Cyclosporine ophthalmic
RESTASIS
Pronunciation: SYE-kloe-spor-een
What it isOphthalmic calcineurin inhibitor that reduces ocular-surface inflammation; chronic dry-eye disease.
Why this oneModifies inflammatory dry eye rather than merely lubricating and avoids steroid-related glaucoma and cataracts.
What limits itBurning and stinging commonly derail adherence, especially because meaningful benefit develops slowly.
Classes and tags
Clinical profile
Legacy pregnancy categoryC
Defining liabilityOcular burning (17 %) and stinging; keep the bottle tip off the eye; remove contact lenses before use. Not detected in blood after ocular use.
FDA label
Read the full label on DailyMed ↗
NO BOXED WARNINGS
| FDA dosing | Population | Start | Target | Max |
|---|---|---|---|---|
| Increase tear production in keratoconjunctivitis sicca (ocular inflammation) | Adults | 1 drop each eye BID | 1 drop each eye BID (~12 h apart) | 1 drop each eye BID |
Renal Undefined
Hepatic Undefined
Instill the two eye doses approximately 12 hours apart
Instructions
- Instill one drop twice a day in each eye approximately 12 hours apart
- Prime by squeezing two drops onto a tissue before initial use
- May be used with lubricant eye drops, allowing a 15-minute interval
- Remove contact lenses prior to use; may reinsert 15 minutes after
Available strengths
- emulsion 0.05, 0.1 %
- cap 25, 50, 100 mg
- drops 0.0009 g/mL
- drops 1 mg/mL
- sol 0.09, 0.1 %
- sol 100 mg/mL
- inj 50 mg/mL
Cautions
- Potential for eye injury and contamination — do not touch bottle tip to eye or surfaces
- Do not administer while wearing contact lenses
Adverse reactions
- Ocular burning (17%)
- Conjunctival hyperemia, discharge, epiphora, eye pain, foreign body sensation, pruritus, stinging, visual disturbance
Pregnancy Not detected systemically after topical ocular use; maternal use not expected to result in fetal exposure
Lactation Blood concentrations undetectable after topical use; exercise caution when administered to a nursing woman
Cost
| Strength | #/mo | generic $/unit | CostPlus | |
|---|---|---|---|---|
| 0.05 % | emulsion | per unit | not offered | |
| 0.1 % | emulsion | per unit | not offered |
Other forms: Cyclosporine (NEORAL)
Open Cyclosporine ophthalmic in the interactive console ↗
Self-check
- Which steroid-related ocular complications does ophthalmic cyclosporine avoid?
Glaucoma and cataracts. - Why can early burning/stinging particularly undermine adherence?
Meaningful benefit develops slowly.