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Xiidra: 7 things you should know

Medically reviewed by Carmen Fookes, BPharm. Last updated on Nov 15, 2020.

1. How it works

  • Xiidra is a brand (trade) name for lifitegrast which is a prescription medicine that may be used to treat dry eye disease.
  • Lifitegrast works by blocking a protein on the surface of leukocytes called integrin LFA-1, blocking its interaction with another molecule called cognate ligand intercellular adhesion molecule-1 (ICAM-1). This is thought to inhibit T-cell activation and adhesion to ICAM-1 which may inhibit the release of inflammatory cytokines. Put simply, lifitegrast reduces inflammation caused by dry eye disease.
  • Xiidra belongs to the class of medicines known as lymphocyte function-associated antigen-1 (LFA-1) antagonists. It may also be called an ophthalmic anti-inflammatory agent.

2. Upsides

  • May be used to treat dry eye disease in adults and adolescents aged 17 years and older.
  • Available as eye drops and one drop is to be instilled into each eye twice daily (approximately 12 hours apart). Can be used together with artificial tears (artificial tears can be instilled as needed).
  • Xiidra was the first (LFA-1) antagonist to be marketed.

3. Downsides

If you are between the ages of 18 and 60, take no other medication or have no other medical conditions, side effects you are more likely to experience include:

  • Eye irritation, stinging or redness; an unusual taste in the mouth; eye discomfort or stinging; teary or watery eyes; eye discharge; blurred vision; or sinusitis, are the most common side effects reported with Xiidra.
  • Headaches may occur in 1% to 5% of patients (1 to 5 out of every 100 patients). Migraine headaches have also been linked with dry eye disease in several studies.
  • Safety in children under the age of 17 years has not been established.
  • There is no data about the effects on the unborn baby if Xiidra is used during pregnancy. Xiidra should only be used if the benefits outweigh the risks. The concentration of Xiidra in breast milk following eye drop administration is very low and there is unlikely to be any risk to a breastfeeding infant; however, you should talk to your doctor about this if you are breastfeeding.
  • Xiidra requires a prescription and costs $522.21 for 30-days.
  • There is currently no generic version of Xiidra.

Note: In general, seniors or children, people with certain medical conditions (such as liver or kidney problems, heart disease, diabetes, seizures) or people who take other medications are more at risk of developing a wider range of side effects. View complete list of side effects

4. Bottom Line

Xiidra is a prescription eye drop that may be used to reduce inflammation associated with dry eye disease. The main side effects are eye irritation or redness and an unusual taste in the mouth. Xiidra is available in single-use containers that contain enough solution for one drop in each eye and should be discarded after one use.

5. Tips

  • Xiidra is used twice a day, about 12 hours apart. You instill one drop in each eye in the morning and one drop in each eye in the evening.
  • When installing the eye drops do not touch the tip of the single-use container to your eye or any surface, to avoid eye injury or contamination of the solution.
  • If you wear contact lenses, remove them before putting the drops in your eyes. Wait for at least 15 minutes before your contacts back in your eyes. If you have dry eye disease, ask your doctor if you should keep wearing contacts, as this may further aggravate your eyes.
  • If Xiidra is combined with other prescription eye drops, you may notice an increase in side effects such as burning, stinging, blurred vision, and eye irritation.
  • Only use Xiidra (lifitegrast ophthalmic) and other prescription eye drops together if your doctor has recommended this treatment for your chronic dry eye. Some dry eye disease eye drops may work similarly to Xiidra and you would not normally combine them. Before you start using Xiidra, be sure to tell your doctor if you are using other eye drops. Wait at least 10 minutes before using any other eye drops your doctor has prescribed.
  • Talk to your doctor before using artificial tears with Xiidra. You can find artificial tears at the pharmacy or grocery store.
  • The most common side effects of Xiidra include eye irritation, discomfort or blurred vision when the drops are applied to the eyes and an unusual taste sensation. Talk to your doctor if your side effects are severe or your dry eye has got worse after using Xiidra.
  • Xiidra comes in a carton of 60 single-use containers. Each single-use contains enough medicine for one dose (one drop in each eye). Throw away the container after one use, even if there is still some medicine left in it. Store the Xiidra eye drop containers in their original foil pouch. Keep at room temperature, 20°C to 25°C (68°F to 77°F). Store single-use containers in the original foil pouch away from moisture, heat, and light.
  • 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. While some of these factors cannot be changed, such as older age, some can (such as computer use) and you should try and modify your lifestyle so you have minimal exposure to environmental factors that can cause dry eye.
  • If you develop new or worsening headaches of any type while using Xiidra, be sure to talk to your doctor.
  • If you have commercial insurance, you may be able to lower your copay cost to as low as $5 by requesting the Xiidra iinsider®️ Savings Copay Card. Commercial insurance would be prescription coverage you get from your employer or through the Affordable Care Act.

6. Response and Effectiveness

  • Some improvement in dry eye symptoms may be noticed within two weeks of starting to use Xiidra; however, it may take up to three months for the full effects to be seen.
  • After 12 weeks an eye exam should show a definite improvement in your eye health if Xiidra is effective for you; however, not everybody who uses Xiidra experiences dry eye relief.

7. Interactions

There are currently no documented interactions with Xiidra, according to the product information.

It is possible that when Xiidra is used with other eye drops, there may be a compounding of side effects such as eye irritation, redness, or discharge. Always talk to your doctor before using other eye drops, both prescription and over-the-counter eye drops. If you are using other eye drops with Xiidra, always space them apart by about 15 minutes.

You should refer to the prescribing information for Xiidra for any updates or newly noted interactions.

References

  • Xiidra (lifitegrast). Updated 07/2020. Novartis Pharmaceuticals Corporation https://www.drugs.com/pro/xiidra.html
  • Donnenfeld ED, Perry HD, Nattis AS, et al. Lifitegrast for the treatment of dry eye disease in adults. Expert Opin Pharmacother. 2017;18(14):1517–1524. doi:10.1080/14656566.2017.1372748

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use Xiidra only for the indication prescribed.

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