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.

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 helps the medication penetrate the eye surface better than older formulations.

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 room temperature

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
• Refrigerating the drops may reduce stinging
• 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 (no generic available)
• Insurance coverage varies
• Manufacturer may offer savings programs
• Check with your pharmacy and insurance

Comparing Dry Eye Prescriptions

Medication	Active Ingredient	Concentration	Dosing
Cequa	Cyclosporine	0.09%	Twice daily
Restasis	Cyclosporine	0.05%	Twice daily
Xiidra	Lifitegrast	5%	Twice daily

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. Some patients who don't respond to Restasis may respond to Cequa, though response varies.

How long until I notice improvement?

It typically takes 4-8 weeks to notice improvement, with maximum benefit at 3-6 months. 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. Refrigerating the drops or using artificial tears before Cequa may help reduce discomfort.

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.