a young woman putting in eye drops

Dry eyes can make life miserable. The eyes feel as though there were sand in them, and they tire easily. People may complain of blurred vision. Until recently, the first-line treatment for dry eyes was tear substitutes to lubricate the eyes. An anti-inflammatory medicine, cyclosporine (Restasis), can be helpful although it may take a long time to act. There is a mechanical approach, LipiFlow, which warms and compresses the eyelids to get the meibomian glands to secrete protective oils. What about the new drug Xiidra? How well does it work for dry eyes?

Searching for Relief for Dry Eyes:

Q. I read recently about LipiFlow treatment to provide temporary relief for dry eyes. However, my ophthalmologist quoted the treatment cost at $1000 per eye.

I am now using a new prescription medication for dry eyes. Since it is new, the prescription cost is outrageous-$500 for a 30 day supply. It’s called Xiidra. Patients are given a trial supply before purchasing.

I’ve found it works immediately. In comparison, Restasis takes months to make any difference.

New Drug Xiidra Is Pricey:

A. The FDA approved lifitegrast (Xiidra) last year as the first in a new class of drugs for dry eyes. It works by affecting the immune system to reduce inflammation (Pflugfelder et al, Journal of Ocular Pharmacology and Therapeutics, Jan/Feb. 2017). More than 2,000 adults participated in randomized controlled trials of these eye drops. Reviewers for The Medical Letter on Drugs and Therapeutics concluded that it is safe and modestly effective (JAMA, April 11, 2017).

Adverse Effects of Xiidra:

Xiidra may cause blurred vision, eye irritation, pain, itching and a peculiar taste in the mouth. The biggest drawback for this new approach is the cost. If insurance companies won’t approve or pay for these eye drops, most people will find it hard to afford them.

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  1. Millie

    My insurance pay for Restasis and Xiidra, so it varies with your insurance. Restasis is free with 90 day prescriptions and using the manufacturer card. I’ve been told Xiidra is $10 a month with insurance and Xiidra card. I used Restasis for years with good results, but it doesn’t seem to be working as well anymore. I am going to try Xiidra.

  2. Mary

    I am on the fence about Xiidra. I have been using it for 23 days. Prior to this time I used Restasis with not half of the positive results of Xiidra. Unfortunately it is not covered by Medicare so my insurance will not pay. To renew the prescription would be $509 dollars, which I simply can’t afford as a senior citizen on a fixed income. Beyond that, I have arthritis and the vials are difficult to squeeze. So I squeeze harder and waste precious drops. I often end up only treating one eye because I’ve wasted drops because I can not control the flow with the vial like the restasis vials.

    Restasis also gives you enough medication that if you mis your aim or squeeze a bit too hard there is still enough medication in one vial to treat both eyes. So onto the eye effects. My lids are quite red and one day I thought I had a sty but it was a reaction to Xiidra. I can see much more clearly which is very exciting. The drops do sting just a bit but overall if I could afford the drops I would continue use. Especially if the manufacturer improves the vial and adds a bit more medication to be sure a patient can get an adequate dose in both eyes with one vial.

  3. Judith

    Thank you, everyone, for ALL of your comments. I’m not going to even pick up my new Xiidra prescription and just tough it out. Might try flax oil capsule, but castor oil, directly into eyes? I’d like to hear more of that homeopathic remedy. My Opthamologist suggest warm compresses in the morning for about 5 minutes should help, but I don’t have all the various dianosed problems that you mentioned. I just complained about dry eyes and rubbed my eyes in front of my doctor.

    • Marilyn
      Boston, Ma.

      I have been using Xiidra for about Five months! I am so upset because I do not feel it is working for me! I feel the same way as I did on Rastasis! Goopy eyes, blurred vision! I will try it one more time, but if that doesn’t work, I do not know what I am going to use! Also they make sure that they put in just enough that you can only use them once a day instead of twice a day! They know what they are doing! Greedy!

  4. Liz

    I have been using Xiidra for about 2 years. I am retired active duty and am able to get it without a copay on base. I am very pleased with it. I had tried Restasis once and vowed never to use it again. The burning was intolerable. I have a little blurring for about 15 minutes with Xiidra and then am fine. The aftertaste is not bad and goes away fast.

    • Anne
      New Orleans

      I have done everything imaginable and nothing has worked. I am using Xiidra and I have immediately noticed the difference. No more migraines. No more red and irritated eyes. It works

  5. Paul
    New Jersey

    OK Day 1 ….. NO burning or eye irritation, NO blurred vision ( In fact I see better with more clarity ) ….. I wear contacts BTW …. weird taste and altered taste Y E S ! My eyes feel better already. My ophthalmologist uses this drug as well and says most side effects dwindle away over time as the body assimilates to the drug. Only time will tell. Like many drugs on the market each person will have different experiences and or side effects.

