Xiidra vs. Restasis: 6 Ways These Dry Eye Treatments Compare
Key takeaways:
Xiidra (lifitegrast) and Restasis (cyclosporine) are two brands of prescription-only eye drops that can treat chronic dry eye. They work in different ways but are both effective options.
Xiidra and Restasis have similar instructions. You apply one drop in each eye twice a day, about 12 hours apart.
Xiidra and Restasis are both available as brand-name medications. But you can also find Restasis as a lower-cost generic. GoodRx can help make your prescription more affordable.
Table of contents
Scratchy, red eyes is just one of the many symptoms of dry eye. Many people have experienced this uncomfortable feeling. But for some people, having dry eyes is an everyday problem.
Often, over-the-counter (OTC) eye drops known as artificial tears can help relieve dry eye. But for some people, this may not be enough. In these cases, prescription dry eye drops may be needed. Two commonly prescribed brands of eye drops for chronic dry eye are Xiidra (lifitegrast) and Restasis (cyclosporine).
But are Xiidra and Restasis the same thing? In short, no. These eye drops work differently to relieve dry eye. But this isn’t the only thing that sets them apart. Below, we review six things to keep in mind when comparing Xiidra versus Restasis.
Xiidra vs. Restasis at a glance
It can be helpful to have all the information side by side when comparing medications. Below are notable similarities and differences between Xiidra and Restasis.
Xiidra | Restasis | |
|---|---|---|
Active ingredient | Lifitegrast | Cyclosporine |
Medication class | LFA-1 antagonist | Calcineurin inhibitor |
Dosage forms | Single-dose vials | Single-dose vials Multiple-dose bottle |
Dosage | Place 1 drop in each eye twice daily, about 12 hours apart | Place 1 drop in each eye twice daily, about 12 hours apart |
Side effects | Temporary eye irritation Taste changes Temporary blurry vision | Burning, red, or watery eyes Temporary blurry vision A feeling that there’s something in your eye Eye pain |
Does it have a generic version? | No | Yes |
1. Xiidra and Restasis work differently for dry eye
Xiidra and Restasis work differently to treat chronic dry eye.
Xiidra contains the medication lifitegrast. Xiidra is a lymphocyte function-associated antigen-1 (LFA-1) antagonist. It’s the only medication in this class.
Xiidra blocks a protein called LFA-1 from attaching to another protein called intercellular adhesion molecule 1 (ICAM-1). When these two proteins connect, it can trigger inflammation (swelling) in the eye. If too much of this happens, it can cause dry eye symptoms.
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Restasis contains the medication cyclosporine. It’s one of a few types of eye drops that contain cyclosporine. But Restasis was the first to be FDA-approved for chronic dry eye. It belongs to a group of medications called calcineurin inhibitors.
Restasis also eases eye inflammation — but it does so differently than Xiidra. Restasis blocks certain immune cells from releasing a protein called interleukin 2 (IL-2). This protein signals your body to create inflammation. And in the eyes, too much IL-2 can cause dry eye symptoms.
2. Xiidra and Restasis have different dosage forms available
Xiidra comes in single-dose vials with enough medication for a drop in each eye. After every dose, you should throw the vial away, even if there’s extra liquid. The extra liquid is there in case you accidentally miss your eye when applying your dose.
Restasis comes as a single-dose option, too. But there’s also a multiple-dose option called Restasis MultiDose. This version comes in a bottle instead of several separate vials. Restasis MultiDose contains the same medication as traditional Restasis. But some people find it more convenient to store at home.
3. The way you use Xiidra and Restasis is similar
The dosages for Xiidra and Restasis are pretty similar. For both medications, you should instill one drop into each eye twice daily, about 12 hours apart. Consistently using your eye drops every day will help the medication work its best.
If you wear contact lenses, remove them before using your medication. You can reinsert them 15 minutes after taking your dose. Be careful not to touch the tip of the dropper to your eye. Doing so can raise your risk of an infection, or it could cause an eye injury.
