XIIDRA

Uses, Dosage, Side Effects and Warnings

XIIDRA

Uses, Dosage, Side Effects, Warnings

Author: Dr. Leigh Plowman (Optometrist)

Xiidra: Uses, Dosage, Side Effects, Warnings

Xiidra is a prescription medication for dry eyes approved by the Food and Drug Administration (FDA). Used in adults and some children, it is an anti-inflammatory eyedrop to reduce the signs and symptoms of dry eye disease.

What Is Xiidra Used For?

Xiidra is used to treat dry eye disease or dry eye syndrome (keratoconjunctivitis sicca). This is a condition in which the body does not produce enough tears, or the tears that it does produce do not provide adequate lubrication.

Symptoms of dry eye syndrome can include:

Tired eyes
Burning, itching, or stinging in the eyes
Light sensitivity
Mucus in/around your eyes
Eye redness
Blurry vision, making objects appear hazy and out of focus
A sensation of having something in your eyes
Watery eyes from irritation

For many people with dry eye syndrome, Xiidra is effective at treating the problem, but how the medication works is not well understood. What is known is that its active ingredient, lifitegrast, reduces inflammation (the cause of dry eye symptoms) by inhibiting the binding of certain cells that produce inflammation. Generally, it takes a few weeks for the drug to work.

Xiidra Dosage Information

Your doctor will typically prescribe Xiidra for the treatment of dry eye syndrome after a physical examination. The dosage will be determined based on your needs. That said, there are general dosing recommendations with this medication, which comes as a liquid solution free of preservatives that you drop into the eyes.

The recommended dosage for treating dry eyes in persons over seventeen is one drop per eye, dropped in twice daily. Ideally, your doses will be taken twelve hours apart. Xiidra solution is packaged in 0.2 mL single-dose containers, each vial containing enough medicine to treat both eyes. There’s only one dosage strength available. Xiidra is available as a brand-name medicine only, with no generic form currently available.

If you happen to miss a dose of Xiidra and you still have a few hours before you are supposed to take your next dose, then simply drop in the solution when you remember. Should it be close to the time for your next scheduled dose, however, then it’s best to skip the dose that you missed. Get back on schedule with your next dose.

Note: For safety reasons, discard Xiidra single-use containers after each dose. If you wear contact lenses, then be sure to remove them before dropping the solution into your eyes. You can reinsert them after 15 minutes.

Side Effects of Xiidra Eye Drops

Some people who use Xiidra for dry eyes may experience side effects. These can be mild or severe. Usually, side effects will dissipate in a matter of days, a couple of weeks at most. When they are more severe, though, or they persist, it’s important to consult a doctor or pharmacist as soon as you can.

Mild side effects of Xiidra can include:

Itchy and/or watery eyes
Eye irritation and redness
Itchy or burning eyes
Blurred vision
Headaches
Sinusitis (inflammation of the sinuses)
Dysgeusia (sour, sweet, bitter or metallic taste in the mouth)

Serious Xiidra side effects may occur due to an allergic reaction and can include:

Shortness of breath (dyspnea)
Urticaria (hives – red, itchy skin welts)
Angioedema (swelling underneath the skin)
Swelling of the tongue, mouth, or throat

It is rare for users of Xiidra to experience serious side effects. In fact, in clinical studies, no serious side effects were reported. Some individuals have reported allergic reactions since the studies, however.

To minimize side effects, it is recommended to close your eyes for at least one minute after instillation. This reduces drainage in the tear ducts, or puncta, and absorption into the back of the throat and body.

Warnings for Xiidra Users

Xiidra eye drops may not be suitable for dry eye sufferers with certain medical conditions and sensitivities. Therefore, it is important that you discuss your health history with your doctor when considering Xiidra treatment. Let them know about any medical problems you have and if you are taking medications to treat your condition.

While Xiidra isn’t known to interact with other drugs, interactions can occur with prescription and over-the-counter medications. They can even occur with vaccines, vitamins, herbs, supplements, and foods – anything that affects how the medicine works. A doctor or pharmacist can inform you about potential interactions with Xiidra.

In regard to pregnancy, there haven’t been any human studies on Xiidra’s safety. Moreover, it is not clear if it passes into breast milk. That’s not to say that the drops aren’t safe to use when pregnant and breastfeeding. Again, this is something to discuss with your doctor.

For best results with Xiidra, use the drops for dry eyes before they expire. Your pharmacist will add a label with an expiration date. Store the medication safely at room temperature, which is about 68°F to 77°F (20°C to 25°C).

Xiidra vs. Restasis

There is another prescription medication, Restasis, that is also used to treat dry eye disease. Like Xiidra, it reduces inflammation, although its active ingredient is cyclosporine. Restasis and Xiidra are sometimes used together or in combination with other drugs to treat dry eyes, yet this is not always safe or appropriate.

Restasis and Xiidra are comparable in that they both lessen inflammation and increase tear production by targeting T-cells that contribute to inflammation and the cause of dry eye disease. They are different in that they work a little differently and are not the same class of drug.

Side effects can occur with Restasis, as with Xiidra, but note that Restasis is more likely to cause burning in the eyes as a side effect. This is because the acidity and electrolyte and water balance of Restasis are not as close to natural human tears as Xiidra. The cyclosporine medication for dry eyes is available as an emulsion eye drop.

What additional dry eye treatments can I use with Xiidra?

Evaporation is a common cause of dry eye disease. Over eighty-six percent of people with dry eye disease have Meibomian Gland Dysfunction. This is where the oily protective layer becomes patchy or insufficient.

Evaporation causes increased saltiness, or osmolarity, of the tears. The saltiness aggravates the sensitive cells on the front of the eye. This triggers them to release inflammatory messengers. Inflammation causes a vicious cycle of dry eye disease.

Most people are unaware that they have bacteria on their skin from birth. Bacteria that live on the skin tend to overgrow. Bacteria produce enzymes that chop up the oily protective layer of normal tears.

Avenova is an antimicrobial spray that kills bacteria on the outside of the eyelids. It is easy to use and feels refreshing.

Using Avenova is an important way to improve your Eyelid Hygeine. See this diagram from the British Journal of Ophthalmology:

Figure 1- Avenova improves Lid Hygeine (Figure from Badouin et al 2016)

Avenova helps by:

Reducing proliferation of bacteria (including Staphylococcus sp., Propionibacterium acnes, Bacillus oleronius)
Reducing Meibum melting temperature
Reducing Meibomian Gland blockage, drop-out and inflammation

Avenova is a safe spray for your eyes. Avenova helps to reduce Meibomian Gland Dysfunction and Inflammation due to Dry Eyes.

If you use Xiidra or Restasis, Avenova is an easy way to give your eyes relief and feel refreshed again.

Talk to your eye doctor about Avenova today or have it shipped to your home or office now