Moxifloxacin Eye Drops (Vigamox): Dosage, Side Effects, Babies, Ointment and US Cost

Moxifloxacin eye drops (moxifloxacin ophthalmic solution 0.5%, sold in the US as Vigamox and as generics) are a prescription fluoroquinolone antibiotic for bacterial conjunctivitis. This guide covers what the US labels say: the dose, the older twice daily version (Moxeza, now discontinued), how to use the drops, side effects, warnings, use in pregnancy and in newborns, why the eye drops carry no boxed warning while moxifloxacin tablets do, how moxifloxacin compares with the other fluoroquinolone eye drops, the moxifloxacin eye ointment question, and what a bottle costs US pharmacies.

Every dose, warning and number below comes from current US labels on DailyMed, Drugs@FDA records via openFDA, and the CMS NADAC price survey, all opened on 3 November 2026 (sources at the end of this page). Your prescriber may give a different schedule; follow the prescription.

Moxifloxacin eye drops at a glance

Item	What the US label says (Vigamox and its generics)
Active ingredient	Moxifloxacin 0.5% (5 mg per mL, from 5.45 mg moxifloxacin hydrochloride), an 8-methoxy fluoroquinolone
Preservative	None listed. Vigamox inactives: boric acid, purified water and sodium chloride
Labeled use	Bacterial conjunctivitis caused by susceptible strains of listed bacteria
Dose	One drop in the affected eye 3 times a day for 7 days
Contraindication	History of hypersensitivity to moxifloxacin, to other quinolones, or to any component
Children	Safety and effectiveness established in all ages, including neonates
Boxed warning	None on the eye drop label
US bottle	3 mL (Vigamox: 3 mL in a 4 mL bottle; generics: 3 mL, bottle size varies by maker)
Storage	2 to 25 C (36 to 77 F)
Status	Prescription only in the US

What moxifloxacin eye drops treat

The Vigamox label has one indication: bacterial conjunctivitis caused by susceptible strains of these organisms.

• Gram-positive: Corynebacterium species*, Micrococcus luteus*, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus haemolyticus, Staphylococcus hominis, Staphylococcus warneri*, Streptococcus pneumoniae and the Streptococcus viridans group.
• Gram-negative: Acinetobacter lwoffii*, Haemophilus influenzae and Haemophilus parainfluenzae*.
• Other: Chlamydia trachomatis.

* The label notes that efficacy for these organisms was studied in fewer than 10 infections.

Moxifloxacin blocks two bacterial enzymes, DNA gyrase (topoisomerase II) and topoisomerase IV, which bacteria need to copy, repair and divide their DNA. The label says there is no cross-resistance between moxifloxacin and macrolides, aminoglycosides or tetracyclines, but cross-resistance has been seen between systemic moxifloxacin and some other quinolones. In practice, if one fluoroquinolone drop has failed, a second one may not help. The drops do nothing for viral, fungal or allergic eye problems.

Unlike ofloxacin and ciprofloxacin eye drops, moxifloxacin eye drops have no US indication for corneal ulcers. Any use beyond conjunctivitis is a decision for an eye doctor.

Do you need antibiotic eye drops for pink eye?

Often not. Pink eye can be viral, bacterial or allergic, and many bacterial cases settle on their own. A 2023 Cochrane review (21 randomized trials, 8,805 people) pooled clinical cure from 5 trials (1,474 people): 55.5% on placebo had clinical resolution by days 4 to 9, against 68.2% on an antibiotic, a relative improvement of 26% (moderate certainty). Our antibiotic eye drops guide covers when pink eye is likely to need an antibiotic and how the antibiotic classes compare. This page stays with moxifloxacin.

Moxifloxacin eye drops dosage

The Vigamox label and the generic labels from Apotex, Aurobindo and Lupin (three times daily formula) give the same schedule:

Product	Dose	Course
Vigamox and its generics	One drop in the affected eye 3 times a day	7 days
Twice daily formula (generic of Moxeza)	One drop in the affected eye(s) 2 times daily	7 days

That is a short, fixed course: 21 drops per treated eye on the three times daily schedule. Unlike ofloxacin or ciprofloxacin drops, there is no loading phase of extra doses in the first two days. Space the doses through the waking day, and finish the course your prescriber sets even if the eye looks better after two or three days.

