A fixed-dose combination ophthalmic suspension/ointment containing a broad-spectrum fluoroquinolone antibiotic (Ciprofloxacin) and a potent corticosteroid (Betamethasone). It is primarily used for the treatment of steroid-responsive inflammatory ocular conditions where the risk of superficial bacterial infection is high or where there is an existing bacterial infection. The combination provides anti-inflammatory, anti-allergic, and antibacterial actions.
Adult: Ophthalmic suspension: One or two drops in the affected eye(s) every 4 to 6 hours. In severe inflammation, may be used hourly initially, tapering as inflammation subsides. Ointment: Apply a small ribbon (approx. 1 cm) into the conjunctival sac up to 3-4 times daily.
Note: 1. Wash hands. 2. Tilt head back. 3. Gently pull lower eyelid to form a pouch. 4. Instill prescribed drops/ointment without touching tip to eye or any surface. 5. Close eye gently for 1-2 minutes, applying gentle pressure to the nasolacrimal duct (inner corner) to minimize systemic absorption. 6. Wait at least 5-10 minutes before instilling any other eye medication.
Ciprofloxacin exerts bactericidal activity by inhibiting bacterial DNA gyrase (topoisomerase II) and topoisomerase IV, enzymes essential for DNA replication, transcription, and repair. Betamethasone binds to cytoplasmic glucocorticoid receptors, triggering anti-inflammatory and immunosuppressive effects by inhibiting phospholipase A2 (reducing prostaglandin/leukotriene synthesis), stabilizing lysosomal membranes, and inhibiting migration of inflammatory cells.
Pregnancy: Category C (US FDA). Corticosteroids have been shown to be teratogenic in animals. Ciprofloxacin may cause arthropathy in immature animals. Use only if potential benefit justifies potential fetal risk. Avoid prolonged use.
Driving: May cause temporary blurred vision; patients should not drive or operate machinery until vision clears.
| Other Corticosteroids (oral/topical) | Additive risk of hypercortisolism and IOP elevation | Major |
| Non-steroidal Anti-inflammatory Drugs (NSAIDs) topical (e.g., Ketorolac, Diclofenac) | May increase risk of corneal healing impairment | Moderate |
| Anticoagulants (e.g., Warfarin) | Theoretical risk of increased INR with significant systemic absorption of betamethasone | Moderate |
| Other Ophthalmic Solutions containing metals (Zinc, Magnesium) | May form chelates with ciprofloxacin, reducing efficacy. Administer at least 10 minutes apart. | Moderate |
Same composition (Ciprofloxacin (0.3%) + Betamethasone (0.1%)), different brands: