wearing contact lenses while the eye is infected and being treated.

Monitoring

Monitor the clinical response, particularly in corneal ulcers, and arrange specialist review if there is inadequate improvement or deterioration.

Counselling the patient

  • Complete the full prescribed course even if the eye looks better.
  • Do not wear contact lenses during the infection and the treatment period.
  • A temporary unpleasant taste or transient blurring after instillation can occur.

Evidence & guidelines

Topical fluoroquinolones such as ciprofloxacin are an established treatment for bacterial keratitis and serious bacterial eye infections.

Reference: RCOphth Corneal Infection Guidelines; Ciloxan SPC; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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