Do not swap between the two formulas without being told to. They are not rated as interchangeable with each other (see the next section).

The twice daily version: Moxeza and its generic

Moxeza (NDA 022428) was a second moxifloxacin 0.5% eye drop, made thicker with xanthan gum and dosed twice daily. Drugs@FDA lists Moxeza as discontinued, with Harrow Eye as the current application holder. A generic of it is still sold: Lupin's moxifloxacin ophthalmic solution USP (ANDA 204079), which Drugs@FDA lists as the reference standard for that formula, with a therapeutic equivalence code of AT2. Vigamox and its generics carry AT1. Different codes mean the two formulas are not rated as substitutes for each other.

Item	Vigamox type (three times daily)	Moxeza type (twice daily)
Dose	1 drop 3 times a day, 7 days	1 drop 2 times daily, 7 days
Inactives	Boric acid, sodium chloride, water	Boric acid, sodium chloride, sorbitol, tyloxapol, xanthan gum, water
pH	About 6.8	About 7.4
Youngest age on the label	All ages, including neonates	Not established below 4 months
Contraindications	Hypersensitivity to moxifloxacin, other quinolones or components	None
Extra warning	None	Not for intracameral use or injection; corneal endothelial damage and toxic anterior segment syndrome
Bottle	3 mL	3 mL in a 5 mL bottle (Lupin)

Vigamox vs generic moxifloxacin eye drops

Vigamox (NDA 021598) was approved on 15 April 2003 and is now held by Harrow Eye. Its generics contain the same 0.5% moxifloxacin at the same dose. The labels we opened from Apotex, Aurobindo and Lupin list the same three inactive ingredients as Vigamox (boric acid, sodium chloride and water, with pH adjusters). Drugs@FDA rates these generics AT1, which means therapeutically equivalent to Vigamox.

Drugs@FDA lists 10 abbreviated applications for moxifloxacin eye drops with a prescription marketing status as of 3 November 2026, from Apotex, Alembic, Eugia, Gland, Lupin (two, one for each formula), Mankind, Regcon, Somerset and Upsher-Smith. Sandoz also sells a moxifloxacin ophthalmic solution under the Vigamox application itself. Three other generic approvals are listed as discontinued.

How to put in moxifloxacin eye drops

1. Wash your hands. Take out contact lenses (see the contact lens section).
2. Tilt your head back and pull the lower lid down gently to make a small pocket.
3. Hold the bottle over the eye and squeeze one drop into the pocket.
4. Close the eye gently. Wipe away any excess with a clean tissue.
5. Do not let the dropper tip touch the eye, your fingers or any surface. The label says this is to avoid contaminating the contents.
6. Replace the cap. If you use other eye drops too, ask your pharmacist how far apart to space them.

Use a separate bottle for each person. Do not share drops, and do not keep an opened bottle to treat a future red eye.

What the label trials showed

The labels describe three sets of trials. They were run separately and with different designs, so their numbers should not be compared head to head.

Trial (formula)	Design	Result
Vigamox, two trials in bacterial conjunctivitis	Randomized, double-masked, controlled; 3 times a day for 4 days	Clinical cure on day 5 to 6: 66% to 69%. Eradication of baseline bacteria: 84% to 94%
Vigamox, newborns (birth to 31 days)	Randomized, double-masked, against another anti-infective	Clinical cure on day 9: 80%. Eradication on day 9: 92%
Twice daily formula vs vehicle	Randomized, double-masked, vehicle-controlled	Clinical cure on day 4: 63% (265 of 424) vs 51% (214 of 423). Eradication on day 4: 75% (316 of 424) vs 56% (237 of 423)

The vehicle arm matters. Half of the people on the drop without any antibiotic (51%) were cured by day 4, which fits the Cochrane finding that many bacterial infections clear on their own. The antibiotic added 12 percentage points of cure at day 4 in that trial. Both labels add that eradication of bacteria does not always match the clinical result.

