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Clin Ophthalmol. 2019 Feb 19;13:403-413. doi: 10.2147/OPTH.S186092. eCollection 2019.

Safety of cetirizine ophthalmic solution 0.24% for the treatment of allergic conjunctivitis in adult and pediatric subjects.

Author information

Ophthalmology Associates, St Louis, MO, USA.
Apex Eye, Mason, OH, USA.
Andover Eye, Andover, MA, USA.
Ora, Inc., Andover, MA, USA.
Eyevance Pharmaceuticals, Fort Worth, TX, USA,



The studies reported here aimed to assess the safety and tolerability of cetirizine ophthalmic solution 0.24%, a new topical ophthalmic medication approved by the US Food and Drug Administration for the treatment of ocular itching associated with allergic conjunctivitis.

Patients and methods:

Three clinical studies evaluated cetirizine ophthalmic solution 0.24% administration: a Phase I prospective, single-center, open-label, pharmacokinetic (PK) study (N=11) evaluating single-dose administration and twice-daily (BID) administration for 1 week in healthy adults, and two Phase III, multi-center, randomized, double-masked, vehicle-controlled, parallel-group studies evaluating the safety and tolerability in adult and pediatric populations (2-18 years of age) for up to 6 consecutive weeks. The first safety and tolerability study evaluated cetirizine BID (study 1, N=512), while the second study examined cetirizine three times daily (TID) (study 2, N=516). Each study assessed best corrected visual acuity, slit-lamp biomicroscopy, IOP, dilated ophthalmoscopy, treatment-emergent adverse events, vital signs, urine pregnancy test, and physical examination (general health, head, eyes, ears, nose, and throat). The PK study also measured hematology, blood chemistry, and urinalysis, while the two Phase III studies additionally assessed corneal endothelial cell counts (ECC) and ECC density in a subset of subjects (via specular microscopy), and drug administration tolerability.


Bilateral administration of cetirizine ophthalmic solution 0.24% resulted in low systemic exposure in the PK study and was associated with a low incidence of mild adverse events. There were no drug-related severe or serious adverse events. The tolerability scores between the active and vehicle groups were comparable, demonstrating high comfort in the administration of cetirizine ophthalmic solution 0.24%.


Cetirizine ophthalmic solution 0.24% dosed BID or TID demonstrated an acceptable safety profile and was well-tolerated when administered to subjects aged ≥2 years.


antihistamine; ocular allergy; ocular itching; tolerability; topical administration

Conflict of interest statement

Disclosure Paul J Gomes is an employee of Ora, Inc. Mark C Jasek is an employee of Eyevance Pharmaceuticals. Zerviate is a proprietary trademark of Nicox SA and is licensed by Eyevance Pharmaceuticals. Controlled adverse environment (CAE®) and Conjunctival Allergen Challenge (Ora-CAC®) are registered trademarks of Ora, Inc.

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