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Tyrvaya

varenicline
Used for Dry Eye
Used for Dry Eye

Tyrvaya (varenicline) is a cholinergic agonist. It's a nasal spray used to treat dry eye in adults. This medication is sprayed into each nostril, typically twice a day. Some side effects of Tyrvaya (varenicline) include sneezing, cough, and throat irritation.

Reviewed by:
reviewer
Kristianne Hannemann, PharmD
reviewer
Allison Gourley, PharmD
Last reviewed on March 17, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsDosageCostAlternativesLatest newsReferencesPricesMedicare
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What is Tyrvaya (varenicline)?

What is Tyrvaya (varenicline) used for?

How Tyrvaya (varenicline) works

Tyrvaya (varenicline) is a cholinergic agonist. The exact way it works to treat dry eye isn't well-understood. But it's thought to work by activating certain receptors in the body responsible for making tear film. So Tyrvaya (varenicline) soothes dry eyes by helping your body make more of its own natural tear film.

Are you looking for information on varenicline (Chantix) to quit smoking instead?

Drug Facts

Common BrandsTyrvaya
Drug ClassCholinergic agonist
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
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$808.64(save 19.84%)
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What are the side effects of Tyrvaya (varenicline)?

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

  • Sneezing (82%)
  • Cough (16%)
  • Throat irritation (13%)
  • Nose irritation (8%)

Source: DailyMed

The following side effects have also been reported

Side effects that you should report to your care team as soon as possible:

Side effects that usually do not require medical attention (report these to your care team if they continue or are bothersome):

pros-and-cons

Pros and cons of Tyrvaya (varenicline)

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Pros

Can relieve dry eyes in as quickly as 5 minutes

Can cause eyes to make 50% more tears after a month of treatment

Can be stored at room temperature

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Cons

Must be used twice a day and in each nostril

Brand name only

Commonly causes sneezing as a side effect

pharmacist-tips

Pharmacist tips for Tyrvaya (varenicline)

pharmacist

  • Tyrvaya (varenicline) comes with two bottles. Each bottle should last about 15 days. Open the second bottle only after you have finished the first.

    • Don't shake Tyrvaya (varenicline) since this can damage the medication. This spray is different from other nasal sprays.

      • Store Tyrvaya (varenicline) at room temperature. Don't ever freeze it or this could damage the medication and make it not work as well. Make sure to throw away any open bottle after 30 days.

        Read the instructions for use or watch this video to get familiar with using Tyrvaya (varenicline):

        • Before using Tyrvaya (varenicline) spray for the first time, you'll need to prime (ready) your bottle. Do this by spraying 7 sprays into the air away from your face. This will help make sure you get the right dose.

          • If you haven't used Tyrvaya (varenicline) for more than 5 days, you'll need to re-prime it by spraying one spray into the air away from your face before using it again.

            • When you're ready for your dose, gently blow your nose first if needed then tilt your head back slightly and insert the tip of the Tyrvaya (varenicline) spray bottle just past the opening of your nostril. Don't put it in too deep since you don't want to spray the medication into your sinuses.

              • Aim the tip of the Tyrvaya (varenicline) spray out towards your ear (on the same side of the nostril you're spraying into) and press your tongue to the roof of your mouth. Breathe gently as you press and release the applicator. The medication will be absorbed into the walls of your nose.

                • Then repeat using Tyrvaya (varenicline) in the other nostril.

                  • Wipe the nasal applicator with a clean tissue each time after using it.

                    faqs

                    Frequently asked questions about Tyrvaya (varenicline)

