Miebo for Dry Eye: 5 Things to Know About This Restasis Alternative

Dry eye disease is a condition that works exactly how it sounds — your eyes dry out from a lack of eye lubrication. If you’ve had dry eyes, you know that this can be bothersome, or even painful. Fortunately, there are several over-the-counter (OTC) and prescription medications to treat dry eye. Miebo is one of them.

Miebo (perfluorohexyloctane) is a prescription-only eye drop that was FDA approved in May 2023. It’s the first medication in its class that’s approved to treat dry eye. And it’s different from other prescription-only dry eye medications, such as Restasis (cyclosporine).

When a new medication comes to market, it’s natural to have questions about how it works and who should take it. So stick with us as we discuss five key facts about Miebo, the newest Restasis alternative.

1. Miebo is the first in a new class of medications

Miebo is a semifluorinated alkane medication. It’s the first medication in this class to be FDA approved. It works a bit differently from other eye drops for dry eye disease. Experts say Miebo works on the surface of your eye to reduce evaporation of natural tears. This keeps more tears on your eye and helps prevent them from drying out.

Other medications, such as Restasis, work by lowering inflammation in and around the eyes. This helps increase your natural tear production and keep your eyes from drying out.

2. Miebo is a potential Restasis alternative

Since Miebo works in a different way from Restasis, it could be a good alternative choice. So if Restasis isn’t working well for you, Miebo may work better. But how well an eye drop works for you can depend on what’s causing your dry eye.

Who should try Miebo?

If your eye doctor suspects that you have a condition called meibomian gland dysfunction, you might be a good candidate for taking Miebo. The meibomian gland helps coat the eye with protective liquid layers. It also helps stabilize the tear film on your eye. If the gland isn’t working properly, this can lead to dry eye disease.

In clinical studies of Miebo, participants had meibomian gland dysfunction. These studies found that people receiving Miebo had improved symptoms of dry eye compared to those receiving saline (non-medicated) eye drops.

But even if you don’t have meibomian gland dysfunction, you may still benefit from Miebo eye drops. There are other eye problems that cause tears to evaporate faster than usual. People with these issues may also find Miebo helpful.

Keep in mind that in these studies Miebo wasn’t compared to other dry eye treatments, including Restasis. So we don’t know if it works better or worse than other medications.

3. Miebo and Restasis are different in several ways

Although Miebo and Restasis are both approved for treating dry eye disease, there are a few ways they’re different.

Who should use them

Miebo eye drops are only approved for use in adults. This medication hasn’t been tested in people younger than 18 years old. In contrast, Restasis eye drops are approved for adults and adolescents ages 16 and older.

Their medication class

As mentioned above, Miebo is in a completely new medication class — semifluorinated alkanes. There are no other currently approved medications that are in the same class. Restasis is in a different medication class. The active ingredient in Restasis, cyclosporine, belongs to the calcineurin inhibitor medication class.

How they work

As discussed above, Miebo works differently than Restasis. Miebo keeps tears from evaporating off of the eye too quickly. Restasis lowers eye inflammation and increases tear production.

How often you use them

The dosages for Miebo and Restasis are different. The dosage for Miebo is typically one drop into the affected eye(s) 4 times a day. The usual Restasis dosage is one drop in each eye twice daily, about 12 hours apart.

Neither medication should be administered while you’re wearing contact lenses. If you do wear contacts, take them out before using your eye drop. You’ll need to wait a certain amount of time after your dose to put them back in. For Miebo, you can put your contacts in 30 minutes after a dose. And for Restasis, you can put your contacts back after 15 minutes.

Whether they have a generic version

Miebo is a brand-name medication. It has no generic version yet. Restasis is available as both a brand-name and generic medication. So there may be more options for you to save on Restasis.

4. Miebo’s side effects are generally mild

As with many eye drops, Miebo’s side effects are usually mild. In fact, the only side effects that were reported in early studies of Miebo were blurry vision and red eyes. These effects were only reported in 1% to 3% of study participants, so they weren’t very common either. No serious or severe side effects were reported with Miebo.

Restasis can also cause blurry vision and red eyes. But people using it also report side effects such as eye pain, burning and watery eyes, and feelings of a foreign sensation in the eye.

5. Miebo should be available by the end of 2023

Miebo is expected to launch in the second half of 2023. But we don’t know the exact date that it will be available. Once it launches, you’ll be able to get Miebo from your pharmacy with a prescription from your healthcare provider. Check back with GoodRx for more information on availability and savings opportunities in the coming months.

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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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