The most common side effects of Cequa (cyclosporine) include eye pain when putting in drops and bloodshot eyes. If Cequa’s side effects become difficult to tolerate, ask your doctor about coping tips or treatment options.

Cequa is prescribed to increase the production of tears in adults who have dry eyes. Cequa comes as a liquid solution eye drop in single-use vials. The active ingredient in Cequa is cyclosporine.

Keep reading to learn about the common, mild, and serious side effects that Cequa can cause. To learn more about Cequa, including its uses, dosage, and cost, read this Cequa overview article.

Some people, but not all, may experience mild to serious side effects during Cequa treatment. These side effects may be temporary, lasting a few days to weeks. Talk with your doctor if side effects do not go away, get worse, or become too difficult to tolerate.

Examples of the drug’s commonly reported side effects include:

  • eye pain or stinging when putting in drops
  • bloodshot or red eyes (See the “Side effects explained” section for more information.)

Mild side effects have been reported with Cequa. These include:

  • bloodshot or red eyes (See the “Side effects explained” section for more information.)
  • eye pain or stinging when putting in drops
  • swollen eyelids (See the “Side effects explained” section for more information.)
  • eye irritation
  • headache
  • urinary tract infection (UTI)

Cequa may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

How long do Cequa side effects last?

In most cases, these side effects (such as eye pain, stinging, and irritation) may happen when putting in Cequa drops. But discomfort should not be severe or last longer than 5 to 10 minutes. Certain other side effects may be managed easily.

If you have ongoing or bothersome symptoms, talk with your doctor or pharmacist. And do not stop using Cequa drops unless your doctor recommends it.

Serious side effects were not reported in studies of Cequa. But every drug poses a risk of severe allergic reaction. To learn more about allergic reaction, see the ”Allergic reaction” section.

If you think you’re experiencing serious side effects while using Cequa, call your doctor right away. If the side effects seem life threatening or you think you have a medical emergency, immediately call 911. Or call your local emergency number.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. Sharing your experience helps make medication safer for everyone. It gives doctors and researchers more information about how the drug works in real life. If you develop a side effect while using Cequa and want to tell the FDA about it, visit MedWatch or call 800-FDA-1088.

Allergic reaction

For some people, Cequa can cause an allergic reaction. But this side effect wasn’t reported in the drug’s studies.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under the skin (usually in your eyelids, lips, hands, or feet)
  • swelling of the mouth, tongue, or throat, which can make it difficult to breathe

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They can determine whether you should keep taking Cequa. They also may suggest a treatment to manage your symptoms, including:

  • an antihistamine you swallow, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If you have symptoms of a severe allergic reaction, such as swelling or difficulty breathing, call 911. Or call your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

Your doctor can confirm whether you’ve had a serious allergic reaction to Cequa. If they do, they may have you switch to a different treatment.

How do side effects of Cequa compare with those seen with Restasis or Xiidra?

Cequa and Restasis eye drops contain the active ingredient cyclosporine. Xiidra contains the active ingredient lifitegrast. All three drugs may cause red or bloodshot eyes. Cequa and Xiidra may cause headache and eye irritation.

Unique side effects to each medication include:

  • Cequa:
    • swollen eyelid
    • UTI
  • Restasis:
    • feeling that something is in your eye
    • stinging in the eye
  • Xiidra:

The table below shows a detailed comparison of the side effects of these drugs.

Side effectsCequaRestasisXiidra
red or bloodshot eyes✓✓✓
pain when putting in drops✓✓
eye irritation✓✓
headache✓✓
blurred vision✓✓
eye discharge✓✓
eye watering✓✓
eye discomfort✓✓
itching✓✓
allergic reaction✓✓
swollen eyelid✓
UTI✓
feeling that something is in your eye✓
stinging✓
bad taste in your mouth✓
sinusitis✓

Does Cequa cause long-term side effects?

Long-term side effects weren’t reported in studies of Cequa. This drug is an immunosuppressant that works by lowering the eye’s defense system. But no long-term safety studies were completed. But so little Cequa is absorbed into the bloodstream. Because of this, the risk of immune system problems is minimal.

If you’re concerned about possible long-term side effects from Cequa, talk with your doctor or pharmacist.

Will using contacts during Cequa treatment raise my risk of side effects?

