Xiidra vs. Restasis: Differences, similarities, and which is better for you

In this article:

• What are Xiidra and Restasis?
• Conditions treated
• Efficacy
• Coverage and cost comparison
• Common side effects
• Interactions and warnings
• FAQs

In this article

• What are Xiidra and Restasis?
• Conditions treated
• Efficacy
• Coverage and cost comparison
• Common side effects
• Interactions and warnings
• FAQs

Xiidra (lifitegrast) and Restasis (cyclosporine) are brand-name medications for dry eye disease. People with dry eye disease often don’t make enough tears to keep their eyes lubricated, which can cause eye discomfort, burning, and trouble focusing when reading or using a computer. Xiidra and Restasis are eye drop medications used in both eyes daily to help relieve dryness and reduce irritation.

What are Xiidra and Restasis?

Xiidra

Xiidra is a newer prescription eye drop approved by the FDA in 2016. It belongs to a class of drugs called LFA-1 antagonists, which reduce inflammation by blocking certain protein interactions in the eyes. This helps improve tear production and relieve dryness. Xiidra is supplied as single-use, preservative-free vials.

Restasis

Restasis has been on the market since 1983 and remains a leading treatment for dry eye disease. It works as a calcineurin inhibitor, reducing inflammation on the eye’s surface and allowing the tear‑producing glands to work better. Restasis is supplied as preservative-free, single-use vials or a multidose bottle. While single-use vials are available in a generic version, the multidose bottle is brand-name only.

Conditions treated by Xiidra and Restasis

Xiidra and Restasis are approved to treat dry eye disease, otherwise known as dry eye syndrome. Dry eye disease may be associated with other eye conditions, such as blepharitis, or inflammation of the eyelids, caused by allergies or other problems. These medications help increase tear production and reduce inflammation on the ocular surface. 

In addition to dryness, Xiidra and Restasis can help treat other symptoms of dry eye disease, including eye redness, eye fatigue, blurry vision, and itchiness. Some doctors may recommend additional treatments while using Xiidra or Restasis, such as warm compresses to soothe the eye. 

Is Xiidra or Restasis more effective?

There are limited randomized controlled trials comparing Xiidra and Restasis. But individual clinical studies show both are effective:

• Xiidra: Across four clinical trials with 1,181 patients, Xiidra significantly improved dry eye symptoms by week 12, with some patients reporting relief in just 2 weeks.
• Restasis: In trials with about 1,200 patients, 15% of those treated with Restasis experienced increased tear production at 6 months, compared to 5% with placebo.

Although Xiidra may work faster, that doesn’t necessarily mean it’s better. In a retrospective review of 64 people who had used both drops, about half (52%) preferred Restasis, around 22% favored Xiidra, and a few couldn’t tolerate either.

Other surveys found that most patients were satisfied with both drugs, but many still experienced delayed or incomplete symptom relief. Around 14% of patients switched between Xiidra and Restasis within six months to get more relief or a faster response. Both treatments can significantly improve symptoms, but results may still vary.

Coverage and cost comparison of Xiidra vs. Restasis

Xiidra doesn’t have a generic version yet, which may make it more costly than other medications. Some insurance companies and Medicare plans now cover it, but coverage and copays can differ. The average retail price can be over $1,000. However, a SingleCare Xiidra coupon card may help lower the price of the medication to around $617. 

Restasis is available as both a brand-name and a generic version, which helps make it more affordable. Most health insurance plans, including Medicare, cover at least one of these options, but what you pay can vary. Without insurance, brand Restasis can cost roughly $411, although a SingleCare Restasis coupon may lower the cost of Restasis to less than $100.

Common side effects of Xiidra vs. Restasis

Both medications may cause mild, temporary side effects.

Common side effects of Xiidra

• Eye irritation, redness, or discharge
• Blurred vision
• Headache
• Unusual taste in the mouth (dysgeusia)

Common side effects of Restasis

• Burning or stinging in the eyes after use
• Redness or irritation
• Blurred vision

These adverse effects usually go away as the eyes adjust to the medication. Still, it’s a good idea to mention any potential side effects to an eye doctor if they worsen or persist.

Serious side effects

Both may rarely cause hypersensitivity reactions, with signs or symptoms such as rash, swelling, or shortness of breath. It’s important to seek medical attention if serious allergic reactions occur. 

There’s also a risk of infection or eye injury if the tip of the dropper touches the eye during application. Make sure to keep the dropper clean by avoiding any contact and preventing contamination.

Drug interactions and warnings

• Xiidra and Restasis don’t have any major drug interactions.
• Avoid using other eye drops at the same time unless directed by your healthcare provider.
• Contact lenses should be removed before applying Xiidra or Restasis. Lenses may be reinserted 15 minutes after using these medications.
• Avoid touching the dropper tip directly to the surface of the eye to prevent contamination.
• Xiidra and Restasis single-use containers need to be discarded after opening.

Frequently asked questions about Xiidra vs. Restasis

Are Xiidra and Restasis the same?

No. Xiidra is an LFA-1 antagonist, while Restasis is a calcineurin inhibitor. They work differently, but both reduce inflammation and increase tear production.

Which is faster – Xiidra or Restasis?

Xiidra may relieve symptoms in as little as 2 weeks, while Restasis usually takes 3 months or longer. Still, results can vary, with some people taking longer to feel relief. 

Can I use Xiidra or Restasis while pregnant?

Both are considered low-risk since absorption into the bloodstream is minimal. Still, it’s best to consult a healthcare provider before using these medications while pregnant or breastfeeding.

Can I use Xiidra or Restasis with alcohol?

Yes. Xiidra and Restasis work locally in the eyes and are not known to interact with alcohol. Drinking in moderation should not affect how these eye drops work.

Can Xiidra cure dry eyes?

Xiidra is not a cure but a long-term treatment to relieve dry eyes and other symptoms of dry eye disease. If Xiidra is discontinued, dryness in the eyes may return.

Is Xiidra a steroid?

No. Xiidra is not a steroid—it’s an LFA-1 antagonist.

Does Xiidra reduce inflammation?

Xiidra is an effective medication that helps reduce eye inflammation and dryness. It can start relieving dry eyes within two weeks, although it can take up to 12 weeks to provide complete relief. Xiidra is administered twice daily as an ophthalmic solution. 

Is there a cheaper alternative to Restasis?

Yes, a generic version of Restasis has been approved since 2022 and is now available at pharmacies. It contains the same active ingredient as the brand-name version but may be more affordable.

Which is better for you: Xiidra or Restasis?

Both Xiidra and Restasis are effective treatments for chronic dry eye disease.

• Xiidra may be a better option if: you want faster relief, don’t mind higher out-of-pocket costs, or haven’t had success with Restasis.
• Restasis may be a better option if: you want a more affordable option with insurance coverage, and you’re comfortable waiting longer for results.

Always talk to your eye care provider about your symptoms and budget when deciding which medication is right for you. Remember, you can lower your prescription costs by using SingleCare coupons.