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What is the difference between Cequa and Restasis?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on July 28, 2022.

Official answer


Both Cequa and Restasis are prescription eye drops that contain cyclosporine and are used to increase tear production in patients with dry eye disease (keratoconjunctivitis sicca). However, Cequa incorporates a novel nanomicellar technology of cyclosporine A to allow delivery of high concentrations of the medication into the eye, whereas Restasis is not manufactured using nanomicellar technology.

Nanomicellar technology can also help deliver poorly water-soluble drugs into the eye and protect the drug molecule.

Cequa (cyclosporine ophthalmic solution 0.09%) from Sun Pharma, and Restasis (cyclosporine ophthalmic emulsion 0.05%) from Allergan, are both classified as calcineurin inhibitor immunosuppressants and are in the same drug class.

Dry eye disease occurs when the amount or quality of tears fails to keep the surface of the eye properly lubricated, causing irritation, redness or a scratchy feeling like something is in the eye. The risk of developing dry eye disease increases with age, and is more common in women than in men.

Which works better - Cequa or Restasis?

In studies, both Cequa and Restasis showed a significant effect in reducing dry eye disease.

  • In clinical studies in 1,048 patients, roughly 17% of Cequa-treated patients compared to about 9% of vehicle-treated patients demonstrated increases of ≥10 mm from baseline in Schirmer wetting of the eye (the primary endpoint) at about 3 months, a significant effect.
  • Restasis also showed significant increases in Schirmer wetting (15% of patients) versus the vehicle (5% of patients) at 6 months in clinical trials of 1,200 patients.
  • A vehicle is a usually inactive substance use to help carry a medicine, in this case a solution for the active eye medicine. The Schirmer's test can help to diagnose whether your eye produces enough moisture and tears.

How do side effects compare between Cequa and Restasis?

Eye pain or burning when you place the eye drop in your eye is the most common side effect with either Cequa or Restasis, but it does not happen with everyone.

Cequa was reported to cause eye pain in 22% of patients (22 of every 100 patients). Cequa is also noted to cause conjunctival hyperemia (eye redness) in 6% of study participants. Other side effects reported in 1% to 5% of patients were blepharitis (eyelid inflammation or swelling), eye irritation, headache, and urinary tract infection.

Restasis caused burning upon instillation of the eye drop into the eye in 17% of patients in studies. Other reactions reported with Restasis in 1% to 5% of patients included conjunctival hyperemia (eye redness), eye discharge, epiphora (tear overflow), eye pain, foreign body sensation, pruritus (itching), stinging, and visual disturbance (most often blurring).

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


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