a young woman putting in eye drops, dry eye disase

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. Richard
    Broomall, Pa

    I’ve been diagnosed with moderate dry eye which caused two back to back incidents of eye infections from complications related to dry eye and contact lenses, which I had worn previously for over 40 years with no problems. I found almost immediate improvement using the sample of Xiidra I received from my doctor. Unfortunately the drug is not on my drug plan’s formulary and since I’m on medicare, I’m ineligible for the manufacturer’s coupon programs.

    The price of Xiidra is over $500.00 per month, which for me is prohibitive for a non-life threatening condition. Restasis is on my drug plan’s formulary, and although it’s not cheap, it’s significantly less expensive than Xiidra so I’m going to give it a try.

    Worse case scenario I’ll continue to use over-the-counter overnight ointment which is effective,plus preservative-free eye drops and warm compresses. At $20.00 for a hundred preservative-free vials at a major chain discount store, they’re much less expensive than these prescription ripoffs.

  2. Lynn
    Okotoks, AB

    Should you use Xiidra if you have had cataract surgery, thus artificial lenses?
    What effect does Xiidra have on Artificial lenses?

  3. DJ

    At $602 for a thirty day supply this drug is out of reach for my 89 year old disabled mother. Having only tried samples, I can not comment on the drop’s effectiveness. I do suspect that a pharmaceutical company CEO has a larger yacht because of it.

  4. Ken

    I got a trial from my doctor and experienced irritation and a taste sensation in the morning.
    But at night I used Xiidra and then followed up with Genteal Severe about 15 minutes later before bed. In the morning I had no irritation, so I decided to do one treatment per day at night and see how that worked. It has been amazing. My redness is much reduced, and my previously droopy right eye has come back to match my left. So I’m extremely happy so far with this regimen, though it is outside of the recommended use. My doctor approves, so I will stick with this for a while.

  5. Sherry

    I’ve been using Xiidra for over 2 months after unsuccessfully using Restasis for years. The Xiidra has helped with the nighttime dryness and I don’t wake up in terrible pain. But the side effects are unpleasant…gooey morning eyes, redness and tearing. But evening my eyes feel like I’ve been awake for 36 hours. Due to the high cost, I’m not sure if it’s worth it or not. Going back to the doctor this morning.

  6. Kristine

    I just used my first dosage. I feel almost immediate relief if that’s possible. My insurance covered it so I’m pleased with that. The only thing I don’t like is the taste in the back of my throat a few minutes after application. There also was a slight burn in the eyes when the drops went in, but that passed in a few seconds. Hopefully Xiidra will work for me.

  7. Carrie

    After a week, my eyes feel drier, right eyelid twitching, and I have a headache. I had hopes for the samples to improve my dry eyes. After reading two patient review sites including comments pro/con, mostly con, I have decided to discontinue. To be clear, I repeat, my eyes feel much worse. Dry-eye was an irritation for me up to the time I started Xiidra, but since, my eyes are a constant concern. I have no doubt that it helps some people, however not I. I’d planned to use the drug to see if I could get past the dry-headachy period. Now, I do not see the point. A week’s long enough.

  8. Anna
    Salinas, CA

    Well, I went to my Eye dr yesterday, and she gave me the XIIDRA to try. So I’m going to pick up my 3month supply that my insurance approved for 40 dollars co-pay. I was shocked that my insurance actually covered all that portion but I’m thankful for it, so I will see how it goes with this new prescription. I have been using Zatidor and moistening gel drops, and they have worked off and on, but my eyes still are very dry. So hopefully this will be a positive for me. Everyone who has dry eyes I know what you go through!!!!!

  9. Cecilia

    I recently discovered that my dry eye syndrome problem is very treatable with the “nighttime” eye ointment available OTC for about $12 a tube. I put just a dab in the outer corner of my affected eye a few times a day. It’s not entirely convenient. It does cause temporary blurriness and makes eye makeup difficult to apply and maintain. But if you want an alternative to Xiidra, it might work for you. I suffered for three months with dry eye syndrome and went through ultrasound, tomography, and a difficult 90-minute MRI before it was realized that the eye was simply very dry. Comparing it with the healthy eye made this clear.

    • marg

      What was the name of the over-the-counter drops?

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