Ikervis (Ciclosporin)

Ikervis, a calcineurin inhibitor, is used to manage ocular surface inflammatory conditions.

• Dry eye disease: reduces ocular surface inflammation, enhances tear film stability, and alleviates discomfort in patients with moderate to severe disease.
• Keratoconjunctivitis sicca: decreases immune‑mediated damage to the cornea and conjunctiva, improving visual comfort and reducing redness.
• Chronic ocular surface inflammation: provides targeted immunosuppression to control persistent inflammatory processes when conventional lubricants are inadequate.

• Ikervis delivers ciclosporin to the ocular surface, where it binds to cyclophilin within T‑lymphocytes. This complex inhibits calcineurin phosphatase activity, preventing dephosphorylation of nuclear factor of activated T‑cells (NF‑AT). Consequently, transcription of interleukin‑2 and other cytokines is reduced, leading to decreased T‑cell activation and suppression of ocular surface inflammation. The localized effect minimizes systemic exposure while providing sustained anti‑inflammatory activity.

Ikervis may cause ocular and systemic adverse reactions, most of which are mild and reversible.

Common Side Effects

• Burning sensation: transient irritation upon instillation, usually lasting seconds to minutes.
• Stinging or itching: mild discomfort that usually resolves without intervention.
• Redness: mild conjunctival hyperemia that improves with continued use.
• Blurred vision: temporary visual disturbance after dosing that clears quickly.

Serious or Rare Side Effects

• Ocular infection: signs of bacterial or fungal keratitis requiring prompt evaluation.
• Persistent epithelial defect: delayed corneal healing that may need specialist care.
• Elevated intraocular pressure: may require monitoring and possible treatment.

Before prescribing Ikervis, clinicians should consider several precautionary measures to ensure safe use.

• Assess severity: evaluate the degree of dry eye disease and prior response to lubricants.
• Monitor ocular health: perform regular slit‑lamp examinations for signs of infection or epithelial damage.
• Avoid concurrent steroids: limit use of topical corticosteroids unless medically necessary.
• Pregnancy and lactation: use only if potential benefit outweighs unknown risks.
• Contact lens wear: discontinue lenses during treatment and resume only after ocular surface stabilizes.
• Store at room temperature: keep below 25°C in the original container, protect from moisture and light.

Ikervis can interact with other ophthalmic agents and systemic medications that affect immune function.

Major Interactions (Avoid)

• Systemic immunosuppressants: concurrent use may increase risk of systemic immunosuppression.
• Topical corticosteroids: combined therapy can heighten infection risk on the ocular surface.

Moderate Interactions (Monitor Closely)

• Antifungal eye drops: may reduce efficacy of ciclosporin.
• Beta‑blocker eye drops: monitor intraocular pressure changes.
• NSAID eye preparations: watch for additive irritation.