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. 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.

  2. Your Excellency

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

  3. 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……

  4. 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.

  5. 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!!!!

  6. laura
    Santa Fe NM

    BEWARE !! I would caution anyone about to take this drug. I’ve enjoyed perfect long distance vision all my life, and after only 4 days of taking these drops, everything at a distance that was previously sharp and crystal clear became out of focus & blurry. My doctor tested me and confirmed my long distance vision had been compromised but thought it was probably transient. Unfortunately that’s NOT the case!!! A year later my long distance vision grows progressively worse, and I keep having to change lenses. Before this happened I only needed glasses for reading small print. Now I have to wear glasses constantly in order to see. Furious & frightened!!!

  7. betty

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

  8. 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.

  9. 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?

  10. 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.

  11. 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!

  12. 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…

  13. 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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