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Cequa

cyclosporine
Used for Dry Eye
Used for Dry Eye

Cequa (cyclosporine) is an eye drop that helps relieve signs and symptoms of dry eye. It works best when used every day, twice a day, for at least 3 months. After using a dose, the vial will need to be thrown away since it doesn't contain any preservatives. The most common side effects include eye pain and eye redness. It's only available as a brand medication, so a generic version is not available.

Reviewed by:
reviewer
Ally Tsai, PharmD
reviewer
Daisy Chau, PharmD
Last reviewed on August 17, 2023
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageCostAlternativesLatest newsReferencesPricesMedicare
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What is Cequa (cyclosporine)?

What is Cequa (cyclosporine) used for?

How Cequa (cyclosporine) works

Cequa (cyclosporine) is a calcineurin inhibitor. Calcineurin is a protein in your body that raises inflammation, including in your eyes. By blocking calcineurin from working, Cequa (cyclosporine) lowers inflammation, which then helps your eyes make more tears.

Are you looking for information on cyclosporine eye emulsion (Restasis), cyclosporine eye emulsion (Verkazia), or cyclosporine eye drops (Vevye) instead?

Drug Facts

Common BrandsCequa
Drug ClassImmunosuppressant
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only

More on Cequa (cyclosporine) essentials

Health: CNI Immunosuppressants: man using eye drops 1479435083

Restasis vs. Cequa vs. Verkazia: 7 Differences Between These Cyclosporine Eye Drops

Written by Austin Ulrich, PharmD, BCACP
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What are the side effects of Cequa (cyclosporine)?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

  • Eye pain (22%)
  • Eye redness (6%)

Other Side Effects

  • Eyelid swelling
  • Eye irritation
  • Headache
  • Urinary tract infection

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Side effects that usually do not require medical attention (report to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Cequa (cyclosporine)

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Pros

Helps your body produce its own tears

Can be used with other lubricating eye drops, such as artificial tears

Designed to deliver more medication to the affected area

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Cons

Can cause eye pain during application

It's not clear whether this medication is safe or works well for children

Can't be used with contact lenses

pharmacist-tips

Pharmacist tips for Cequa (cyclosporine)

pharmacist

  • Always wash your hands with soap and water before using Cequa (cyclosporine). The medication should only be applied to your eyes.

    • If you have to use another eye drop in the same eye(s), wait at least 15 minutes after using Cequa (cyclosporine). This gives enough time for both eye drops to absorb properly into your eye(s).

      • Make sure to take your contact lenses out before using Cequa (cyclosporine). Wait at least 15 minutes before putting your lenses back in.

        • Don't let the tip of the Cequa (cyclosporine) vial touch the eye or other surfaces. Doing so can contaminate the medication with bacteria.

          • To use Cequa (cyclosporine), pull down your lower eyelid with one hand and hold the bottle upside down with the other. Squeeze 1 drop, then close your eye, and press your finger on the corner of your eye closest to your nose for a minute. Doing this helps the medication stay in your eye and prevents it from leaking into your nose.

            • After you've used a drop of Cequa (cyclosporine) in each eye, throw the vial away. Don't save the leftover medication. Since single-use vials don't contain preservatives to prevent bacteria from growing, using leftover medication can raise your risk of an eye infection.

              faqs

              Frequently asked questions about Cequa (cyclosporine)

