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How does Xiidra differ from OTC dry eye treatments?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Jan 22, 2024.

Official answer

by drugclasses.com

Key Points

Xiidra ophthalmic solution contains lifitegrast, a prescription medication that is classified as a lymphocyte function-associated antigen-1 (LFA-1) antagonist. Over-the-counter dry (OTC) eye products are referred to as "artificial tears" or "lubricants" and are usually made of a combination of glycerin and propylene glycol used for the temporary relief of dry eye or irritation. They do not require a prescription.

  • Xiidra is used for the treatment of the signs and symptoms of dry eye disease in adult patients 17 years and older.
  • In dry eye disease, your eyes do not make enough tears or your tears will not keep your eyes moist and lubricated.
  • The normal dose of Xiidra is one drop instilled into each eye twice daily (approximately 12 hours apart). You use this medicine every day.

Over-the-counter dry (OTC) eye products:

  • Usually contain glycerin and propylene glycol, povidone, or carboxymethylcellulose.
  • They are used for the temporary symptom relief of irritation, burning and discomfort due to dry eye. They do not increase the ability of the eyes to produce their own tears.
  • You can use artificial tears as needed or directed by your doctor, but you do not have to use them every day.

Are Xiidra and Restasis different?

Xiidra (lifitegrast ophthalmic solution) and Restasis (cyclosporine ophthalmic emulsion) are both prescription eye drops used to treat dry eye disease but they work differently.

  • Xiidra helps to reduce inflammation due to dry eyes. Xiidra is classified as a lymphocyte function-associated antigen-1 (LFA-1) antagonist.
  • It works by blocking a protein on the surface of cells that can lessen the amount of tears your eyes make or reduce the quality of your tears.
  • It can start working as quickly as 14 days, but it may take up to 12 weeks in some patients.
  • The recommended dose of Xiidra is one drop instilled into each eye twice daily (approximately 12 hours apart).

Restasis appears to act as a partial immunomodulator (an agent that modifies the immune response).

  • It is used in patients whose tear production may be caused by eye inflammation (swelling) associated with dry eye disease.
  • Exactly how Restasis works is not fully known, but it is classified as a calcineurin inhibitor.
  • It may take up to 12 weeks for Restasis to have a noticeable effect, and up to 6 months for a full effect on your dry eyes.
  • The recommended dose of Restasis is one drop instilled into each eye 2 times a day.

Do not use Xiidra and Restasis together unless your doctor has recommended this treatment for you. Both drugs are used to treat dry eye disease and you should normally not need to combine them. Using Xiidra and Restasis together may worsen side effects such as burning, stinging and eye irritation. Contact your doctor for re-evaluation of your symptoms if they are not improving.

This is not all the information you need to know about Xiidra (lifitegrast) for safe and effective use. Review the full Xiidra information here, and discuss this information and any questions you have with your doctor or other health care provider.

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References
  • Xiidra [product information]. Novartis Pharmaceuticals. East Hanover, NJ. Updated June 2020. Accessed Jan. 31, 2021 at https://www.novartis.us/sites/www.novartis.us/files/xiidra.pdf
  • Xiidra.com. Accessed Jan. 31, 2021 at https://www.xiidra.com/why-xiidra/how-does-xiidra-work
  • Restasis.com. Accessed Jan. 31, 2021 at https://www.restasis.com/about

Read next

Can you get Restasis eye drops over the counter?

No, Restasis (cyclosporine ophthalmic) eye drops require a prescription from your doctor, you cannot buy them over the counter (OTC). An optometrist or ophthalmologist are eye doctor specialists that usually prescribe this medicine. This drug is approved to treat dry eye disease. Continue reading

Are there any Restasis withdrawal symptoms?

Restasis withdrawal symptoms do not usually occur, but clinical studies have shown your persistent dry eye symptoms may return if you stop treatment. Depending upon your symptoms, you may need 3 to 6 months of Restasis treatment before your dry eyes start to improve. Restasis is typical meant for long-term use, but some patients may be able to stop treatment after 6 months. Continue reading

What is the difference between Cequa and Restasis?

Both Cequa and Restasis are eye drops that contain cyclosporine. They are used to increase tear production in patients with dry eye disease (medically called keratoconjunctivitis sicca). However, Cequa incorporates a novel nanomicellar technology of cyclosporine A to allow delivery of high concentrations of the medication into the eye. Restasis is not manufactured using nanomicellar technology. Nanomicellar technology can help deliver poorly water-soluble drugs into the eye and protect the drug molecule. Continue reading

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