Cequa Now Available on the PBS

Cequa Eye Drops Now Available on the PBS

Cequa Eye Drops

Cequa, a prescription eye drop that helps to treat chronic dry eye disease, is now available on the PBS for adults living with moderate to severe dry eye disease.

Is Cequa a Steroid?

Cequa is not a steroid. It is an immunosuppressant, which is a type of drug that works by reducing the activity of the immune system. Steroids are also immunosuppressants, but they work in a different way than Cequa. Steroids can cause side effects such as increased eye pressure, cataracts, and glaucoma, which is why Cequa is often preferred over steroids for the treatment of dry eye.

How does Cequa work?

Cequa stands out as a clear and preservative-free eye drop solution that uniquely penetrates the aqueous layer of the tear film, ensuring optimal delivery of ciclosporin to the ocular surface. Cequa contains the immunosuppressant drug cyclosporine. Cyclosporine works by suppressing the immune system's inflammatory response, which can help to reduce the symptoms of dry eye disease. It also boosts tear production in individuals with moderate to severe dry eye disease (keratoconjunctivitis sicca), offering them newfound comfort and improved eye health.

The recommended dosage entails applying one drop of Cequa into the affected eye(s) twice daily, with a 12-hour interval between administrations. For those already utilizing artificial tears, a 15-minute gap between products is advised to maximize the benefits of both treatments.

Cequa is a safe and effective treatment for chronic dry eye disease. In clinical trials, Cequa was shown to significantly reduce the symptoms of dry eye disease, including:

  • Eye dryness
  • Eye irritation
  • Eye pain
  • Blurred vision
  • Redness of the eyes

The Innovative Delivery System

Cequa's nanomicellar technology revolutionizes the absorption of ciclosporin within the body, leading to enhanced treatment outcomes. Compared to the traditional 0.05% ciclosporin ophthalmic emulsion, Cequa boasts a more than 10-fold increase in aqueous solubility. This innovative delivery system enables a more effective and efficient response to dry eye disease, making Cequa a leading solution in the field.

The PBS Approval Journey

Although the Therapeutic Goods Administration (TGA) granted initial approval to Cequa in Australia back in February 2020, it had yet to receive the coveted PBS listing. This recent breakthrough signifies a major advancement for patients and optometrists alike, as it enables broader access to a ciclosporin-based treatment that specifically targets the root causes of dry eye disease. Optometry Australia's Chief Clinical Officer, Luke Arundel, expressed his enthusiasm regarding the availability of Cequa on the PBS, highlighting the positive impact it will have on patients struggling with the debilitating effects of this chronic condition.

Qualifying for Cequa Treatment

Therapeutically qualified optometrists throughout Australia now possess the authority to prescribe Cequa as a private prescription for suitable patients. For patients seeking coverage under the PBS scheme, certain criteria must be met, as outlined on the PBS website under the 'authority required' section. This step ensures appropriate allocation and administration of the treatment, guaranteeing maximum benefits for those in need.

Cequa Side Effects

In addition to its impressive efficacy, Cequa has demonstrated a remarkable safety profile for long-term use. The most commonly reported adverse effects include mild instillation site pain, conjunctival hyperaemia.

How long does Cequa take to work?

People start noticing a difference as soon as 1 month but usually around 4-6 months.

Cequa vs Restasis

Restasis (Cyclosporine 0.05%) works by binding to proteins in the cells called immunophilins. This reduces activation and inflammation in dry eye disease. 

Cequa eye drops use coatings of nano-particles to help them travel through the tear film and reach the surface of the eye. The theory is that these coatings make Cequa more effective than compounded cyclosporine or Restasis.


Cequa is a nanomicellar ophthalmic solution, which means that it is made up of tiny micelles that help to deliver the drug cyclosporine directly to the eye. This helps to improve the drug's effectiveness and reduces the risk of side effects.

Cequa was first approved by the Therapeutic Goods Administration (TGA) in Australia in 2020. It is now available on the PBS for adults living with moderate to severe dry eye disease.

For more information on non-inflammatory eye drops, visit this link here

💡 It is important to remember that Restasis, Cequa, Ikervis and Xiidra do not cure other causes of dry eyes - for example, blepharitis, Meibomian Gland Dysfunction or other medical causes of dry eyes. It is also important to work with an optometrist to identify other dry eye causes.

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  1. Pharmaceutical Benefits Scheme. Ciclosporin: Eye drops 900 micrograms per mL, single dose units, 0.25 mL, 60; Cequa®, https://www.pbs.gov.au/info/industry/listing/elements/pbac-meetings/psd/2022-03/ciclosporin- eye-drops-900-micrograms-per-ml-single-dose-units-0-25-ml-60-cequa. (2022).
  2. Therapeutic Goods Administration (TGA). CEQUA (Sun Pharma ANZ Pty Ltd).
  3. CEQUA® Approved Product Information. (2020).
  4. Rhee MK & Mah FS. Clinical utility of cyclosporine (CsA) ophthalmic emulsion 0.05% for symptomatic relief in people with chronic dry eye: a review of the literature. Clin Ophthalmol 11. (2017).
  5. Goldberg DF & et al. A Phase 3, Randomized, Double-Masked Study of OTX-101 Ophthalmic Solution 0.09% in the Treatment of Dry Eye Disease. Ophthalmology 126(9), 1230-1237. (2019).
  6. Tauber J & et al. A Phase II/III, randomized, double-masked, vehicle-controlled, dose-ranging study of the safety and efficacy of OTX-101 in the treatment of dry eye disease. Clinical ophthalmology (Auckland, N.Z.) 12, 1921-1929. (2018).
  7. How to use Cequa, https://www.cequa.com/how-to-use. (2023).