              How well does Cequa (cyclosporine) work?
              In clinical trials, about 17% of people who were treated with Cequa (cyclosporine) noticed more tear production compared to only 9% of people who were treated with placebo. If you have any questions about whether Cequa (cyclosporine) is right for you, ask your provider for more information.
              Is Cequa (cyclosporine) a steroid?
              No. Cequa (cyclosporine) is considered a calcineurin inhibitor, not a steroid medication.
              How long should you use Cequa (cyclosporine)?
              It depends. Follow your provider's instructions and use Cequa (cyclosporine) for as long as they recommend. Even though it can start working in about 2 weeks, it might take up to 2 months before you notice improvement in your vision. And up to 3 months before you start to notice your eyes making more tears. Therefore, it's important to use this medication every day for the best results.
              What's the difference between Cequa (cyclosporine) and Restasis (cyclosporine)?
              Both Cequa (cyclosporine) and Restasis (cyclosporine) contain the same active ingredient to help your eyes produce more tears. The manufacturer of Cequa (cyclosporine) claims that Cequa (cyclosporine) has a special delivery system that allows most of the medication to be released in the most inflamed area. In animal studies, Cequa (cyclosporine) was absorbed 3 times better into different portions of the eyes than Restasis (cyclosporine). Discuss with your provider about which medication is right for you.
              Is Cequa (cyclosporine) the same as Xiidra (lifitegrast)?
              No. While both Cequa (cyclosporine) and Xiidra (lifitegrast) are used to treat dry eye, they work a little differently to lower inflammation in the eye. But they do have similar instructions, apply one drop in each eye twice a day, about 12 hours apart.
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              What are the risks and warnings for Cequa (cyclosporine)?

              Cequa (cyclosporine) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

              risk-warning

              Eye injury or infection

              Don't let the tip of the vial touch the eye, eyelid, fingers, or other surfaces. Doing so can contaminate Cequa (cyclosporine) and cause serious harm to the eye, such as infection and vision loss.

              risk-warning

              Use with contact lenses

              Don't use Cequa (cyclosporine) while wearing contact lenses. If you wear contact lenses, consider taking them out before using this medication. You can put your contact lenses back in 15 minutes after using Cequa (cyclosporine).

              dosage

              Cequa (cyclosporine) dosage forms

              The average cost for 1 box of 60 vials of 0.09% of Cequa (cyclosporine) is $591.44 with a free GoodRx coupon. This is 31.47% off the average retail price of $862.98.
              box
              Box
              DosageQuantityPrice as low asPrice per unit
              60 vials of 0.09%1 box$591.44$591.44

              Typical dosing for Cequa (cyclosporine)

              Each drop of Cequa (cyclosporine) contains 0.09% of cyclosporine.

              • Adults: The typical dose is to place 1 drop in affected eye(s) twice a day, 12 hours apart.

              More on Cequa (cyclosporine) dosage forms

              Cequa: closeup eye drops 1216071967

              Cequa Dosages for Adults: Your GoodRx Guide

              Written by Austin Ulrich, PharmD, BCACP
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              Cequa (brand)
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              alternatives

              What are alternatives to Cequa (cyclosporine)?

              There are a number of medications that your doctor can prescribe in place of Cequa (cyclosporine). Compare a few possible alternatives below.
              Cequa (cyclosporine)
              Used for:
              $591.44 Lowest GoodRx priceView Prices
              Xiidra (lifitegrast)
              Used for:

              • Dry eyes

              $709.84 Lowest GoodRx priceView Prices
              Cyclosporine (Restasis)
              Used for:

              • Dry eye in people 16 years and older

              $97.64 Lowest GoodRx priceView Prices

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              References

              Best studies we found

              Anglade, E., et al. (2007). Next-generation calcineurin inhibitors for ophthalmic indications. Expert Opinion on Investigational Drugs.

              Goldberg, D. F., et al. (2019). A phase 3, randomized, double-masked study of OTX-101 ophthalmic solution 0.09% in the treatment of dry eye disease. Ophthalmology.

              Gudgel, D. T. (2023). How to put in eye drops. American Academy of Ophthalmology.

              View All References (3)

              Sun Pharmaceutical Industries, Inc. (2022). Cequa- cyclosporine solution/drops [package insert]. DailyMed.

              Sun Pharmaceutical Industries, Inc. (n.d.). The Cequa® effect.

              Sun Pharmaceutical Industries, Inc. (n.d.). The difference is in the delivery.

              GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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