How much moxifloxacin reaches the blood

Very little. In healthy adults using Vigamox in both eyes 3 times a day, the mean steady-state peak plasma level was 2.7 ng/mL and the AUC was 41.9 ng·hr/mL. The label says these were 1,600 and 1,100 times lower than after a therapeutic 400 mg oral dose. The plasma half-life was estimated at 13 hours.

For the twice daily formula, the label puts the peak plasma level at about 0.02% of the level reached with an oral 400 mg tablet (4.5 mcg/mL), with an average steady-state AUC over 12 hours of 8.17 ng·h/mL.

Low blood levels are the reason the eye drop labels carry none of the systemic warnings found on moxifloxacin tablets (covered below). They are not a reason to use the drops more often than prescribed.

Moxifloxacin eye drops side effects

The Vigamox label does not give a table of rates by event. It gives ranges:

Type	Reported events	Frequency on the label
Eye (most frequent)	Conjunctivitis, decreased visual acuity, dry eye, keratitis, eye discomfort, eye redness (hyperemia), eye pain, eye itching, bleeding under the conjunctiva, tearing	About 1% to 6% of patients
Outside the eye	Fever, increased cough, infection, ear infection (otitis media), sore throat (pharyngitis), rash, runny nose (rhinitis)	1% to 4%
Twice daily formula (1,263 patients aged 4 months to 92 years)	Eye irritation, fever (pyrexia), conjunctivitis	1% to 2%

The label lists the events outside the eye as adverse events reported in the trials; it does not say the drops caused each of them. Blurred vision that does not clear, increasing pain or a worsening eye should be checked.

Allergic reactions: when to stop the drops

The label warns that serious and occasionally fatal hypersensitivity (anaphylactic) reactions have been reported in people taking systemically administered quinolones, including moxifloxacin, some after the first dose. Reactions included cardiovascular collapse, loss of consciousness, swelling of the throat or face, airway obstruction, shortness of breath, hives and itching.

The patient instructions say to stop the drops immediately and contact your physician at the first sign of a rash or allergic reaction. Swelling of the face or throat, or trouble breathing, needs emergency help. If you have ever reacted to any quinolone (ciprofloxacin, levofloxacin, ofloxacin and others), Vigamox and its generics are contraindicated.

Warnings: long use and not for injection

• Resistant organisms: prolonged use may result in overgrowth of non-susceptible organisms, including fungi. If a superinfection occurs, the label says to discontinue use and start other therapy. Your doctor may examine the eye with a slit lamp and fluorescein stain.
• Not for injection into the eye: the twice daily label states "NOT FOR INTRACAMERAL USE OR INJECTION" and says moxifloxacin ophthalmic solution will cause damage to the corneal endothelium if introduced directly into the anterior chamber of the eye. It also reports toxic anterior segment syndrome (TASS) after intraocular moxifloxacin. This is a warning for surgeons and compounders, not for normal use of drops on the eye surface.

Contact lenses and moxifloxacin drops

The label is short: patients should be advised not to wear contact lenses if they have signs or symptoms of bacterial conjunctivitis. In practice that means no lenses while the eye is infected and being treated. A red, painful eye in a contact lens wearer can be a corneal infection rather than conjunctivitis, and it needs an eye examination the same day.

Pregnancy and breastfeeding

Pregnancy. The Vigamox label says: "There are no adequate and well-controlled studies with VIGAMOX in pregnant women to inform any drug-associated risks." It adds that oral moxifloxacin in pregnant rats and monkeys, and intravenous moxifloxacin in pregnant rabbits, during organogenesis "did not produce adverse maternal or fetal effects at clinically relevant doses." Effects appeared only at much higher exposures, from 277 times the human AUC from the eye dose in rats; in rabbits, at 1,086 times, a dose that also caused maternal weight loss and death.

