What Is Cequa?

Cequa (cyclosporine 0.09%) is a treatment option for keratoconjunctivitis sicca (dry eyes).

As a calcineurin inhibitor, cyclosporine is thought to work by suppressing the immune system (the body's defense system) to relieve eye inflammation (swelling). Eye inflammation is thought to block tear production in people with dry eyes.

As an eye medication for dry eyes, cyclosporine is available by prescription as a Cequa (cyclosporine 0.09%) solution and Restasis (0.05%) emulsion. Cyclosporine is also available by prescription as a Verkazia (cyclosporine 0.1%) emulsion for another eye condition called vernal keratoconjunctivitis, a chronic (long-term) severe eye allergy.

What Is Cequa Used For?

Cequa (cyclosporine 0.09%) is used as a treatment option for dry eyes, which is a common medical condition. While anyone can get dry eyes, you might have a higher likelihood of having dry eyes if you:

• Are age 50 years or older
• Have been assigned female at birth
• Wear contact lenses
• Have low vitamin A intake
• Have an autoimmune condition—like lupus or Sjogren's syndrome—where your immune system attacks parts of your body by mistake

If you have dry eyes, you may experience some of the following symptoms:

• Blurry vision
• Burning sensation in your eyes
• Eye sensitivity to light
• Gritty or scratchy sensation in your eyes
• Itchy eyes
• Red eyes
  

How to Use Cequa

Since directions may vary for different eye medications, carefully read the directions and packaging label on your container.

In general, however, squeeze one drop from the Cequa vial into each eye twice daily. Also, keep the following in mind about Cequa:

• Don't touch the tip of the Cequa vial to your eye or any surface. This is to prevent injuring your eye or contaminating (dirtying) the solution.
• Don't use Cequa with contact lenses. Remove contact lenses from your eyes before using Cequa. After using Cequa, wait 15 minutes before wearing contact lenses again.
• Cequa is available in single-use vials. So, don't open a vial until you're ready to use it right away. Immediately throw away the opened vial after each scheduled dosing time. Don't save an opened vial to use later in the day or on a future date.
• Wait between different eye products. You can typically wait five minutes between each eye medication. For Cequa, however, separate it from other eye products (like artificial tears) by 15 minutes.

The following are also some general steps on how to use eye drops:

1. Wash your hands before using your eye drops.
2. Tilt your head back to look up.
3. Pull down your lower eyelid to form a small cup or pocket.
4. Place one eye drop into this pocket.
5. Close your eyes and press down on your tear duct, which is the corner of your eye that's closest to your nose. Do this for at least one minute.
6. Repeat steps two through five for the other eye.
7. Wash your hands after using your eye drops.
   

Storage

Since Cequa is a non-controlled medication, your healthcare provider may authorize refills for up to one year from the original date on the prescription.

When you receive your Cequa prescription from the pharmacy, store the eye medication at room temperature, which is between 68 degrees to 77 degrees Fahrenheit (F). Do not store Cequa in the bathroom.

If you're going to travel with Cequa, become familiar with your final destination's regulations. In general, however, make a copy of your Cequa prescription. You may also want to keep the original container or packaging from the pharmacy, with your name on it.

Off-Label Uses

The Food and Drug Administration only approved Cequa for dry eyes.

Cyclosporine, however, is also available as another prescription eye medication called Verkazia (cyclosporine 0.1%). Instead of dry eyes, the Verkazia emulsion is used for a different eye condition called vernal keratoconjunctivitis. Vernal keratoconjunctivitis is a chronic severe eye allergy.

What Are the Side Effects of Cequa?

Side effects are possible with Cequa.

This is not a complete list of side effects, and others may occur. A medical professional can advise you on side effects. If you experience other effects, contact your pharmacist or a medical professional. You may report side effects to the FDA at www.fda.gov/medwatch or 1-800-FDA-1088.

Common Side Effects

Common side effects for Cequa include mild eye pain and red eyes, or other irritation.

Severe Side Effects

Eye injury and eye infection are possible with Cequa. To limit these serious side effects, avoid touching the vial tip to your eye or any other surface.

If you suspect that you're experiencing an eye injury or infection, get medical help right away.

Long-Term Side Effects

Cyclosporine is typically a safe long-term treatment option for dry eyes.

Dosage: How Much Cequa Should I Use?

