Cequa (Cyclosporine 0.09%)

Cequa (cyclosporine ophthalmic solution 0.09%) is a prescription eye drop for treating dry eye disease. It uses nanomicellar technology to deliver a higher concentration of cyclosporine than Restasis, potentially improving tear production in dry eye patients.

Official website: cequa.com

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How It Works

Cyclosporine is an immunomodulator that:

• Reduces inflammation on the eye surface
• Allows the lacrimal glands to produce more tears
• Addresses the underlying inflammatory component of dry eye

Nanomicellar technology is a different delivery formulation. A higher concentration alone does not establish that it will work better for an individual patient than another cyclosporine product.

Common Uses

• Dry eye disease
• When artificial tears alone aren't sufficient
• Moderate to severe dry eye with inflammation
• May be used alongside other dry eye treatments

How to Use

• Dosing: One drop in each eye twice daily (approximately 12 hours apart)
• Instillation: Wash hands, tilt head back, pull down lower eyelid, apply drop
• After instillation: Close eyes gently, don't blink excessively
• Contact lenses: Remove before instillation; wait 15 minutes before reinserting
• Other eye drops: Wait at least 15 minutes between different eye drops
• Storage: Store at 20–25°C (68–77°F)
• Single-use vials: Use in both prescribed eyes immediately after opening, then discard the vial and any remainder

What to Expect

Timeline

• First few weeks: May not notice significant improvement
• 4-8 weeks: Some improvement may begin
• 3-6 months: Full effect typically achieved
• Ongoing: Continued use needed to maintain benefits

During Treatment

• Continue using artificial tears as needed
• Temporary discomfort upon instillation is common
• Consistent twice-daily use is important

Side Effects

Common

• Burning or stinging upon instillation (most common)
• Redness
• Eye pain
• Itching
• Blurred vision (temporary)

Less Common

• Eye discharge
• Foreign body sensation
• Headache

Managing Side Effects

• Burning usually improves over time
• Follow the labeled room-temperature storage; ask your pharmacist before changing it
• Preservative-free artificial tears can be used for comfort

Precautions

• Eye infections: Don't use during active eye infection
• Contact lenses: Remove before use; wait 15 minutes to reinsert
• Pregnancy/breastfeeding: Discuss with doctor
• Keep tip sterile: Don't touch dropper tip to eye or any surface

Cost and Coverage

• Brand-name medication; generic availability can change, so ask your pharmacist about current options
• Insurance coverage varies
• Manufacturer may offer savings programs
• Check with your pharmacy and insurance

For a full side-by-side comparison of all prescription dry eye medications, see comparing dry eye prescription drops.

Comparing Dry Eye Prescriptions

Frequently Asked Questions

How is Cequa different from Restasis?

Cequa contains a higher concentration of cyclosporine (0.09% vs 0.05%) and uses nanomicellar technology for better penetration. Response varies; a change is best judged against a specific symptom and follow-up examination.

How long until I notice improvement?

Response varies and may take weeks to months. Agree on a review date to assess symptoms, technique, and the eye surface. Dry eye medications work by reducing inflammation gradually, not providing immediate relief.

Can I use artificial tears with Cequa?

Yes, you should continue using artificial tears for comfort. Just wait 15 minutes between different eye drops.

Why does it burn when I use it?

Burning upon instillation is common with cyclosporine drops. It usually improves with continued use. Lubricant drops may help when separated by 15 minutes. Ask the prescriber about severe or persistent irritation; do not change storage outside the label to manage it.

Can I stop using Cequa once my eyes feel better?

Cequa works by controlling ongoing inflammation. If you stop, dry eye symptoms typically return. Most patients need to continue long-term, though some can reduce frequency.

References

• DailyMed. CEQUA prescribing information and single-use instructions.