cyclosporine
Cyclosporine eye drops, also known by the brand names Restasis and Restasis MultiDose, treat dry eye in people 16 years and older. It's an immunosuppressant called a calcineurin inhibitor, and it helps with tear production. Cyclosporine (Restasis) comes in single-use vials and multi-dose bottles. Only the single-use vials have a generic version. The eye drops are used twice every day. The most common side effect is a burning feeling in the eye, which usually gets better as you continue to use the medication.
What is Cyclosporine (Restasis)?
What is Cyclosporine (Restasis) used for?
- Dry eye in people 16 years and older
How Cyclosporine (Restasis) works
Cyclosporine (Restasis) is a type of immunosuppressant called a calcineurin inhibitor. The medication stops a protein called calcineurin from working. It lowers inflammation in the eye, which helps your eye make more tears.
Drug facts
Side effects of Cyclosporine (Restasis)
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Burning sensation in the eye (17%)
Less Common Side Effects
- Eye redness
- Eye discharge
- Watery eye
- Eye pain
- Feeling like there's something in the eye
- Itchy eye
- Stinging in the eye
- Eye swelling
- Blurry vision
More on Cyclosporine (Restasis) side effects
The following Cyclosporine (Restasis) side effects have also been reported
Side effects that you should report to your care team as soon as possible:
- Allergic reactions—skin rash, itching, hives, swelling of the face, lips, tongue, or throat
- Dizziness, loss of balance or coordination, confusion or trouble speaking
- Hemolytic anemia—unusual weakness or fatigue, dizziness, headache, trouble breathing, dark urine, yellowing skin or eyes
- High potassium level—muscle weakness, fast or irregular heartbeat
- Increase in blood pressure
- Infection—fever, chills, cough, sore throat, wounds that don't heal, pain or trouble when passing urine, general feeling of discomfort or being unwell
- Kidney injury—decrease in the amount of urine, swelling of the ankles, hands, or feet
- Liver injury—right upper belly pain, loss of appetite, nausea, light-colored stool, dark yellow or brown urine, yellowing skin or eyes, unusual weakness or fatigue
- Pain, tingling, or numbness in the hands or feet, muscle weakness, change in vision, confusion or trouble speaking, loss of balance or coordination, trouble walking, seizures
- Unusual bruising or bleeding
Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):
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Pros and cons of Cyclosporine (Restasis)
Pros
- Helps your eye make its own tears
- Can use with other lubricating eye drops, such as artificial tears
- Available as single-use vials and multi-dose bottles
Cons
- Need to use twice a day
- Can take a long time (up to 6 months) to see improvement in dry eyes
- Commonly causes a burning sensation in the eye
Pharmacist tips for Cyclosporine (Restasis)
- Make sure you know how to use cyclosporine (Restasis). Ask your pharmacist or eye specialist if you have any questions.
- Put cyclosporine (Restasis) into the affected eye(s) twice a day, about 12 hours apart. If you use other eye drop medications too, wait at least 15 minutes between each medication. This gives your eye time to absorb each medication properly.
- Take out your contact lenses from your eye(s) before you use cyclosporine (Restasis). Wait at least 15 minutes before you put your lenses back into your eye(s). Ask your eye specialist if you should keep wearing contact lenses or switch to glasses since contacts can sometimes make dry eye worse.
- Wash your hands before you put cyclosporine (Restasis) drops in your eye(s). Don't touch the dropper tip with your hands, and don't let the tip touch your eye or any other surface. This helps prevent eye infections by lowering the risk of contaminating the medication. You might get prescribed two bottles of cyclosporine (Restasis), one for each eye, to lower the risk of contamination.
- Tilt your head backward and look up. Gently pull your bottom eyelid down to make a small pocket. Then, hold the cyclosporine (Restasis) bottle upside down right above the eye. Squeeze the bottle so that 1 drop of medication falls into the pocket. Close your eye. Then, press a finger against the inside corner of your eye for about a minute to help keep the medication in your eye.
- Throw away the 0.4 mL single-use vials after placing the drop in your eye(s). Don't save any leftover medication. Use each single-use vial just once. They don't have a cap that you can put back on like the Restasis MultiDose bottles do.
- Store cyclosporine (Restasis) at room temperature (between 59 and 77 degrees Fahrenheit). Keep the medication in the original package to protect it from light.