Modifications

Your healthcare provider might slightly modify (change) your Cequa treatment under the following situations:

Pregnancy: There are limited safety and effectiveness data about Cequa in pregnant people. Talk with your healthcare provider to weigh the benefits and risks of using Cequa during pregnancy.

Nursing: It's unlikely that large amounts of cyclosporine would be absorbed through your eye. So, negative effects on your nursing baby are also unlikely. You can, however, further lower the risk of cyclosporine reaching the breastmilk. After placing a cyclosporine drop in your eye, press down for one minute on your tear duct, which is the corner of your eye that's closest to your nose. Then, use a tissue to remove any excess solution.

People who use contact lenses: Remove your contact lenses before using Cequa. After using Cequa, wait 15 minutes before wearing contact lenses again.

People who use other eye medications: If you have multiple eye medications, don't immediately use one after another. You should usually wait five minutes between different eye medications. For Cequa, however, separate it from other eye medications by at least 15 minutes.

Missed Dose

If you accidentally forgot your Cequa dose, place a Cequa drop in each of your eyes as soon as you remember. If it's already close to your next scheduled dose, however, then skip the missed dose and use Cequa again at your next scheduled time. Don't try to double up to make up for the missed dose.

Overdose: What Happens If I Use Too Much Cequa?

It's unlikely that you would overdose from Cequa. If you suspect that you're experiencing life-threatening side effects, however, seek immediate medical attention.

Precautions

What Are Reasons I Shouldn't Use Cequa?

Talk with your healthcare provider before using Cequa if any of the following apply to you:

• Severe allergic reaction: If you've had a severe allergic reaction to Cequa or any of its components (ingredients), then Cequa isn't an ideal option for you.
• Pregnancy: There are no safety and effectiveness data for Cequa on pregnant parents. Reach out to your healthcare provider to weigh the benefits and risks of using Cequa during pregnancy.
• Nursing: It's unlikely for large amounts of cyclosporine to be absorbed through the eye. So, negative effects on the nursing baby are also unlikely. There are ways, however, to further lower the risk of cyclosporine reaching your breast milk. After placing a cyclosporine drop in your eye, press down for one minute on your tear duct, which is the corner of your eye that's closest to your nose. If there is any excess solution, remove it with a piece of tissue.
• Children: There is no safety or effectiveness information for Cequa in children under the age of 18 years old.
• Older adults: There are no safety or effectiveness differences between older adults—people over 65 years of age—and younger adults.
• People who use contact lenses: Remove contact lenses before using Cequa. After using Cequa, wait 15 minutes before wearing contact lenses again.

What Other Medications Interact with Cequa?

If you have multiple eye medications, don't immediately use one after another. Separate Cequa from other eye medications by at least 15 minutes.

If you have any questions or concerns about medication interactions with Cequa, talk with your pharmacist or healthcare provider.

What Medications Are Similar?

There are a number of eye medications used for dry eyes. Some are over-the-counter (OTC) artificial tear products, and others are prescription eye drops.

For the prescription products, there are steroid eye drops, such as Eysuvis (loteprednol). Steroid eye drops, however, tend to have a higher risk of side effects.

As a result, some healthcare providers might prefer non-steroid eye medications for long-term use. Examples of non-steroid eye medications include Xiidra (lifitegrast) and cyclosporine products. Xiidra works differently than cyclosporine eye medications. It might also work a little faster. Some people using Xiidra may notice some improvement in dry eye symptoms as soon as two weeks.

As for the different cyclosporine products, cyclosporine is available as Cequa and Restasis for dry eyes. Compared to Restasis, studies suggest that Cequa might be more effective—with fewer side effects.

How Can I Stay Healthy While Using Cequa?

Dry eye symptoms can be irritating. Thankfully, there are ways to prevent worsening dry eye symptoms. Refer to the following general tips:

• Use your dry eye medications according to your healthcare provider's recommendations.
• Drink plenty of water.
• Consider using a humidifier in your home, office, and/or bedroom.
• Limit your screen time.
• Blink more often if you can't limit your screen time.
• Wear sunglasses and/or a sunhat to protect your eyes from sunny, windy, or dry environments.
• Limit contact lens use—especially when your eyes are irritated.
• Get adequate amounts of sleep.
• Use a warm compress or have eye massages to lessen eye inflammation.