Indications

Civox 0.3% Ophthalmic Solution is an azole antifungal medicine indicated for the treatment of eye infections caused by susceptible strains of bacteria, including: 

• Corneal ulcers
• Conjunctivitis
• Blepharitis

Composition

Each ml of eye drops contains: 

• Active Substance: Ciprofloxacin Hydrochloride BP equivalent to Ciprofloxacin 3 mg. 
• Preservative: Benzalkonium Chloride 0.06 mg. 

Pharmacology

Ciprofloxacin is a bactericidal quinolone anti-infective agent. It works by inhibiting the A subunits of DNA gyrase (topoisomerase), an enzyme essential for bacterial DNA reproduction. It is active against a wide range of Gram-negative and Gram-positive organisms. 

Dosage & Administration

• For Corneal Ulcers:
  • First 6 hours: Instill 2 drops into the affected eye every 15 minutes. 
  • Remainder of the First Day: Instill 2 drops every 30 minutes. 
  • Second Day: Instill 2 drops hourly. 
  • Third to Fourteenth Day: Place 2 drops every four hours. 
  • Treatment may continue after 14 days if the cornea has not re-epithelialized. 
• For Bacterial Conjunctivitis/Blepharitis:
  • First two days: Instill 1 drop to the conjunctival sac(s) every two hours. 
  • Next five days: Instill 1 drop every four hours. 
• Pediatric Use: Safety and effectiveness have not been established in children under 1 year of age. 

Interaction

No specific studies have been conducted with the ophthalmic solution. Systemic use of quinolones may elevate the plasma concentration of theophylline, interfere with caffeine metabolism, enhance the effects of warfarin, and be associated with elevated serum creatinine in patients receiving cyclosporin. 

Contraindications

• Hypersensitivity to Ciprofloxacin or any other component of the product. 
• Hypersensitivity to other quinolones (e.g., Nalidixic acid) may also contraindicate use. 

Side Effects

• Most Frequent: Local burning or discomfort. 
• Common (approx. 17% in corneal ulcer studies): White crystalline precipitates in the eye. 
• Less Common (less than 10%): Lid margin crusting, foreign body sensation, itching, conjunctival hyperemia, and a bad taste following instillation. 
• Rare (less than 1%): Corneal staining/keratitis, allergic reactions, lid edema, tearing, photophobia, nausea, and decreased vision. 

Pregnancy & Lactation

There are no adequate and well-controlled studies in pregnant women. Ciprofloxacin ophthalmic solution should be used during pregnancy only if the potential benefit outweighs the potential risk to the fetus. 

Precautions & Warnings

• Super-infection: Prolonged use may lead to the overgrowth of non-susceptible organisms, including fungi. If super-infection occurs, discontinue the product and start alternative therapy. 
• Hypersensitivity: Discontinue immediately at the first sign of a skin rash or other hypersensitivity reaction. 

Overdose Effects

A topical overdose may be flushed from the eye(s) with warm tap water. 

Therapeutic Class

Aural Anti-bacterial preparations, Ophthalmic antibacterial drugs. 

Storage Conditions

Store at room temperature and protect from light. The contents should not be used more than one month after the bottle is first opened.