SEE THE DIFFERENCE: RESTASIS VS. XIIDRA
Millions of Americans suffer from dry eye – if you are one of the people who feel personally victimized by Meatloaf’s song “Not a Dry Eye In The House,” you might be one of them. Torture-like symptoms include scratchy sensations as if something is stuck in the eyeball, stinging, burning, discharge, pain, redness -- and, ironically, excess tearing, followed by intense dryness.
Luckily, the FDA has now approved not one, but two prescription medications to stop the madness that is dry eye: Restasis, the oldie but goodie eye-drop approved by the FDA in 2003, and Xiidra, the new eye-drop on the block, which was just approved last year. New choices! Great! Until you go down an internet rabbit hole trying to discern the difference between the two drugs and end up gauging your dry eyes out in frustration. To avoid that eventuality, here is a handy breakdown of the differences between Restasis and Xiidra.
Dry Those Eyes
Both Restasis and Xiidra are prescribed to treat chronic dry eye, which is basically exactly what it sounds like -- a condition in which the eyes do not produce enough tears, or good enough tears, to keep them wet enough to do their job. 30 million people in the US suffer from dry eye: the older you get, the more likely you are to develop it, and, unfortunately for the ladies out there, women are more prone to it than men.
Dry eye can be caused by a number of factors: certain medications (like antihistamines, decongestants, or any drugs that alter hormones), conditions such as rosacea, autoimmune disorders, rheumatoid arthritis, diabetes, thyroid disorders, and Vitamin A deficiencies can all result in dry eye. Even staring at screens for too long (which slows blinking) can lead to dry eye -- but in this day and age, trading in that iPhone for the sake of your real eyes may not always be possible. Enter Restasis or Xiidra to save the day.
Name of the Game
Restasis is a class of drug called cyclosporine, which is an immunosuppressant (meaning it weakens the body’s immune system). Although the immune system is generally helpful, immune cells in the eyes create swelling, one of the causes of dry eye. Cyclosporine attacks those immune cells, decreases swelling, and helps the body create more of its own natural tears.
Xiidra, on the other hand, is a lymphocyte function-associated antigen-1 (LFA-1 for short), the first approved drug of its class. Xiidra works by blocking a protein that stops eyes from producing enough healthy tears.
I Saw the Sign
The biggest difference between these two drugs is that Restasis treats only the signs of dry eye, whereas Xiidra treats both the signs and the symptoms.
Signs of dry eye are things that other people can notice, such as eye discoloration or redness. Symptoms of dry eye are things that only you experience, including pain, headaches, scratching, and irritation. In other words, Restasis will only increase tear production, whereas Xiidra will do the same, plus treat additional problems you may be experiencing as a result of dry eye.
Time Flies When Your Eyes are Dry
In clinical trials, Xiidra began working in as early as 2 weeks, whereas Restasis takes about 3 months to fully kick in. Although Restasis may work for them, many patients give up on Restasis before it is fully engaged, because of its long onset of action.
The Flip Side
While both Xiidra and Restasis have their benefits, they also come with their own individual set of side effects. Restasis may cause stinging and redness, while some people who take Xiidra experience noticeable altered taste.
Eye Contact
Restasis and Xiidra cannot be used while wearing contact lenses. However, with both drugs, contact lenses can be put back in 15 minutes after use.
The Bottom Line
When Restasis arrived on the scene, it was the first of its kind -- a prescription-grade treatment for chronic dry eye, that helped the body produce its own natural tears. After 13 years, Xiidra’s introduction is a game-changer, in that it treats both signs and symptoms -- but that is not to say it is better. Both drugs can be effective in combating dry eye, but, like any medication, different drugs work for different people. Before you ask for that Rx, talk to your doctor -- and soon you, too, can be embarrassed when you tear up during a sappy love song, just like the rest of us.