Breastfeeding. There are no data on moxifloxacin in human milk after eye use. Moxifloxacin passes into milk in rats after oral dosing. The label says systemic levels after eye use are low, and that "the developmental and health benefits of breastfeeding should be considered along with the mother's clinical need for VIGAMOX and any potential adverse effects on the breastfed child." Tell your prescriber if you are pregnant or breastfeeding.

Children, newborns and older adults

The Vigamox label, like the ciprofloxacin eye drop label, establishes safety and effectiveness in all ages. The label cites trials in adults, children and neonates, including a trial in babies from birth to 31 days old. It also says there is no evidence that eye use has any effect on weight bearing joints, even though some oral quinolones cause joint damage in young animals.

The twice daily formula is different: its label says safety and effectiveness below 4 months of age have not been established.

Any newborn with red, sticky eyes needs to be seen by a doctor before any drops are used. For older adults, the label says no overall differences in safety and effectiveness have been observed between elderly and younger patients.

Drug interactions

The label says drug interaction studies have not been conducted with Vigamox. In laboratory studies moxifloxacin did not inhibit the liver enzymes CYP3A4, CYP2D6, CYP2C9, CYP2C19 or CYP1A2, so the label says it is unlikely to alter the levels of medicines broken down by them. With blood levels this low, interactions from the drops are not expected. Mention all your eye drops to your pharmacist, mainly so they can be spaced apart.

No boxed warning on the eye drops: the tablets are different

The Vigamox label, and every generic eye drop label we opened, has no boxed warning. Moxifloxacin tablets (400 mg) do. The current US label for moxifloxacin tablets carries a boxed warning for serious adverse reactions including tendinitis, tendon rupture, peripheral neuropathy, central nervous system effects and exacerbation of myasthenia gravis. It says these reactions can be disabling and potentially irreversible. It says to avoid moxifloxacin in people with a known history of myasthenia gravis, and to reserve the tablets for patients with no alternative treatment options for acute bacterial sinusitis and acute bacterial exacerbation of chronic bronchitis.

Those warnings belong to the oral product, whose blood levels are more than a thousand times higher. They are not on the eye drop label. The reverse also holds: tablets are not a treatment for pink eye. Our Moxiflox 400mg listing is an oral tablet for systemic infections under a prescriber's care, not an eye product.

Moxifloxacin vs other fluoroquinolone eye drops

Drop (US label)	Conjunctivitis dose	Youngest labeled age	Corneal ulcer indication
Moxifloxacin 0.5% (Vigamox)	1 drop 3 times a day, 7 days	All ages, including neonates	No
Moxifloxacin 0.5% twice daily	1 drop 2 times daily, 7 days	4 months	No
Ofloxacin 0.3% (Ocuflox)	1 to 2 drops every 2 to 4 hours on days 1 and 2, then 4 times daily to day 7	1 year	Yes
Ciprofloxacin 0.3%	1 or 2 drops every 2 hours while awake for 2 days, then every 4 hours while awake for 5 days	All ages	Yes
Gatifloxacin 0.5% (Zymaxid)	Day 1: every 2 hours while awake, up to 8 times; days 2 to 7: 2 to 4 times daily	1 year	No
Besifloxacin 0.6% (Besivance)	Shake once; 1 drop 3 times a day, 4 to 12 hours apart, 7 days	1 year	No

Moxifloxacin's main practical advantages on paper are the simple 3 times daily schedule, no preservative listed among Vigamox's ingredients, and a label that covers newborns (as the ciprofloxacin label also does). Ciprofloxacin and ofloxacin are the fluoroquinolone drops with a US corneal ulcer indication. No trial on these labels compares the drops head to head, so the table is not a ranking of which works best. Our ofloxacin eye drops guide covers ofloxacin in detail, and the prescription eye drops guide maps the other eye drop classes.

Moxifloxacin eye ointment: no US approved version

Drugs@FDA lists moxifloxacin for the eye only as an ophthalmic solution (drops). There is no FDA approved moxifloxacin eye ointment, so no US label sets a dose, an age limit or safety data for one.

