Restasis vs Xiidra: Which Is Better?

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Restasis and Xiidra are both Federal Drug Administration (FDA) approved medications used to treat dry eye syndrome. Dry eyes occur when a person’s tears are not capable of providing adequate eye lubrication. Tears can be insufficient for several reasons including that some people do not produce enough tears. Other times, people create poor-quality tears.

Dry eyes impact countless people and make it difficult to perform activities that require substantial eye work like computer work or reading. Because it can be difficult to determine whether Restasis or Xiidra would be best to repeat this condition, this article reviews some critical differences between the two medications.

Restasis, Xiidra and Inflammatory Diseases

Inflammatory disease is associated with a higher risk of dry eye disease. Some of the most common types of inflammatory diseases include Crohn’s disease, Lupus, Psoriasis Ulcerative Colitis, and Rheumatoid arthritis as well as many others. If a person with an inflammatory disease does not treat dry eyes with Restasis or Xiidra and instead relies on artificial tears, their condition will often grow worse. This makes sense because t-cells cause both symptoms associated with dry eyes as well as other inflammatory disease problems.

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Sometimes referred to by its chemical name of cyclosporine, Restasis is much older than Xiidra and was first approved by the FDA in 1983. Medical professionals believe that Restasis regulates the eye’s inflammatory process that impacts tear production. Administered similarly to Xiidra, Restasis is also used twice a day and contacts must be removed before usage. The most common side effect associated with Restasis is burning in the eyes, but blurry vision and irritation are also common.


Sometimes also referred to by its chemical name of lifitegrast, Xiidra was first approved for use in 2016. While the medication’s exact method of action is not currently known, Xiidra prevents the interaction of LFA-1 with ICAM-1, which is believed to play a critical role in treating people with dry eye disease. Available as a 5% topical eye solution, Xiidra is administered as one drop delivered twice a day in each eye. People who wear contacts must remove them before using Xiidra, but can place the contacts back into their eyes after 15 minutes. Xiidra is often used as a long term medication because dry eye is a chronic condition. While helpful in treating dry eyes, Xiidra results in some minor side effects including blurry visions, changes in taste, and irritation.

Only One Drop at a Time

A critical issue to appreciate if you take either Restasis or Xiidra is that you also cannot concurrently take another eye drop. Instead, you must make certain to space out the administration of these medications by at least 15 minutes. This is because a person’s eye is only capable of holding about 10 micro-liters of fluid and one eye drop is 25 micro-liters. While it might seem like as much medication as possible is a good thing, a person who uses these medications together in such a close period will only wash out the medication through their tear duct.

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The Differences Between Restasis and Xiidra

Both Restasis and Xiidra are used to treat dry eyes. These medications share other similarities as well including that there is no generic form and both are ophthalmic agents which are substances that decrease the size of the pupil. There are also some significant differences between the two medications, which include:

  • Common side effects. Xiidra results in common side effects like blurry vision, change in test sensation, eye irritation. Restasis, however, commonly results in burning sensations, blurry vision, and redness.
  • Price. Restasis is slightly more expensive than Xiidra. Xiidra is on average $571 while Restasis is $586 on average
  • Onset. The effects of Xiidra can be felt within 6 weeks, while Restasis takes up to six months to reach its point of maximum effectiveness. The reason for these differences in onset time is that Xiidra is believed to work in a slightly different way on the immune system.

As a result, for people who are looking to save more or who want to more quickly experience eye relief, Restasis is the best option. There are, however, some shortcomings associated with Restasis. The medication often takes several months before it becomes effective. Before the medicine becomes effective, a person might still experience dry eyes.

Options to Try First

Both Restasis and Xiidra come with large price tags. Consequently, many people decide to utilize first-line treatments before using these medications. Some of the common types of first line treatment options that people utilize to combat dry eyes include artificial tears, punctal plugs which are placed by a medical professional and used to block tear ducts, and warm compresses applied to a person’s eyes.

Other Issues Whether Taking Restasis or Xiidra

Whether a person takes Restasis or Xiidra, some of the other important issues to consider include:

  • Cooler medication stings less. If a person experiences burning or stinging in the eyes, it is a good idea to place the medication in the refrigerator. This is helpful because cold eye drops often sting less than warm ones.
  • Steroids are sometimes used. Steroids are sometimes needed to reduce the burning sensation that accompanies Restasis or Xiidra. Once a person becomes used to these medications, the individual can often stop the steroid after several weeks when they become used to the medication.
  • Strange tastes in the mouth. Strange tastes in a person’s mouth after taking these medications is common. That’s because the tear duct drains into your throat. To avoid this sensation, people can swallow water before using the medication.

Speak with a Knowledgeable Medical Professional

Deciding between Xiidra and Restasis can be challenging, but having a detailed conversation about the two medications with your medical professional. By exchanging details about these medications, you can make informed decisions about what works best for you. Deciding on the best blood thinner is not easy, but a skilled medical professional can help.

About Cary Byrd

eDrugSearch founder, Cary Byrd, has been called an “e-health innovator” by MarketIntellNow, interviewed by top pharmaceutical industry journalists, invited to Matthew Holt’s Health 2.0 Conference and a Consumer Report's health summit, and highlighted on numerous health blogs.

Restasis vs Xiidra

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