Zoxan D 5 ML

ZOXAN-D Eye/Ear Drops is a sterile ophthalmic and otic solution available in a 5 ml bottle. Each ml of the solution contains Ciprofloxacin 3 mg (0.3% w/v) and Dexamethasone 1 mg (0.1% w/v) as the active ingredients, along with Benzalkonium Chloride 0.01% w/v as a preservative and sterile aqueous vehicle. The product is strictly for external ophthalmic and otic use only and must not be injected or ingested. It is a combination preparation containing a broad-spectrum fluoroquinolone antibiotic and a potent corticosteroid, used for the treatment of bacterial eye and ear infections accompanied by inflammation. The product is packaged in a white box with a prominent orange block displaying the brand name “ZOXAN-D” in bold white text, with the “Rx” symbol confirming it is a prescription-only medicine.

Ciprofloxacin is a broad-spectrum fluoroquinolone antibiotic that works by inhibiting two key bacterial enzymes, DNA gyrase (topoisomerase II) and topoisomerase IV. These enzymes are essential for bacterial DNA replication, transcription, and recombination. By blocking their activity, ciprofloxacin prevents the bacteria from replicating their genetic material, effectively stopping bacterial growth and leading to cell death. This mechanism gives ciprofloxacin a wide spectrum of activity against both gram-positive and gram-negative bacteria, including common eye and ear pathogens such as Staphylococcus aureus, Streptococcus pneumoniae, Haemophilus influenzae, Pseudomonas aeruginosa, and Escherichia coli. Dexamethasone is a potent synthetic corticosteroid that works by inhibiting the production of prostaglandins and other inflammatory mediators. It reduces redness, swelling, itching, and pain associated with the infection by suppressing the immune response at the site of infection. Together, these two agents provide both antibacterial action and anti-inflammatory relief, making this combination highly effective for treating infected and inflamed eyes or ears.

The primary indications for ZOXAN-D Eye/Ear Drops are the treatment of superficial bacterial infections of the eye and ear, including bacterial conjunctivitis, blepharitis, keratitis, and otitis externa (outer ear infection, also known as swimmer’s ear). It is also indicated for the management of acute otitis media (middle ear infection) in cases where the eardrum is intact. The product is effective in reducing redness, swelling, discharge, pain, and irritation associated with these conditions. It is not effective against viral or fungal infections and should not be used for these conditions. The product is intended for use in adults and children above 1 year of age, though it should be used under medical supervision in pediatric patients.

The recommended dosage for eye infections is 1 to 2 drops instilled into the affected eye(s) twice daily (morning and evening) for 7 days. For ear infections, 2 to 4 drops are instilled into the affected ear twice daily for 7 days. It is essential to complete the full course of treatment even if symptoms improve before the course is finished, to prevent the development of antibiotic-resistant bacteria and recurrence of infection. Stopping the medicine too early may bring back the infection. The product should only be used under the supervision of a qualified ophthalmologist or otolaryngologist.

The most common side effects include eye discomfort, corneal deposits (white particles on the eye surface), ocular hyperemia (eye redness), taste change (dysgeusia), ear discomfort, ear pain, and application site reactions such as burning, irritation, itching, and redness. These effects are generally mild and transient, resolving within a few minutes to a few days. Other common side effects include temporary blurred vision, dry eyes, eye itching, increased tearing, and a foreign body sensation. Uncommon side effects may include keratitis, conjunctivitis, photophobia (light sensitivity), eyelid edema, eye swelling, and headache.

Serious but rare side effects include severe hypersensitivity reactions (rash, hives, swelling of face/lips/tongue, difficulty breathing), which have been reported with fluoroquinolones and can occasionally occur even after the first dose. Prolonged or inappropriate use of the corticosteroid component may result in increased intraocular pressure leading to glaucoma, posterior subcapsular cataract formation, and delayed wound healing. Fungal superinfection may occur with prolonged use. Patients should seek immediate medical attention if they experience severe eye or ear pain, sudden vision changes, persistent redness or swelling, hearing changes, or signs of a severe allergic reaction.

Important precautions include not wearing contact lenses during treatment, as the infection itself and the preservative in the drops can both damage the lenses. If using other eye or ear medications simultaneously, a gap of at least 5 to 10 minutes should be maintained between different drops. Patients should avoid driving or operating heavy machinery until their vision is clear after application, as temporary blurred vision is common. The product should not be used in patients with a known hypersensitivity to ciprofloxacin, other fluoroquinolones, dexamethasone, or any of the excipients. It should not be used in cases of viral infections of the outer ear canal such as herpes simplex or varicella. The product should not be used if there is a perforated eardrum, as it could enter the middle ear and cause side effects. It should be used with caution in patients with glaucoma, as the corticosteroid component may increase intraocular pressure. The product is not recommended during pregnancy or breastfeeding unless the potential benefit clearly outweighs the risk. The dropper tip should not be touched to the eye, ear, or any surface to maintain sterility. The product should not be used if the solution changes color or becomes cloudy.

The product should be stored below 30 degrees Celsius in a cool and dry place away from direct sunlight and kept out of reach of children. The bottle should be tightly closed after each use. The product is available in India at a price range of approximately 20 to 35 rupees per 5 ml bottle and is available through major online pharmacy platforms and offline pharmacies with a valid prescription.