That matters for our own listing. Our listed product Mosi Eye Ointment (moxifloxacin, FDC Ltd, 5 g tube) is an ointment sold in India, not the same product as Vigamox drops. The Vigamox dose, trial results and age range above do not transfer to it. Use it only as directed by your prescriber and the leaflet in the pack. Our listing gives the tube size but not the moxifloxacin concentration, so check the strength printed on the tube.

FDC Ltd does hold a US approval for moxifloxacin eye drops (ANDA 219475, approved 4 August 2025), but Drugs@FDA now lists it as discontinued. That approval covers drops, not the ointment we sell.

Is moxifloxacin available over the counter?

No. Drugs@FDA lists Vigamox and all marketed moxifloxacin eye drop generics with a prescription marketing status. In the US you need a prescription, usually after an exam that separates bacterial from viral or allergic pink eye. Over the counter "red eye" drops are not antibiotics and do not treat a bacterial infection.

Approval history and US status

Product	Application	Approved	Status on Drugs@FDA
Vigamox (Harrow Eye)	NDA 021598	15 April 2003	Prescription
Moxeza (Harrow Eye)	NDA 022428	19 November 2010	Discontinued
Lupin generic, three times daily	ANDA 202867	4 September 2014	Prescription
Lupin generic, twice daily	ANDA 204079	28 May 2015	Prescription
Apotex generic	ANDA 090080	30 June 2017	Prescription

Moxifloxacin itself was first approved in the US as Avelox tablets (NDA 021085, 10 December 1999). Oral and intravenous moxifloxacin are separate products with their own labels.

What moxifloxacin eye drops cost in the US

The CMS NADAC survey records what US retail pharmacies pay for drugs. It is an acquisition cost, not the price at the counter, which adds the pharmacy's dispensing fee and margin. The rates below are the latest in the CMS file dated 4 November 2026. Generic rates took effect on 21 October 2026; the Vigamox rate took effect on 17 June 2026 and is still current.

Product	Bottle	NADAC per mL	Per bottle
Moxifloxacin 0.5% eye drops (generic, 10 NDCs)	3 mL	$1.66499	$4.99
Vigamox 0.5% eye drops (brand, 2 NDCs)	3 mL	$31.80800	$95.42

A brand bottle costs pharmacies about 19 times as much as a generic one. The ten generic NDCs include Apotex 60505-0582-4, Aurobindo 65862-0840-03, Lupin 68180-0422-01 and the Sandoz bottle sold under the Vigamox application (0781-7135-93), each a 3 mL bottle on its label. NADAC has no separate row for Moxeza or for Lupin's twice daily generic.

Fluoroquinolone eye drop	Type	US label bottle	NADAC per mL	Per bottle
Moxifloxacin 0.5%	Generic	3 mL	$1.66499	$4.99
Ofloxacin 0.3%	Generic	5 mL	$1.22968	$6.15
Ciprofloxacin 0.3%	Generic	5 mL	$1.47777	$7.39
Gatifloxacin 0.5%	Generic	2.5 mL	$9.46564	$23.66
Vigamox (moxifloxacin)	Brand	3 mL	$31.80800	$95.42
Besifloxacin 0.6%	Generic	5 mL	$33.67760	$168.39
Besivance (besifloxacin)	Brand	5 mL	$44.10026	$220.50

Per bottle is the per mL rate times the bottle size. Ofloxacin and ciprofloxacin also come in 10 mL bottles at lower per mL rates ($1.10143 and $0.87407). At the label bottle sizes, generic moxifloxacin has the lowest per bottle cost in this group, partly because its 3 mL bottle is smaller than the 5 mL ofloxacin and ciprofloxacin bottles. What you pay at a US pharmacy will be higher than NADAC and depends on your insurance.

