Cequa (cyclosporine) is a prescription eye drop used to treat dry eye in adults. Cequa can cause side effects that range from mild to serious. Examples include eye pain when putting drops in and bloodshot eyes.

Cequa comes as a liquid solution eye drop in single-use vials. The active ingredient in Cequa is cyclosporine. (An active ingredient is what makes a drug work.)

Keep reading to learn about the common, mild, and serious side effects that Cequa can cause. For a general overview of the drug, including details about its uses, see this article.

Some people, but not all, may experience mild to serious side effects during Cequa treatment. Examples of the drug’s commonly reported side effects include:

  • eye pain or stinging when putting drops in
  • bloodshot or red eyes*

* To learn more about this side effect, see the ”Side effects explained” section below.

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

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 5–10 minutes. Certain other side effects may be easily managed.

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.

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

* To learn more about this side effect, see the ”Side effects explained” section below.
† An allergic reaction is possible after using Cequa, but this side effect wasn’t reported in studies.

Serious side effects were not reported in studies of Cequa. But there’s always a risk of severe allergic reaction*.

If you develop serious side effects while taking 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 your local emergency number.

* An allergic reaction is possible after using Cequa, but this side effect wasn’t reported in studies. To learn more about allergic reactions, see the ”Side effects explained” section below.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks and reviews side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Cequa, visit MedWatch.

Get answers to some frequently asked questions about Cequa’s side effects.

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

You may wear contacts during Cequa treatment. But there are recommendations on how to safely use them to 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

Even when using Cequa and following these recommendations, chronic (long-term) dry eye may prevent you from wearing contacts. If you have bothersome symptoms such as eye pain or discharge while wearing contacts, take them out right away and contact your eye doctor.

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 headaches.

Unique side effects to each medication include:

The chart below shows a detailed comparison of these drugs’ side effects.

Side effectsCequaRestasisXiidra
red or bloodshot eyes
pain when putting in drops
eye irritation
blurred vision
eye discharge
eye watering
eye discomfort
allergic reaction
swollen eyelid
feeling like there’s something in your eye
bad taste in your mouth

* An active ingredient is what makes a drug work.

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 there are no long-term safety studies on this. However, because so little Cequa is absorbed into the bloodstream, 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.

Learn more about some of the side effects Cequa may cause.

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
  • sensitivity to light
  • watery eyes

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

If you have red or bloodshot eyes during Cequa treatment, consider over-the-counter (OTC) or home remedy options to help relieve your symptoms, such as:

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, puffiness, and flaky skin along the eyelashes
  • sticky drainage
  • sensitivity to light
  • itchy eyes, especially eyelids
  • gritty sensation in the eyes

Factors that can increase the risk of blepharitis when using this drug include rosacea, dandruff, or defective oil glands along the eyelashes.

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.

Allergic reaction

Like most drugs, Cequa can cause an allergic reaction in some people. However, this side effect wasn’t reported in studies. Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin (usually in your eyelids, lips, hands, or feet)
  • swelling of your mouth, tongue, or throat, which can make it hard 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 may suggest a treatment to manage your symptoms. Examples include:

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

If your doctor confirms you’ve had a mild allergic reaction to Cequa, they’ll decide whether you should continue using it.

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

If your doctor confirms you’ve had a serious allergic reaction to Cequa, they may have you switch to a different 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.


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 had a previous 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

There are no known interactions between alcohol and Cequa. 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

There is limited information about the safety of Cequa use during pregnancy.


There haven’t been enough studies to know if using Cequa is safe for pregnant people or if it can cause any problems.

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


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 from Cequa, is there a lower dose I can try?
  • Is it usual for Cequa to cause eye burning?
  • Can Cequa cause side effects in the other parts of my body?
  • Is Cequa likely to cause light sensitivity?

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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.