Alcon releases Moxeza

MOXEZA from Alcon

Billed as "A NEW ophthalmic solution for the treatment of bacterial conjunctivitis". Well, okay. Moxeza is 0.5% moxifloxacin, which is the exact same drug in the exact same concentration as Alcon's older drug Vigamox, which has been available for quite some time. This link says the two are "formulated differently", but does not specify how they are different:

They're different?

Moxeza is to be used twice a day for bacterial conjunctivitis, whereas Vigamox was to be used 3x/day. I'm sure there is some difference in the "formulation", but I'd like to know what it is. I personally doubt they are very "different". I'm pretty cynical, right? :P


  1. Hi Dr. Prince,
    I am also a SUNY O grad ('04) and have been enjoying your blog. I found it a couple weeks ago. I have been blogging too since '08. You and I are on the same page with a lot of prescribing/treatment philosophies. Have you ever considered making a public professional profile on FB or using Twitter to promote the blog as well? I now do all three. Would love to talk to you sometime!

    Keep up the GREAT WORK and excellent writing!!!
    Cheryl G. Murphy, OD

  2. Can you talk about an eye sickness that looks like pink eye, but it's not. So, no eye pinkness, but wake up with eye glued together.

  3. its very, very difficult (impossible?) to make a diagnosis based on a description. plenty of things can cause the eye to do all sorts of weird stuff.

    ok an eye thats "glued together" in the morning, BUT NOT RED...could be allergies or a contact lens wearer it could be GPC (mentioned many times here)...there are a few other possibilities

  4. Hi,

    I don't know if anyone ever answered your question... but I was curious myself, since I'm a PharmD student.

    In any case, I found a rather satisfactory answer here under the "Place in Therapy" section.

    Based on my limited knowledge of ophthalmic dosage forms, it seems like a reasonable answer.

  5. thank you for that comment! yes, info much appreciated!

  6. from that link:

    " Moxeza differs from Vigamox in dosing regimen; twice daily for
    Moxeza compared to thrice daily for Vigamox. Additionally, Moxeza’s inactive ingredients differ
    from Vigamox. Specifically, Moxeza contains xanthan gum which increases the viscosity of the
    formulation increasing the time of residence on the eye allowing for enhanced penetration
    through the cornea. However, there are no data to support superior efficacy or safety of twice
    daily compared to thrice daily moxifloxacin"

  7. Hi Dr.Prince,
    I am an M.pharm student, I had used Moxeza the last time I had conjunctivitis. I felt the product was quite viscous in nature. I am just a little curious to know the viscosity of the product. I would be glad if you would answer my question.

  8. It's pretty viscous. Don't have any specific data

  9. After presenting w/an infectious corneal ulcer, the docs at Cal Optometry sent me home with Moxeza samples [and a consult with their supervisiing specialist the next day]. The samples expire in 4 months. Not sure anyone noticed that, but might have checked when I mentioned that the tiny bottles are not well-matched to the product's viscosity. zit is impossible to get a drop from the tip after the first opening. Close the bottle, try gain later, get nada or a great big stinging glop. My symptoms only worsened with use, every 15min then 30 then 60 for the first few days [which direction, fyi, precludes directing a patient to drive to misc. destinations for exams and Rxes. either suggest or offer transit, or consolidate services to one stop, offer protective gear for those injured and dilated pupils, and put her in a cab.]. As a bonus, the product is pretty much never in stock at any consumer-facing pharmacies; I got my Rx swapped out for Vigamox and am much relieved. No one needs the anxiety that goes along with product failure, when already hobbled by injury.

  10. sorry you had trouble, but that's not really "product failure". the expiration date should not have been a factor. 4 mo is plenty of time. apparently it's pretty viscous, tho! thanks for the comment

  11. There is a study showing moxeza has 1.8x greater concentration in the conjunctiva approx 15 minutes post dose compared to vigamox. This was in a post op setting. I believe it was in Journal of Occular Pharmacology and Therapy.
    Great Blog!
    - Dr. Z.

  12. after using it for a year with post-op's thick. a lot thicker than vigamox. patients complain about how thick it is (as did one comment above). that's probably why it has higher concentration...the stuff doesn't run out haha. it's a "glop" for sure.

  13. Since cataract surgery on April 3 I've had a "raging case" of blepharitis. No antibiotics for the first three weeks, then Azasite since. The terrible "stick in eye" feeling finally abated, but my eyelids still are swollen and uncomfortable against my eyes. Apparently there's rosacea involved, as well as the usual stopped-up glands, so my dermatologist prescribed doxycycline for that. I've just been prescribed Moxeza in place of the Azasite but haven't started it. What's been your experience with Moxeza and blepharitis?

  14. I have zero experience with moxeza for bleph b/c I've never Rx'd it for that

  15. i was just diagnosed with a corneal ulcer this afternoon and have been using the sample of moxeza i got from the doctor until i can find a pharmacy that carries it (or get a confirmation from my doctor that vigamex is ok to substitute). it's definitely viscous and the other jessica is right, it's really tough to get out of the sample size bottle… you have to hold it at an angle so the air can slowly head towards the top of the bottle and push the medicine towards the nozzle. then you can get a drip out!

    that being said… if i don't hear from her (my eye doctor) tomorrow, is it ok for me to get vigamex from the pharmacy? i don't want to go without medicine and risk an infection.


  16. Hello, I recently was told that I had two corneal ulcers and the optometrist gave me a sample of Moxeza to treat it. I only been using it for two days but I've applied it several times, around 8 times, and I just noticed that the expiration date on it was October of 2013. Do you know if it will have any effect on my eye? Should I stop using it and tell the optometrist? What should I do about this?

  17. I am a registered pharmacist in Texas and all I see here is a way to extend a patent. I see it all the time. Before a generic goes multi-source they release the "authorized generic" which is the same product in the brand package. Just spoke with Alcon and they said pH is different viscosity is different and osmolality is different giving the moxeza better efficacy with twice a day dosing. My opinion is poppycock.


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