Our moxifloxacin eye product and prices

We do not sell a moxifloxacin eye drop that matches Vigamox. Our moxifloxacin eye product is the Mosi ointment described above. Prices from our product listing as of 3 November 2026, before shipping:

Product	Pack	Price	Per tube
Mosi Eye Ointment (moxifloxacin, FDC Ltd, 5 g)	1 tube	$5.00	$5.00
Mosi Eye Ointment	3 tubes	$14.00	$4.67
Mosi Eye Ointment	6 tubes	$25.00	$4.17

Other antibiotic eye products we list include Oflox Eye Drop (ofloxacin), Besix Eye Drops (besifloxacin), Zaha Eye Drop (azithromycin), Azithral Eye Ointment (azithromycin) and Toba Eye Drop (tobramycin).

Our shipping page lists standard registered shipping at a $25 flat rate, free on orders of $149 or more, with delivery in 7 to 14 business days to the US. One tube of Mosi therefore costs $30.00 delivered, against about $4.99 that a US pharmacy pays for a generic moxifloxacin bottle. An eye infection needs treatment within days, not weeks. For one infection, a US prescription filled locally is faster and usually cheaper. Please do not keep spare tubes to treat future red eyes without an exam.

Importing eye medicines into the US

Mosi Eye Ointment is not an FDA approved product. The FDA's personal importation page says: "In most circumstances, it is illegal for individuals to import drugs or devices into the U.S. for personal use" and "If a drug is approved for use in another country but is an unapproved new drug in the U.S. it is illegal to import." The same page describes limited situations in which FDA personnel may consider a more permissive decision. Check your own situation before ordering. Our guide to eye drop recalls and checking your bottle explains what to look at when a product arrives.

When to see a doctor about an eye infection

• Eye pain, blurred vision that does not clear with blinking, strong sensitivity to light, or a white spot on the clear front of the eye: these can be signs of a corneal infection and need same-day eye care.
• Any red, painful eye in a contact lens wearer.
• A newborn with red or sticky eyes.
• A rash, hives, swelling of the face or throat, or trouble breathing after a dose: stop the drops and get emergency help.
• No improvement after a few days, or a worsening eye: the label warns of overgrowth of non-susceptible organisms, including fungi.
• Red eyes with a cold, itch or watery discharge in both eyes: often viral or allergic, which an antibiotic will not treat.

Sources

• VIGAMOX (moxifloxacin ophthalmic solution) 0.5%, US prescribing information, Harrow Eye (DailyMed, published 26 January 2026). DailyMed
• Moxifloxacin ophthalmic solution USP 0.5%, Apotex Corp., US prescribing information. DailyMed
• Moxifloxacin ophthalmic solution 0.5%, Aurobindo Pharma, US prescribing information. DailyMed
• Moxifloxacin ophthalmic solution USP 0.5%, Lupin (three times daily), US prescribing information. DailyMed
• Moxifloxacin ophthalmic solution USP 0.5%, Lupin (twice daily formula), US prescribing information, revised November 2024. DailyMed
• Moxifloxacin hydrochloride tablets 400 mg, US prescribing information (American Health Packaging). DailyMed
• OCUFLOX (ofloxacin ophthalmic solution) 0.3%, US prescribing information. DailyMed
• Ciprofloxacin ophthalmic solution 0.3%, Advagen, US prescribing information. DailyMed
• ZYMAXID (gatifloxacin ophthalmic solution) 0.5%, US prescribing information. DailyMed
• Besifloxacin ophthalmic suspension 0.6%, US prescribing information. DailyMed
• US Food and Drug Administration, Drugs@FDA via openFDA: moxifloxacin hydrochloride applications (32 records), queried 3 November 2026. Drugs@FDA
• Chen YY, et al. Antibiotics versus placebo for acute bacterial conjunctivitis. Cochrane Database Syst Rev. 2023. PMID 36912752. PubMed
• Centers for Medicare and Medicaid Services, National Average Drug Acquisition Cost (NADAC) 2026, file dated 4 November 2026. data.medicaid.gov
• US Food and Drug Administration, Personal Importation (content current as of 18 August 2025). FDA

This page is for information and is not medical advice. Moxifloxacin eye drops and ointment are prescription medicines; a clinician should confirm a bacterial infection and set your treatment.