You may wear contacts during Cequa treatment. But you should follow some recommendations on safely using them to help lower your risk of side effects. These include:

  • taking contact lenses out of your eyes before putting in Cequa drops
  • waiting 15 minutes before placing contacts back into your eyes
  • following your eye doctor’s instructions for cleaning and storing your contacts
  • checking with your eye doctor before using contact rewetting drops

Sometimes, though, chronic (long-term) dry eye may prevent you from wearing contacts. Watch for bothersome symptoms such as eye pain or discharge while wearing contacts. If you develop these, remove the contacts right away and notify your eye doctor.

Bloodshot or red eyes

Bloodshot or red eyes was the most common side effect reported in studies of Cequa. This may cause symptoms such as:

  • white of the eye looking red
  • enlarged blood vessels in the white of the eye
  • eye pain
  • a feeling of eye swelling
  • eye sensitivity to light
  • eye watering

Factors that can raise the risk of red or bloodshot eyes when using Cequa include seasonal allergies, infection, and lack of sleep.

What might help

During Cequa treatment, consider over-the-counter (OTC) or home remedy options to help relieve symptoms of red or bloodshot eyes. These include:

If this side effect becomes bothersome, talk with your doctor. They may recommend treatment for the underlying cause, such as allergy or infection. And always ask your eye doctor before using Cequa with any eye drops other than artificial tears.

Swollen eyelids

Swollen eyelids, also called blepharitis, was an uncommon side effect reported in studies of Cequa. Blepharitis may cause symptoms such as:

  • redness (or discoloration), puffiness, and flaky skin along the eyelashes
  • sticky drainage from the eyes
  • eye sensitivity to light
  • itchy eyes, especially eyelids
  • gritty sensation in the eyes

Some factors can increase the risk of blepharitis when using this drug. These include:

What might help

If you have blepharitis during Cequa treatment, consider home remedies or OTC options to help relieve your symptoms. These include:

  • eye wash
  • lid scrub
  • warm or cool compresses
  • gel eye pads

If your blepharitis doesn’t clear up or if you get it frequently, you should talk with your doctor. They’ll likely recommend switching to a different dry eye treatment.

Keeping track of side effects

During your Cequa treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking a new drug or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how your symptoms affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Cequa affects you. They can then use this information to adjust your treatment plan if needed.

Below is important information you should consider before using Cequa.

Warnings

Cequa can sometimes cause harmful effects in people with certain conditions. This is known as a drug-condition interaction. Other factors may also affect whether Cequa is a good treatment option for you. Talk with your doctor about your health history before using Cequa. Be sure to tell them if any of the following factors apply:

  • you wear contacts
  • you use other eye drops
  • you’ve ever had an allergic reaction to Cequa
  • you’re pregnant or breastfeeding

Cequa’s single-dose vials do not have preservatives in them. This means that after putting Cequa into your eyes, you should discard the vial right away, even if it still has medication in it. Using Cequa single-dose vials that have been opened and sitting out raises your risk of a serious eye infection.

To lower the risk of infection or eye injury, do not let Cequa’s vial tip touch any surface of your eye.

Alcohol and Cequa

Cequa and alcohol have no known interaction. Experts generally agree that it should be safe to drink alcohol during your Cequa treatment.

If you have questions about consuming alcohol during Cequa treatment, talk with your doctor or pharmacist.

Pregnancy and breastfeeding with Cequa

Information about the safety of Cequa use during pregnancy is limited.

Pregnancy

It’s not known whether Cequa is safe for pregnant people or can cause any problems. Not enough studies have been completed concerning this.

If you’re pregnant or planning to become pregnant, talk with your doctor before starting treatment with this medication.

Breastfeeding

It isn’t known whether Cequa is safe to use while breastfeeding. After putting Cequa drops into the eye, only a very small amount gets into your blood. But experts don’t know whether it can pass into breast milk, affect milk production, or harm a child who’s breastfed.

If you’re breastfeeding or planning to do so, talk with your doctor before starting this medication.

Like most drugs, Cequa can cause some side effects that range from mild to serious. But most are temporary and others are easily managed. If you have questions about side effects that Cequa can cause, talk with your doctor.

Examples of questions to help get you started include:

  • Will using other eye drops with Cequa cause Cequa’s side effects to worsen?
  • If I have side effects, is there a lower Cequa dosage I can try?
  • Is it usual for Cequa to cause eye burning?
  • Can Cequa cause side effects in other parts of my body?
  • Is Cequa likely to cause eye sensitivity to light?

Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.