Can Restasis and Xiidra be used together?
Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on April 23, 2020.
Xiidra (lifitegrast ophthalmic solution) and Restasis (cyclosporine ophthalmic emulsion) are both prescription eye drops used to increase tear production in patients with dry eye disease (keratoconjunctivitis sicca). These drugs are used to treat dry eye disease and lessen inflammation.
These treatments work in different ways, although both target T cells which are key contributors to the cause of chronic dry eye. You should not use them together unless directed to do so by your doctor.
How do dry eye disease medicines work?
In patients whose tear production is thought to be reduced due to eye inflammation associated with dry eye disease, Restasis is thought to act as a partial immunomodulator (an agent that modifies the immune response). Exactly how Restasis works is not known; it is classified as a calcineurin inhibitor.
Xiidra also targets inflammation due to dry eyes. It works by blocking a protein on the surface of cells that can cause your eyes to not produce enough tears or produce tears that are not the right consistency. Xiidra is classified as a lymphocyte function-associated antigen-1 (LFA-1) antagonist and is the first medication in this new class of drugs.
Both Restasis and Xiidra are associated with side effects. Burning, stinging and eye irritation can be common. Discuss these side effects with your doctor before starting treatment.
- Restasis can lead to a temporary burning sensation in your eye. Other side effects can include eye redness, watery eyes or eye discharge, eye pain, foreign body sensation, itching, stinging, and blurred vision.
- Xiidra side effects include eye irritation, discomfort or blurred vision when the drops are applied to the eyes, and an unusual taste sensation.
- Using these drugs together may magnify these side effects.
What causes dry eye disease?
Chronic dry eye is a long-lasting disease that can be caused by:
- older age
- wearing contacts
- some types of medications such as antihistamines, decongestants, or blood pressure medications
- medical conditions such as rheumatoid arthritis, diabetes and thyroid problems
- eye diseases
- reduced tear production due to inflammation
- environmental factors, such as smoke, wind or dry air
- failure to blink while using electronics can lower tear production
Only use Xiidra and Restasis together if your doctor has recommended this treatment. Both drugs are used to treat dry eye disease and inflammation and you would not usually need to combine them.
Both Xiidra and Restasis can be linked with similar side effects such as burning, stinging and eye irritation. Using them together may worsen these side effects.
Chronic dry eye is a common disorder often due to older age or eye inflammation, but treatments can relieve symptoms.
- Xiidra [package insert].East Hanover, New Jersey: Novartis Pharmaceuticals Corporation, 2019. https://www.novartis.us/sites/www.novartis.us/files/xiidra.pdf
- Restasis [package insert]. Irvine, California: Allergan, 2019. https://media.allergan.com/actavis/actavis/media/allergan-pdf-documents/product-prescribing/Combined-Restasis-and-MultiDose-PI_8-3-17.pdf
- Pflugfelder SC, de Paiva CS. The Pathophysiology of Dry Eye Disease: What We Know and Future Directions for Research. Ophthalmology. 2017;124(11S):S4–S13. doi:10.1016/j.ophtha.2017.07.010
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