More tips for Restasis MultiDose (cyclosporine) bottles:
- Each time you use a new bottle of Restasis MultiDose, prime the bottle before you put any of the medication into the eye(s). Take off the olive green cap and squeezing two drops of medication onto a tissue. Don't let the tip of the bottle touch the tissue.
- Before using Restasis MultiDose, turn the bottle upside down a few times. This makes sure the medication is mixed well. Don't shake the bottle really hard.
- After each time you use Restasis MultiDose, put the green cap back on the bottle until you need to use it again. The cap helps prevent germs from getting into the medication.
Common questions about Cyclosporine (Restasis)
In studies, it took about 6 months for people using cyclosporine (Restasis) to see improvement in their dry eye. But those with milder symptoms might feel some relief within a month. Talk to your prescriber if you have questions about how fast the medication is working. You can also ask about other options to try as you wait for cyclosporine (Restasis) to work.
No. Cyclosporine (Restasis) is only available with a prescription from a healthcare professional (HCP). But there are over-the-counter (OTC) options for dry eye available. OTC options like artificial tears might work faster to relieve dry eye, but they don't last very long. Also, the FDA recommends using OTC eye drops for dry eye for up to 3 days before asking an HCP for more help. Don't use OTC eye drops in place of cyclosporine (Restasis) unless your prescriber said you can.
No, cyclosporine (Restasis) won't make dry eye worse. It works to improve dry eye. But using other eye drops, like over-the-counter artificial tears, often or for a long time sometimes can. This is especially true if the eye drops have preservatives. Talk to your prescriber if your dry eye doesn't get better after starting cyclosporine (Restasis).
Yes. Having a burning feeling in the eye is the most common side effect of cyclosporine (Restasis). But it should get better and eventually go away as you continue to use the medication. Tell your prescriber or eye specialist if the burning feeling bothers you too much or if it doesn't go away.
Xiidra and Restasis are both eye drops that are used twice a day to treat dry eye. But they're different medications. They work in different ways to lower inflammation and relieve dry eye. Some people might feel improvement after about 2 weeks of using Xiidra. But for people using Restasis, they might feel relief after at least a month. These two medications haven't been directly compared, so it's not clear which one works better. But studies show that both can help with dry eye. Talk to your eye specialist if you have questions about which medication is best for you.
No, cyclosporine (Restasis) isn't a steroid medication. It's a type of medication called a calcineurin inhibitor. Cyclosporine (Restasis) and some steroid eye drops, like Eysuvis (loteprednol), work in different ways to reduce inflammation related to dry eye.
Use each single-use vial of cyclosporine (Restasis) one time only. After you open it and place a drop into the eye(s), throw away the vial even though there'll be some medication left. Single-use vials don't have a cap to put back on, so there's a higher chance of germs getting into the medication. This isn't the case for Restasis MultiDose, which you can use many times until it expires. Just make sure to put the cap back on the MultiDose bottle after each use.
The Restasis 0.4 mL single-use vial is available as a generic. But there's no generic for the Restasis MultiDose 10 mL bottle; the MultiDose is only brand name right now.
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Risks and warnings for Cyclosporine (Restasis)
Cyclosporine (Restasis) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
For use in the eye only
Cyclosporine (Restasis) is an eye drop medication that you should place onto the surface of the eye only. Don't put cyclosporine (Restasis) on or into any other place on your body.
Avoid use with contact lenses
Don't place cyclosporine (Restasis) in the eye while you're wearing contact lenses. If you wear contact lenses, take them out before using this medication. You can put your contact lenses back in 15 minutes after using cyclosporine (Restasis).
In general, people with dry eye shouldn't wear contact lenses because having lenses in can make the dryness worse. Ask your eye specialist if you should wear glasses or contact lenses while you're being treated for dry eyes.
Cyclosporine (Restasis) dosage
Package| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 30 vials of 0.4ml | 2 packages | $94.06 | $47.03 |
| 60 vials of 0.4ml | 1 package | $94.07 | $94.07 |
Typical dosage for Cyclosporine (Restasis)
Restasis, Restasis MultiDose, and generic cyclosporine eye emulsion contain 0.05% of medication.
The typical dose is 1 drop in affected eye(s) twice a day about 12 hours apart.
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