Medications (restasis/xiidra) for dry eye

Medications are an additional treatment option for patients suffering from dry eye.

Amplify EyeCare Manhattan

Medications remain an effective tool for treating dry eye. Two of the biggest brand names in that group are Restasis and Xiidra. What are each of these medications best at, and what other important information about them is there to know? Keep reading to find out.

Restasis vs. Xiidra: What is the Difference?

Both Restasis and Xiidra are eye drop medications meant to be used daily to keep dry eyes lubricated.

Restasis, manufactured by Allergan and also known by its generic name, cyclosporine, was approved by the FDA in 1983. It works by regulating the inflammatory processes in the eyes which can impact tear production and lead to dry eye.

It is recommended to use Restasis twice daily, or every 12 hours. It can take up to 3 months to experience relief from symptoms with Restasis, and in some cases it can take as long as 6 months.

Xiidra, also known by its generic name, lifitegrast, is manufactured by Shire and was approved by the FDA in 2016. It is classified as a different type of medication known as lymphocyte function-associated antigen 1 (LFA-1) antagonists. While it is not known exactly how it works, it is believed to decrease inflammation and increase tear production through the blocking of a protein called LFA-1 from interacting with another protein in the eyes called ICAM-1.

Xiidra is also to be used twice daily (12 hours apart), and has been found to help relieve dry eye symptoms within two weeks. However, it can take as many as six to 12 weeks for some patients to experience complete relief from symptoms.

Restasis vs. Xiidra: What is the Difference?
Uses for Restasis and Xiidra

Uses for Restasis and Xiidra

Both Restasis and Xiidra are used as long-term treatments for dry eye through the reduction of inflammation on the surface of the eyes and increasing tear production. Along with dryness, both of these medications can relieve other dry eye symptoms, including redness, blurry vision, itchiness, and eye fatigue.

Uses for Restasis and Xiidra

Restasis and Xiidra: Which is More Effective?

At present, there are no clinical trials which directly compare the effectiveness of Restasis against Xiidra. However, clinical trials have found both of these effective when compared to placebo.

Your doctor will be best able to recommend which medication might work best for you.

Restasis is typically covered by insurance, while Xiidra is not, so that might also factor into decisions on which to take.

Side Effects

As with all medications, there are both common and rare side effects for both Restasis and Xiidra.

Common side effects of Restasis include redness and irritation of the eyes, along with blurry vision.

Common side effects of Xiidra include redness and irritation of the eyes, eye discharge, blurry vision, and headaches. It can also lead to an unusual taste in the mouth, referred to as dysgeusia.

Serious side effects of both include hypersensitivity reactions, including itching, rash, swelling, and shortness of breath.

Restasis vs. Xiidra: What is the Difference?
Uses for Restasis and Xiidra

Drudge Interactions of Restasis and Xiidra

There have not been significant drug interactions reported with either Restasis or Xiidra.Generally speaking, other medical eye drops should be avoided while using either Restasis or Xiidra, unless directed by your healthcare provider. If you are considering taking either of these medications, be sure to tell your doctor about other medications you are taking, including prescriptions, vitamins, and herbal supplements.

Common Questions

There are several different ways you can clean your eyelids for dry eyes, one method is to use OcuSoft lid scrubs (or you can use any other brand lid scrubs). These scrubs are packaged in a pre-moistened pad. First you should wash and clean your hands, then fold the Ocusoft pre-moistened pad over your index finger, close your eyes, and then gently scrub your eyelid with your index finger using side to side strokes. Then rinse your eyes with water and repeat the same for the other eyelid. Another method of cleaning your eyelids is using Avenova Antimicrobial lid and lash Solution. First wash your hands prior to application and be sure to remove any make-up or lotions around your eyes. Apply the spray to a cotton pad (or you can also apply the spray directly onto your eyelids with your eyes closed). Then close your eyes and using a horizontal motion wipe the base of all the upper lid lashes at least 3 times, applying to the base of your eyelashes along the lid margin. Then look up and wipe the base of the lower lashes with a horizontal motion at least 3 times, applying to the base of your eyelashes along the lid margin. Then with a new cotton pad repeat on the other eye.
When you have dry eyes this sends out a signal to your lacrimal gland to produce more tears, but then this results in an overproduction of tears causing tearing/watery eyes. The overproduction of tears is called reflex tearing. Your body is trying to counteract your dry eyes, so it then starts to produce more tears, but then it ends up flooding your eyes with too much tears, resulting in a vicious cycle of dry and then teary eyes. That is why it’s important to deal with the root of the cause of the tearing, which is your dry eyes, to stop this sequence of events from happening. But it’s important to also note that watery eyes can be caused by other conditions as well, so be sure to get a thorough evaluation by your eye doctor to determine the proper diagnosis and treatment.
Depending on the severity of your dry eyes there are different eye drops we would recommend. If you have the milder version of dry eyes then over the counter artificial tears such as Systane Balance or Refresh Optive Artificial Tears may be sufficient enough to help relieve your symptoms of dry eyes. However, if you have more moderate/severe dry eyes a more viscous drop such as a gel drop or ointment may be more beneficial. In the event that over the counter eye drops are not providing much relief, there are other various prescription eye drops that your eye doctor can prescribe, such as Restasis or Cequa or Xiidra. Dry eye is a multifactorial disease of the ocular surface, and one component that causes dry eyes is ocular surface inflammation and damage; so Xiidra and Restasis/Cequa work by regulating the inflammatory processes in the eye that can affect tear production.
Medications (restasis/xiidra) for dry eye
Dr. Wernick cartoon

Summary

Restasis and Xiidra are two prescription eye drops for dry eye which have been found to be effective at treating its symptoms. If you have additional questions, or think either Restasis or Xiidra might be helpful for treating your dry eye symptoms, you can contact Amplify EyeCare Manhattan at (212) 752-6930. Patients with dry eyes visit our clinic from all over New York, and we are proud to be a leading provider of dry eye care for patients from New York, Queens, Brooklyn, and Long Island.

Testimonials


At Amplify with Dr Wernick I was seeking help for seemingly intractable, probably age-related dryness. I've seen other doctors about it, and that has been helpful, but what he explained to me about it and the careful way he answered all my questions gave me so much more of a clear understanding of what is going on (and is not) that I am more able to implement all his and others' recommendations than I was before. And he gave me additional resources for further follow-up. I am most grateful.


Cynthia Norton

Wow! This is a great Eye Care medical facility. I was thoroughly examined by Dr. Pinkhasov for over 2 hours. She made sure to check my eyes for pretty much everything and patiently explained proper care for my eyes. They definitely know how to provide great care and treat their patients right. Now I know why they have such a great reputation and been around for so long.


Steve Fay

Dr. Kavner is a gifted diagnostician and orthoptic therapist. He treated me several decades ago for a condition similar to dyslexia. I was having migraines five times per week. I worked with him for about a year and I experienced tremendous improvement (down to 3-4 per year) that has lasted.


Mary K.

Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


Peter G.

Dr. Kavner recommended two types of eye therapy for my daughter. One of them using bio-feedback. In just three sessions she is seeing considerably better. She shouted this morning: Ooh my God! I could not see these letters with my glasses on, and now I can see them without my glasses. If you are willing and able to invest in improving your vision, this is a good place to go to!


Kinkie F.

I have always found Dr Kavner's work, expertise and wisdom of the highest caliber. As one of the fathers of OT, occupational othomology, his depth and breadth of knowledge about the eyes' health and wellbeing of the patient is exemplary. Cannot say enough good things about him.


Allen B.
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