  6. Pat

    I am 65 yrs old and have worn contacts lenses since I was 18. I never had a day’s problem wearing lenses until recently when my eyes began to feel dry only with the lenses. So I sign up for the dry eye study with my eye doctor. She ran a million different tests on my eyes and determined that along with inflammed corneas, I have dry eye disease. I have been on Xiidra for about 3 months with no relief on my dry eyes. My left cornea is inflamed again and my eyes are too dry to wear the new lenses. I am at my wits end. Thinking of stopping the Xiidra as I don’t think it’s helping. I want to wear my lenses again but feeling as if this isn’t going to happen either. Just frustrated all the way around.

  7. Anna

    Started using Xiidra and immediately have had all the side effects: blurry, burning, and, what is most bothering me, is the terrible bitter taste for the rest of the day. Don’t know what to do: to stop or continue using drops hopefully for the better reaction?

  8. carolyn

    Horrible! I asked my doctor to let my try it since Restasis was so $$. I soon regretted it. blurred vision, burning, and the bad taste in throat. Really reduced my visual acuity and gave me bad headaches. I had LASIK in 2002 and have heard Xiidra is not good for patients like me due to thinner cornea. Suggest anyone having adverse event report them to medwatch.

  9. Carole
    Rochester, New York

    Got a free sample from eye doctor and was immediately pleased in the difference in my vision. Had them call in a prescription for me and was told that my insurance doesn’t cover it so it would cost $560 a month but I might be able to get a coupon for $75 off. I am 77 years old and get social security and still work three days a week to make ends meet after taking care of my severely disabled husband for 20 years before he passed. I have worked 42 years at a medical center and one would think that that my health insurance would be good — so much for the ACA.

  10. Peter Beinetti

    Have used once. Terrible burning, blurred vision for 2-3 hours. Doctor didn’t tell me anything about side effects. I had high hopes, like I always do with a new eye medicine. Nothing works!

  11. Lorri
    So Cal

    I think Xiidra may be working better for me but it leaves a sour taste in the back of my throat and my mouth feels coated. I think it’s impacting my taste. Not sure that I’ll continue after this month. I purchased it at Costco for $25 a month with insurance.

  12. Lucy

    I tried this Xiidra. Terrible burning sensation and I could not tolerate it. The vials were made so you can’t recap them so there’s a lot of wasted liquid. The medication is very expensive. I have become very skeptical of new drugs. Drug companies often hide the trials and the bad side effects. These companies are very greedy.

    Restasis is also very expensive and it’s been out for years! IMO Restatsis is largely placebo, dry eyes was and wane with hormones and environmental conditions. Restasis takes 6 months to “work” Which leaves a lot of time for environment to change.

    I think it’s probably just putting the castor oil drops in the eyes twice a day that works and not really anything in the medication. If you read the insert, the drug isn’t all that effective.

  13. Your Excellency

    Xiidra is the same price as Restasis. If you think it is too expensive, don’t buy it.

    • Anne

      I wish I could say they don’t work because they are expensive but they do.

  14. Louise

    I don’t think xiidra should have been approved by the FDA. It burns no matter what I do. The taste can linger for hours. The vials are purposely made so it’s difficult to use….and it’s horribly expensive. Big pharma must have had a lot of lobbyists on this drug.

    The trial run was short as well as the number of people taking the drug….mostly women probably……now I understand that Rastasis and xiidra are fighting over who gets covered in drug plans. All about money……

    • Heather

      No, it’s not. Xiidra is double the cost. $100 a month with insurance if it’s approved. Restasis is $47 a month and is only a tier 3 drug and it does not have to be preauthorized. My brother works for a company that makes a lot of eye drops and solutions. He thinks it’s a way for drug companies to make money, and the ultra eye drops will work with the same results if you are on a budget

      • Kay

        Must depend on your insurance co. Dr prescribed Restasis but insurance co. denied and said I had to use Xiidra. It’s been over 2 months now, and I am ready to stop. The burning is incredible. The first week or two my dry eye seemed better, but now it is worse. Some days I can barely see.

  15. Susan

    Made the mistake of putting the drops in and driving to work. Not a good idea. Vision compromised and it takes approximately 11/2 hrs for my eyes to clear.

    Switched to putting in once I got to work however vision unable to clear enough to work on my computer. Previously used Restasis which helped for a few years and then became ineffective. This is my second attempt at using Ziidra.

    Severe dry eyes with recommendations from my eye professional to have a debridement and polishing of my cornea.

  16. Dawn

    I think my eyes are feeling better after 2 weeks. Wondering if you need to be on these indefinitely or does it actually cure the dry eyes?

  17. kathy
    West Virginia

    Tried this for a few months, and it worked fairly well. Then my samples ran out. Even WITH the Xiidra coupon, it would cost me over $400/month. Why are these companies so greedy??? WHY do they make a drug that gives people who are suffering some hope – and then charge more than the patient can possibly afford. SHAME ON THEM!!!!

    • Dave

      Yes, very greedy to spend over a billion dollars to develop and test a new drug, and then have a limited window to recover those costs before the patent runs out. These companies should spend billions of dollars of investors money with no expectation of cost recovery or profit. And when all the investors pull out, shame on them those greedy people. Maybe Kathy from West Virgina should invest all her money in a company that behaves that way.