                    Is Tyrvaya (varenicline) a steroid?
                    No, Tyrvaya (varenicline) isn't a steroid; but rather, it belongs to a group of medications called cholinergic agonists. Typically, steroid nasal sprays are used to ease allergy symptoms, such as runny nose and congestion. But Tyrvaya (varenicline) is used to treat dry eye by triggering your eyes to make more tears.
                    How to use Tyrvaya (varenicline)?
                    Before using Tyrvaya (varenicline), make sure to prime your bottle by pressing and releasing the applicator 7 times. Once you're ready, hold the Tyrvaya (varenicline) nasal spray upright and place one finger on each side of the top and your thumb underneath. Tilt your head back slightly and insert the nasal applicator into one nostril. Point the tip towards the top of the ear on the same side as your nostril. But don't press the tip against the wall of your nose; make sure to leave a small gap. Put your tongue to the roof of your mouth, breathe gently, and press and release the applicator once. Repeat this in your other nostril. Never use Tyrvaya (varenicline) in your eyes since it's only meant to be used as a nasal spray.
                    Does Tyrvaya (varenicline) work?
                    Two different one-month studies looked at how well Tyrvaya (varenicline) worked to treat dry eyes. About half of people who used Tyrvaya (varenicline) noticed 50% more tear production at the end of treatment. But only about a-third of the people who used placebo (a spray with no medication in it) noted the same results. Tyrvaya (varenicline) might not work well for everyone. Let your ophthalmologist know if you don't see an improvement in your symptoms after about a month.
                    How long does it take Tyrvaya (varenicline) to work?
                    Tyrvaya (varenicline) works pretty fast, even as quickly as 5 minutes after the first dose. But this medication might take a bit longer to work for some people.
                    How many sprays in Tyrvaya (varenicline)?
                    Each Tyrvaya (varenicline) nasal spray bottle contains 60 sprays, which should last you 15 days. Tyrvaya (varenicline) comes as a carton that contains two bottles, so you'll have enough sprays for a 30 day supply. But because you need to prime your Tyrvaya (varenicline) spray bottle when you first use it or anytime you stopped using it for 5 days or longer, each bottle might last less than 15 days.
                    Is Tyrvaya (varenicline) safe to use during pregnancy?
                    There isn't enough information available to know if Tyrvaya (varenicline) is safe to take during pregnancy. If you're pregnant, discuss the risks and benefits of using Tyrvaya (varenicline) with your obstetrician. Also, ask them about other options to treat dry eyes.
                    What if I miss a dose of Tyrvaya (varenicline)?
                    If you happen for miss a dose of Tyrvaya (varenicline), just skip that dose and take your next dose at your usual time. Don't take extra doses to make up for missed doses of Tyrvaya (varenicline), because this could lead to side effects.
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                    dosage

                    Tyrvaya (varenicline) dosage forms

                    The average cost for 1 carton of 2 nasal spray bottles of 0.03mg of Tyrvaya (varenicline) is $648.17 with a free GoodRx coupon. This is 19.84% off the average retail price of $808.64.
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                    DosageQuantityPrice as low asPrice per unit
                    2 nasal spray bottles of 0.03mg1 carton$648.17$648.17

                    Typical dosing for Tyrvaya (varenicline)

                    Each spray contains 0.03 mg of varenicline.

                    • Adults: The typical dose is 1 spray in each nostril every 12 hours.

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                    Tyrvaya (brand)
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                    alternatives

                    What are alternatives to Tyrvaya (varenicline)?

                    There are a number of medications that your doctor can prescribe in place of Tyrvaya (varenicline). Compare a few possible alternatives below.
                    Tyrvaya (varenicline)
                    Used for:
                    $648.17 Lowest GoodRx priceView Prices
                    Xiidra (lifitegrast)
                    Used for:

                    • Dry eyes

                    $681.60 Lowest GoodRx priceView Prices
                    Cyclosporine (Restasis)
                    Used for:

                    • Dry eye in people 16 years and older

                    $97.64 Lowest GoodRx priceView Prices

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                    References

                    Best studies we found

                    American Academy of Ophthalmology. (2017). Tear film.

                    Oyster Point Pharma. (2024). Tyrvaya- varenicline spray [package insert]. DailyMed.

                    Viatris Inc. (2024). Forget what you know about other nasal sprays. Learn the Tyrvaya® way to spray.

                    View All References (3)

                    Viatris Inc. (n.d.). Get ready to spray: Learn the correct way to spray Tyrvaya®.

                    Wirta, D., et al. (2021). Efficacy and safety of OC-01 (varenicline solution) nasal spray on signs and symptoms of dry eye disease. Ophthalmology.

                    Wirta, D., et al. (2022). ONSET-1 phase 2b randomized trial to evaluate the safety and efficacy of OC-01 (varenicline solution) nasal spray on signs and symptoms of dry eye disease. Cornea.

                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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