Restasis vs. Cequa vs. Verkazia: 7 Differences Between These Cyclosporine Eye Drops

There are many causes for dry eye, and it can be hard to know the best treatment. You can often manage symptoms at home without medication. But sometimes you may need to use eye drops. Treatments, such as artificial tears, are available over the counter (OTC). There are also prescription-only eye drops that may help with certain dry eye conditions, including Restasis, Cequa, and Verkazia.

These three eye drops all contain cyclosporine as their active ingredient. And there are many similarities between them, but there are a few key differences that stand out. Your healthcare provider can help choose the best eye drop for your situation, so always follow their instructions. Here we’ll cover seven notable differences between Restasis, Cequa, and Verkazia.

1. All three eye drops contain different amount of the same active ingredient

Even though Restasis, Cequa, and Verkazia all contain cyclosporine, they contain a different amount per drop. This is one of the key differences between them. Sometimes, you may need more medication to help manage your symptoms. But if you’re having bothersome side effects, an eye drop with less medication may help lessen them.

The concentration (amount of medication in each eye drop) is measured in milligrams (mg) per milliliter (mL). The concentration can also be represented with a percentage. Restasis contains the lowest amount of cyclosporine per mL, followed by Cequa, and then Verkazia.

These are the amounts of cyclosporine in each of the three eye drops:

• Restasis: contains 0.5 mg per mL (0.05%)

• Cequa: contains 0.9 mg per mL (0.09%)

• Verkazia: contains 1 mg per mL (0.1%)

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Good to know: There’s a fourth cyclosporine eye drop solution that was FDA approved in May 2023, called Vevye. It contains 1 mg of cyclosporine per 1 mL (0.1%). Vevye is a new formulation that’s water-free and preservative-free. In clinical trials, it started working after 4 weeks.

2. Restasis and Cequa treat dry eye, while Verkazia treats seasonal eye irritation

Restasis, Cequa, and Verkazia all help with health conditions that can cause dry eye. But their specific FDA-approved uses aren’t all the same. Restasis and Cequa are approved to treat keratoconjunctivitis sicca (chronic dry eye or dry eye disease). Verkazia is approved to treat vernal keratoconjunctivitis (a condition that causes seasonal eye irritation).

3. They’re all approved for different age groups

Each of these three eye drops were studied and approved in adults. But for children, there are different age limits. The age recommendations are based on studies that included (or didn’t include) children of specific ages.

Here are the approved ages for each of the three eye drops:

• Restasis: ages 16 and older

• Cequa: ages 18 and older

• Verkazia: ages 4 and older

This age difference is also due to the condition each eye drop is approved to treat. Vernal keratoconjunctivitis is most often diagnosed in children and young adults, which is why Verkazia is approved for younger age groups. Dry eye disease is rare in children and becomes more common as people get older. This is why Restasis and Cequa are approved for older age groups.

4. Verkazia’s dosage is different from Restasis and Cequa

Aside from how much medication is in each eye drop, there’s also a difference in how often you use them. The typical Restasis and Cequa dosages are one drop placed in each eye twice daily, about 12 hours apart.

Verkazia is used more often. The recommended dosage is one drop in the affected eye(s) 4 times daily: morning, noon, afternoon, and evening.

5. Only Restasis offers a multiple-dose bottle

Restasis, Cequa, and Verkazia all come as individually packed, single-dose vials. Each vial contains less than 0.5 mL of liquid. After applying a dose (up to one drop in each eye), the vial should be thrown away. You shouldn’t save open containers for later, even if there’s liquid left inside.

But Restasis has another option — a multiple-dose bottle called Restasis MultiDose. It looks similar to OTC eye drop bottles. The bottle contains 5.5 mL of liquid. And it can be used until the medication is gone (as long as it’s not expired). Restasis MultiDose may be a more convenient on-the-go option than the single-dose vials.

6. Restasis and Verkazia are emulsions, but Cequa is a solution

The formulation of eye drops is important because it can affect how the medication is absorbed. It can also make a difference when it comes to side effects. Researchers seek to develop eye drops that maximize the medication’s effectiveness while limiting side effects.

Restasis and Verkazia are emulsions (a mixture of oil and water). Cequa, though, is a solution (a water-based formulation). Solutions tend to be better absorbed than emulsions. Solutions also tend to cause fewer side effects when applying drops, such as stinging or burning.

Many people may not notice a big difference between emulsions or solutions. And all three eye drops have been proven effective. But some people may find that one is more comfortable to use than the other.

7. Only Restasis has a lower-cost generic available

Restasis, Cequa, and Verkazia are all available as brand-name medications. But as of February 2022, Restasis has an FDA-approved generic formulation. Generic medications offer the same quality and effectiveness as brand-name medications. But they can help you save money at the pharmacy.

This means that generic Restasis may be a lower-cost dry eye treatment. Your healthcare provider can help choose an eye drop that’s appropriate and most cost-effective for you. Keep in mind, generic Restasis might not be right for treating your specific eye condition.

How to save on Restasis, Cequa, and Verkazia

There are ways to save on Restasis, Cequa, and Verkazia. GoodRx can help you navigate your options, which may include GoodRx discounts, copay savings cards, and patient assistance programs.

How to save on Restasis

If you have commercial insurance, you may be eligible for a Restasis copay savings card that could lower your prescription cost to $0. If you’re uninsured or underinsured or have government insurance, you may be eligible to get Restasis at no cost through the manufacturer’s patient assistance program.

As discussed above, Restasis also has a generic version. GoodRx can help you save over 70% off the average retail price of the generic. The price of cyclosporine eye drops (generic Restasis) at certain pharmacies is as low as $97.64 with a free GoodRx discount.

How to save on Cequa

Cequa is only available as a brand-name medication right now. If you have commercial insurance, you may be eligible for a Cequa copay savings card that could lower your prescription cost to $0. If your insurance doesn’t cover Cequa, or if you have government-sponsored insurance such as Medicare or Medicaid, you can sign up for Cequa Direct Pricing. The cost of a one-month supply with this pricing is $89.

How to save on Verkazia

Verkazia is currently only available as a brand-name medication. If you’re uninsured or underinsured, you may be eligible for Verkazia’s patient assistance program, which offers the medication free of cost.

How to save on Vevye

Anyone with a valid prescription, regardless of insurance status, can use GoodRx to purchase a bottle of Vevye at an exclusive cash price of $299.

If you have commercial insurance, you may be eligible to pay as little as $0 for Vevye using a savings card from the manufacturer.

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Written by:

Austin Ulrich, PharmD, BCACP

Austin Ulrich, PharmD, BCACP, is a board-certified ambulatory care clinical pharmacist. In his early career, he provided direct patient care in a variety of settings, including hospital and community pharmacies, and in a primary care clinic as a clinical pharmacist.

Edited by:

Christina Aungst, PharmD

Christina Aungst, PharmD, is a pharmacy editor for GoodRx. She began writing for GoodRx Health in 2019, transitioning from freelance writer to editor in 2021.

Reviewed by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

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