4. Xiidra and Restasis both work well for dry eye
Neither Xiidra nor Restasis is the first choice for chronic dry eye. Experts recommend first trying OTC eye drops, such as artificial tears. But if those don’t work, or your symptoms are severe, prescription eye drops are usually the next step.
Experts don’t recommend either Xiidra or Restasis more than the other. Both work well for chronic dry eye. Your prescriber should take multiple factors into consideration when selecting Xiidra or Restasis for you. For instance, your prescriber may select one because your insurance covers it.
5. Xiidra and Restasis have slightly different side effects
Side effects from Xiidra and Restasis are generally mild. When used properly, neither medication is linked to any serious risks or life-threatening side effects.
The table below lists common side effects for Xiidra and Restasis. This isn’t a comprehensive list for either type of eye drops. If you experience any bothersome side effects, contact your prescriber.
Xiidra side effects | |
• Eye irritation • Taste changes • Blurry vision | • Eye burning or stinging • Red eyes • Watery eyes • Itchy eyes • Eye discharge (“eye boogers”) • Eye pain • A feeling that there’s something in your eye • Blurry vision |
6. Restasis has a generic version, while Xiidra is brand-name-only
Restasis has a generic version available for the single-dose vials. Restasis MultiDose and Xiidra are available only as brand-name medications. This difference can affect insurance coverage. And it might be a major factor in why your prescriber recommends one over the other.
Generic medications contain the same active ingredients at the same dose as their brand-name counterparts. They can often help you save money without sacrificing quality. And insurance plans tend to cover generic medications with lower copays.
Can you use both Xiidra and Restasis together?
No. This combination hasn’t been studied for any use. So it’s unclear if this would be safe or effective. Because of this lack of information, it’s best to avoid using both Xiidra and Restasis at the same time.
How to save on Xiidra and Restasis
Xiidra and Restasis are available as brand-name medications. But you can also find Restasis as a lower-cost generic. GoodRx can help you navigate the many ways to save on your prescription.
Save with GoodRx. GoodRx can help you save on the average retail price of the generic version of Restasis. The price of generic Restasis at certain pharmacies is as low as $97.64 with a free GoodRx coupon.
Save with a copay savings card. If you have commercial insurance and meet eligibility requirements, Xiidra costs as little as $0 if you use the manufacturer’s savings card. Brand-name Restasis and Restasis MultiDose cost as little as $0 if you use the manufacturer’s savings card.
Save with patient assistance programs. If you’re uninsured or underinsured, you may be eligible for Xiidra and Restasis patient assistance programs, which offer the medication at no charge.
Frequently asked questions
Yes. It’s possible to switch from Restasis to Xiidra. But there are no standard instructions for changing eye drops. So ask your prescriber how and when they recommend making the switch. They’ll likely tell you to start Xiidra about 12 hours after your last dose of Restasis. This is because Restasis lasts in the eyes for about 12 hours.
No. There are no OTC alternatives to Xiidra or Restasis. The available OTC medications for dry eye are lubricant drops. They help moisten the eye and act like your natural tears. They’re usually the first choice for managing dry eye. If they don’t work well enough for you, try prescription eye drops, such as Xiidra or Restasis.
The bottom line
Xiidra (lifitegrast) and Restasis (cyclosporine) are two brands of prescription eye drops that treat chronic dry eye. While both medications work well for dry eye, they work in different ways. Both medications are used twice a day and should be used every day for the best effects.
Both Xiidra and Restasis are safe and effective for treating dry eye. If you’re finding that OTC eye drops aren’t helping your dry eyes, be sure to discuss both Xiidra and Restasis with your primary care provider or eye specialist. They’ll help you decide which medication would be the best choice for you.
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References
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De Oliveira, R. C., et al. (2019). Practical guidance for the use of cyclosporine ophthalmic solutions in the management of dry eye disease. Clinical Ophthalmology.
Drugs@FDA. (2017). New drug application (NDA) 050790. U.S. Food and Drug Administration.
Gao, D., et al. (2022). Comparison of seven cyclosporine A formulations for dry eye disease: A systematic review and network meta-analysis. Frontiers in Pharmacology.
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