Bad Taste, Blurry Vision, and More: 7 Xiidra Side Effects You Should Know About

Living with chronic dry eye can be frustrating. But there are several treatments available for this condition. Xiidra (lifitegrast) is one such prescription-only option for adults. It’s an eye drop that you apply twice a day.

If you’re just starting Xiidra, it’s normal to have questions about it. Potential side effects are commonly top of mind. Blurry vision and eye irritation are two possible Xiidra side effects. But what other potential side effects should you know about?

Xiidra side effects at a glance

Most Xiidra side effects are limited to the area around the eye. That’s because your body doesn’t absorb much of the medication after you apply it.

Common Xiidra side effects include:

• Eye irritation

• Bad taste or taste changes

• Lower visual acuity (vision sharpness)

Less common but mild Xiidra side effects include:

• Blurry vision

• Headache

• Watery eyes

• Eye discharge, or “eye boogers”

• Eye discomfort

• Red eyes

• Sinusitis (sinus pain and inflammation)

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Serious side effects are rare with Xiidra. But using the eye drop incorrectly could cause eye injury or lead to an eye infection. Be sure to review how to use Xiidra before applying your dose for the first time. Xiidra’s labeling includes instructions for use. But you can also ask your prescriber or pharmacist to go over it with you if you’re unsure.

Below, you’ll find information about seven Xiidra side effects and how to manage them if they arise.

1. Eye irritation

Eye irritation is a common Xiidra side effect. This usually happens during or shortly after applying the drops. Less commonly, people also experience eye discomfort or redness while using Xiidra.

These side effects should improve within a few minutes of applying your drops. They may also be more noticeable when you first start using Xiidra. Once Xiidra starts improving your dry eye (after about 6 to 12 weeks of use), irritation generally improves.

If eye irritation is severe or persistent, tell your prescriber. This isn’t a typical Xiidra side effect.

2. Bad taste

Many medications can cause a bad taste in your mouth or taste changes. This may happen with Xiidra. This side effect happens because your tear ducts are connected to your nose. Tears and eye drops may drain into your nose and down your throat.

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This side effect isn’t bothersome enough to cause most people to stop using Xiidra. The bad taste usually improves within an hour after applying your drops.

Using Xiidra correctly may help lessen or prevent this side effect. Try gently pressing on the inner corner of your eye for 1 to 2 minutes after placing Xiidra. This may stop some of the liquid from draining into your nose.

3. Blurry vision

Blurry vision or less sharp vision are other possible Xiidra side effects. They usually happen right after applying your drops. Once your eye absorbs the drop, it should resolve.

If you have blurry vision after using Xiidra, sit and wait for it to pass. You shouldn’t drive while you’re experiencing this side effect. If your vision usually blurs after using Xiidra, set aside some extra time when you apply your drops.

Keep in mind that chronic dry eye can also cause blurry vision. So if you’re experiencing this symptom frequently, it might be from the condition itself — not your eye drops. In this case, Xiidra may actually help improve this symptom as it starts working for dry eye.

4. Headache

Headaches are an uncommon but mild Xiidra side effect. But there are many potential causes for headaches. What’s more, chronic dry eye may be associated with migraines. So it can be hard to say for sure whether Xiidra is the true cause of this symptom.

Regardless of the reason, there are ways to help manage headaches at home:

• Drink extra water.

• Rest in a dark room while experiencing headaches, if possible.

• Avoid alcohol and limit caffeine.

• Ask your prescriber or pharmacist if you can safely take an over-the-counter (OTC) pain reliever, such as ibuprofen (Advil, Motrin).

If these tips don’t help, tell your prescriber. Severe or persistent headaches aren’t typical with Xiidra. There may be another cause for this symptom.

5. Watery eyes

Xiidra is supposed to increase the amount of tears you make. But sometimes, it can make your eyes watery. It may also cause you to have eye discharge, often referred to as eye boogers. These side effects are generally harmless, but they can be annoying.

Tell your prescriber if watery eyes are bothersome or interfering with your usual routine. They may have you try a different dry eye medication. And if you notice eye discharge that’s green or yellow, tell your prescriber. This is a sign of a possible eye infection.

6. Sinusitis

Sinus pain or inflammation are unusual Xiidra side effects. In clinical trials, this symptom was reported by similar percentages of people using Xiidra and a placebo (an eye drop with no medication). So it’s possible that Xiidra may not have caused sinus-related side effects.

Most people can manage sinus pain at home. These tips might help relieve sinus pain:

• Take a hot shower and breathe in the steam.

• Use a humidifier.

• Stay well hydrated.

• Elevate your head while lying in bed.

• Apply a warm compress to your nose, cheeks, and forehead.

• Massage the areas where you feel sinus pressure or pain.

• Try a nasal saline rinse, such as a neti pot.

• Ask your healthcare team if you can safely use OTC nasal decongestants, such as pseudoephedrine (Sudafed), for a few days.

• If it’s safe for you, take an OTC pain reliever.

If sinus pain lasts for more than 7 to 10 days or you also have a fever, tell your healthcare team. This could point to a sinus infection. In this situation, your healthcare professional may suggest additional treatments.

7. Eye infection

Using Xiidra incorrectly may cause eye infections. Wash your hands with soap and water before applying your drops, and be careful not to touch the dropper tip with your fingers. Doing so could introduce bacteria and other germs into your eye. Also, don’t let the dropper tip touch your eye. This could cause an eye injury.

Xiidra comes in single-use vials. Throw the vial away after each dose, even if there’s liquid left inside. You shouldn’t save vials to use later. Xiidra doesn’t contain preservatives, so germs may grow in vials if they’re left open.

Tell your prescriber if you experience any of following symptoms of an eye infection:

• Eye redness or itching

• Eyelid redness or swelling

• Green or yellow eye discharge

• Eye crusting in the morning

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Written 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:

Jennifer Gershman, PharmD, CPh, PACS

Jennifer Gershman, PharmD, is a licensed pharmacist in Florida. She has worked in the pharmacy industry for more than 15 years and is currently a medical writer.

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