      • Heather

        Dave, I understand they want to make their money back but not everyone is in the 1% and can afford $400 a month. Am lucky I guess, and my insurance picks up all but $100. Really I have two things to say about this drug: Some companies like Pfizer have a plan for people who make less than $40,000 a year to get their products for free, but you do have to disclose private information. It would be nice if other companies did the same since they sell these products to other countries for way less than Americans pay.

        The other thought is that I have a brother who works for a pharmaceutical company, and they have over-the-counter ultra eye drops that seem to work as well without the side effects, and it’s is a more cost effective way to go. I’m not seeing that Ziidra is doing anything but causing blurred vision.

      • Fred M

        You must be a drug company CEO.

  18. betty

    some one told me Xiidra increases blood pressure… but I find nothing in these articles the say that. Does it increase blood pressure?

  19. Clare
    New York

    I’ve only tried Xiidra for 3 doses and I only find a little relief for 1 hour after the 2nd dose. And then my eyes start burning like crazy. I had my 3rd dose last night and my eyes were burning like hell again in the morning. Now I am very afraid to keep using it. I did get a coupon and got the 1st month for free and my co pay is $75 after that, but it just doesn’t seem to work. It actually irritates my eyes more than before.

  20. Scoho
    New York

    Artificial tears don’t work for me at all. They help for about 5 minutes. I tried Restasis for six months – it helped a little. Xiidra helped – a lot – within a couple of days. I still have trouble with blurry vision and some burning when I drive to work in the morning and when I watch tv in the evening – but it’s much better than it was before. And during the course of the day I can focus again, on things that are not directly in front of my face. Before Xiidra my doctor had assured me that my vision is still 20/20 but I really felt like I was going blind. Constant blurring. Yes, there is a slight test for a little while after I use it. And yes, sometimes it burns for a few minutes. So what? If this deters you then your problem must not be very bad! That being said I HATE the packaging. For this exorbitant price they give you tiny vials, mysteriously packaged in little foil packets. The vials have such a small amount of the medication that the very most you would ever be able to get out of them would be four drops. Since the amount is so small it’s difficult to get it down to the tip of the vial, and usually a drop or two is wasted at a minimum. I don’t know how older people who have trouble with the mechanics of using it, particularly with shaky hands, would be able to cope with the extremely meager and parsimonious daily supply of this EXORBITANTLY expensive medication. But hey – no reason the CEO, executives and stockholders of Shire should not be able to gouge every penny they can from people who have no other options, right?

  21. Aretha

    I just started using my Xiidra again. I became fearful of the possible bad taste, blurry vision and eye pain adverse reactions, but tossed my fears aside. I’m giving Xiidra a chance to work it’s “magic” for my dye eyes. After all, Xiidra is recommended by my ophthalmologist, and I have 6 refills.

  22. Laurie

    The coupon only worked for one refill. They tell you $10 thereafter, but there is an asterisk that explains “only up to $250”. This means that if you have crappy insurance (like me), it’s $459 for a one month supply. I’m single and can’t not even come close to affording that. I have Sjogrens Syndrome. I am living life basically through blurry vision. Im screwed!

    • Sherry

      To lessen the bad taste, after putting a drop in each lower lid, close eyes and bend over for a couple of minutes so drops don’t run down tear ducts into throat. It’s been a miracle to me. Restasis didn’t help and I was putting artificial tears in at 3 hour intervals even at night. Much better but my copay is over $200. Fortunately I can pay it. I did have LASIK about 20 years ago.

  23. Wolf
    Rancho Santa Fe

    All drugs are expensive due to research costs, true, but the real reason the cost is so high is the expense of the tort insurance the drug companies have to buy. This is caused by past and potential litigation.

    If it touches your eyes or skin at all, the drug companies’ insurance costs are astronomical. See also all cosmetics…

    Just bought some xiidra and will let you know how it goes…

  24. Margie
    Athens GA

    I have to say that Xiidra is working better so far than anything else I have tried. I have suffered for many years since having Lasik surgery in 2003 (that’s another story). Tried plugs, surgery and recently found out both ducts in my left eye have been cauterized (I thought I had a blocked duct in bottom; I had surgery on top duct for ‘stones’ in tear duct). I have also tried any other drops (prescription and over the counter) including Restasis, all to no avail. I also have chronic blepharitis.

    So, I was willing to try Xiidra. No bad taste, but it does make my eyes quite blurry but the time that they are blurry has decreased over time. On mornings I am going to work, I just make sure to use the drops first thing so that my vision is clear by the time I need to drive. I have noticed an improvement slowly – the other day I realized that I had worked an entire shift in front of a computer and only used lubricating drops once or twice (as opposed to at least once an hour).

    I am pleased. I hope it keeps working. Oh, and I also have a coupon – first round free and then $10 per month thereafter.

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