Alternatives to Vigamox If You Can't Fill Your Prescription

If you've been prescribed Vigamox (moxifloxacin ophthalmic 0.5%) and can't get it filled — whether it's out of stock, too expensive, or not covered by your insurance — you have options. Several other antibiotic eye drops are well-established treatments for bacterial conjunctivitis and other ocular infections.

Important: Never switch antibiotic eye medications without consulting your doctor or eye care provider first. Different antibiotics cover different bacteria, and your prescriber needs to approve any change. This guide is meant to help you have an informed conversation with your provider.

Why Might You Need a Vigamox Alternative?

Your pharmacy is out of stock

Brand-name Vigamox is too expensive and no generic is available locally

You have a quinolone allergy and cannot take moxifloxacin

Your insurance won't cover Vigamox or generic moxifloxacin ophthalmic

Alternative #1: Ciprofloxacin Ophthalmic (Ciloxan)

Ciprofloxacin 0.3% eye drops (brand: Ciloxan) are a second-generation fluoroquinolone antibiotic and one of the most commonly prescribed alternatives. They're available in both drops and ointment form, and generic versions are widely stocked at most pharmacies.

Coverage: Broad spectrum including S. aureus, H. influenzae, and most common conjunctivitis pathogens

Dosing: Typically 1–2 drops every 2–4 hours initially, then tapered over 7 days

Cost: Generic typically $10–$30 with a discount card — often the most affordable option

Note: Ciprofloxacin drops may leave a white crystalline deposit on the eye's surface — harmless but surprising if you're not expecting it

Alternative #2: Tobramycin Ophthalmic (Tobrex)

Tobramycin 0.3% eye drops (brand: Tobrex) are an aminoglycoside antibiotic — a completely different class from fluoroquinolones. This makes tobramycin a good option if you've had a reaction to quinolones.

Coverage: Especially strong against Pseudomonas aeruginosa (important for contact lens wearers)

Dosing: 1–2 drops every 4 hours for mild-to-moderate infection; up to every 1 hour for severe

Cost: Generic available; typically $15–$40 with a discount card

Alternative #3: Besifloxacin Ophthalmic (Besivance)

Besifloxacin (Besivance) is a fourth-generation fluoroquinolone like moxifloxacin, but it was specifically developed for ophthalmic use — never used systemically. This reduces the chance of resistance developing because the bacteria have never encountered it through other routes.

Coverage: Excellent broad-spectrum including MRSA and MRSE isolates

Dosing: 1 drop 3 times daily for 7 days — similar to Vigamox

Cost: Generally more expensive than ciprofloxacin; check your insurance formulary

Alternative #4: Polytrim (Polymyxin B / Trimethoprim)

Polytrim combines two antibiotics from completely different classes, giving it broad coverage against both gram-positive and gram-negative bacteria. It's been used for decades, is inexpensive, and is widely stocked. It's not a fluoroquinolone, making it an option for patients who can't take that class.

Dosing: 1 drop every 3 hours (up to 6 times daily) for 7–10 days

Cost: One of the most affordable options — generic often $10–$20

Alternative #5: Azithromycin Ophthalmic (Azasite)

Azithromycin 1% ophthalmic solution (Azasite) is a macrolide antibiotic with anti-inflammatory properties. It has a convenient twice-daily dosing for the first two days, then once-daily for five more days — making it popular for children and patients who have difficulty adhering to frequent dosing.

Best for: Pediatric patients and adults who need simpler dosing

How to Ask for an Alternative

Call your prescriber's office and explain that Vigamox is unavailable at pharmacies near you

Mention the alternatives above — having this information ready speeds up the call

Ask them to send the new prescription directly to a pharmacy that has the alternative in stock

Before giving up on Vigamox, make sure you've exhausted availability options. Read our guide on why Vigamox can be hard to find and use medfinder to check pharmacies near you before requesting a new prescription.