How does this medication work? What will it do for me?

Cyclosporine eye drops are used by people aged 4 years old and over to treat the symptoms of a severe form of allergic reaction that affects the surface of the eye called vernal keratoconjunctivitis. People who have this condition experience severe redness, irritation, and swelling of the eyes, as well as hard bumps on the eyelid, when exposed to allergens in the air.

Cyclosporine works by decreasing the release of natural chemicals from cells in the body (mast cells) that are involved in an allergic reaction. This helps reduce the amount of swelling, itching, and redness in the eyes.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Each 0.3 mL of sterile, unpreserved ophthalmic emulsion in a low-density polyethylene (LDPE) container, contains 0.3 mg of cyclosporine. Nonmedicinal ingredients: cetalkonium chloride, glycerol, medium-chain triglycerides, poloxamer 188, tyloxapol, sodium hydroxide (to adjust pH), water for injection.

How should I use this medication?

The usual dose of this medication is 1 drop in each eye, 4 times a day. After the irritation and redness is gone, your doctor may suggest that you decrease the use of the drops to 1 drop twice a day. If your symptoms do not improve or get worse, stop using this medication and contact your doctor.

Wait at least 15 minutes after using other eye drops before using cyclosporine eye drops.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

Ask your doctor or pharmacist to show you the correct method for using eye drops. It is very important to avoid touching the dropper tip to any surface, skin, or your eye. This contaminates the dropper and can result in a bacterial infection. Report any signs of an eye infection (e.g., redness, irritation, pain) to your doctor immediately.

To use the eye drops:

  • Wash your hands before using the eye drops to avoid introducing bacteria into the eye.
  • Gently shake the single-dose container of eye drops to ensure that the liquid is thoroughly mixed.
  • Tilt your head back and look towards the ceiling.
  • With your index finger, gently pull the lower eyelid down and away from the eye to form a pouch.
  • Apply one drop into the pouch of each eye. Do not allow the tip of the container to touch the eye or areas around the eye.
  • Close your eyes and gently apply pressure to the inner corner of the eye (at the bridge of the nose) for 2 minutes. (This is called nasolacrimal occlusion.) This prevents the medication from dripping down through the tear duct and being swallowed to be absorbed by the body, which could cause you to experience some side effects.
  • Wash your hands again to remove any medication residue.

It is important to use this medication exactly as prescribed by your doctor. If you miss a dose, skip the missed dose and continue with your regular dosing schedule. Do not instill a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature and keep it out of the reach of children.

Safely discard any medication remaining in the dropper container after putting the drops in the eyes. Each container is intended to be used only once. Do not keep the medication in the container for future doses.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not use this medication if you:

  • are allergic to cyclosporine or any ingredients of this medication
  • have or may have an eye infection
  • have or may have a cancerous or pre-cancerous eye condition

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent.

The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

  • burning, redness, itching, dryness, tearing, or stinging of the eye
  • cold symptoms (e.g., runny nose, sore throat)
  • cough
  • ear pain
  • eye pain
  • headache
  • increased tearing
  • sensation of something in your eye
  • swelling or redness on the edge of the eyelid

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

  • reduced vision

Stop taking the medication and seek immediate medical attention if any of the following occur:

  • symptoms of a severe allergic reaction (e.g., hives; difficulty breathing; swelling of the face, eye, mouth, throat, or tongue)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Blurred vision: Cyclosporine eye drops may cause blurred vision, affecting your ability to drive or operate machinery. Avoid driving, operating machinery, or performing other potentially hazardous tasks until your vision has cleared.

Contact lenses: The safety and effectiveness of using this medication while wearing contact lenses has not been established. Do not wear contact lenses while you are using this medication.

Infection: Eye medications that affect the immune system, such as cyclosporine, may increase the risk of more frequent eye infections. If you experience symptoms of an eye infection (e.g., eye redness, discharge, pain, or itching), or changes to your vision, contact your doctor.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while using this medication, contact your doctor immediately.

Breast-feeding: It is not clear whether the eye drop form of cyclosporine passes into breast milk. If you are a breast-feeding mother and are using cyclosporine eye drops, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using this medication have not been established for children less than 4 years of age.

What other drugs could interact with this medication?

Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them. Depending on your specific circumstances, your doctor may want you to:

  • stop taking one of the medications,
  • change one of the medications to another,
  • change how you are taking one or both of the medications, or
  • leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

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