How long does it take for Xiidra to work?

In this article:

• How long does it take Xiidra to work?
• Influencing factors
• Dosage
• Contraindications
• The bottom line

In this article

• How long does it take Xiidra to work?
• Influencing factors
• Dosage
• Contraindications
• The bottom line

Dry eye disease is a common condition, affecting over 16 million Americans, according to the National Eye Institute. Also known as keratoconjunctivitis sicca, dry eye occurs when your eyes don’t produce enough liquid to stay wet. While it may sound minor, it causes a lot of uncomfortable symptoms, including burning, stinging, itching, grittiness, or pain in the eyes. Treatment options include lifestyle changes, tear duct plugs, surgery, and over-the-counter or prescription eye drops. Before trying different treatments, it is important to consult an eye specialist to make sure there is no underlying serious medical condition.

One popular prescription option is Xiidra (lifitegrast), a brand-name medication that can have you feeling better in just a couple of weeks. Here’s what you need to know if you’re wondering how soon you might experience some relief from using Xiidra eye drops to treat your dry eye symptoms.

How long does it take for Xiidra to work? 

Most people begin to experience improvement in their symptoms within two or three weeks of starting to use Xiidra eye drops, if this particular medication is going to be effective for them, says Daniel C. Brocks, MD, ophthalmologist and chief medical officer at BostonSight. “Improvement in signs and symptoms is generally the guiding light in determining effectiveness,” Dr. Brocks says.

Xidra belongs to a class of medications called lymphocyte function-associated antigen 1 antagonists, or LFA-1 antagonists. It reduces inflammation by blocking the action of a certain protein to increase tear production. Most cases of dry eye disease are caused by one of two problems, or a combination of the two:

• Your glands don’t produce tears
• Your tears evaporate too quickly (often because of meibomian gland dysfunction, a problem with the part of the eyelid that secretes oil)

Dry eye can also occur after eye surgery. Like nearly all medications, Xiidra may cause some side effects, though most are considered tolerable according to a research review. The most common are temporary pain, blurred vision, and eye irritation upon putting the drops in. To avoid this, some providers recommend using preservative-free artificial tears about 15 minutes before using Xiidra may help. “It just adds a little barrier of protection so it doesn’t sting as much,” says Maria Laura Gomez Freeman, MD, ophthalmologist and director of the Dry Eye Clinic at San Diego Health. 

Another common side effect is a funny taste sensation in the mouth or the back of the throat as your system absorbs the medication through your tear ducts. “It is not dangerous and is not a reason that one has to stop the medication,” says Dr. Brocks. “However, many find it off-putting and choose to stop the medication if they get this side effect.” You can lessen this side effect by pressing your finger over your tear duct as you put the drops into your eye.

Hypersensitivity or allergic reactions are rare but serious side effects of Xiidra. Symptoms include hives, difficulty breathing, wheezing, swelling of the face, lips, tongue, or throat, or anaphylaxis.

RELATED: What causes eye pain?

What can affect how long Xiidra takes to work?

There are two main ways to help Xiidra work most effectively to heal dry eye.

1. Follow the dosing instructions. “To my knowledge, the only thing that will make it work faster is compliance with twice-a-day dosing and eyelid closure with drop instillation,” Dr. Brocks says. 
2. Use a mild steroid drop, such as loteprednol, for two weeks in addition to Xiidra eye drops to help speed up the healing process, suggests Dr. Freeman. 

However, steroids should not be used long-term, and they must be used appropriately to receive the benefits. “You must wait 15 minutes in between drops so they don’t wash each other out,” Dr. Freeman says. 

What is the standard Xiidra dosage?

A standard dose of Xiidra is one drop in each eye, twice daily. The drops should be administered 12 hours apart. “It’s two drops a day, and you have to stick with it for at least eight to 12 weeks,” says Dr. Freeman.

Who should avoid taking Xiidra?

You should not use Xiidra eye drops if you:

• Are pregnant or breastfeeding
• Are 17 or younger
• Have an active viral, bacterial, or fungal eye infection
• Have a history of allergic reaction to any of the ingredients in Xiidra
• Have not had a comprehensive exam with an eye specialist

You should stop using Xiidra if you experience hypersensitivity reactions like swelling, itching, irritation, or rash. “You cannot use Xiidra while wearing contact lenses,  so contact lens wearers have to apply the drops and wait at least 15 minutes before putting lenses back in,” says Dr. Freeman. 

Xiidra vs. other dry eye medications

Xiidra is a commonly prescribed dry eye medication, but it’s not the only option. Other treatments for chronic dry eye include:

Xiidra vs. other dry eye medications
Drug name	Formulation	Time to onset
Xiidra (lifitegrast)	Ophthalmic solution	2-3 weeks
Restasis (0.05% cyclosporine)	Ophthalmic emulsion	2-3 months
Cequa (0.09% cyclosporine)	Ophthalmic solution	4-6 months
Vevye (0.1% cyclosporine)	Ophthalmic solution	2-4 weeks
Lotemax (loteprednol)	Ophthalmic solution	Immediate effects, 0 hours
Tyrvaya (varenicline)	Nasal spray	3-4 weeks
Miebo (perfluorohexyloctane)	Ophthalmic solution	2-8 weeks

“Typically, in recent years, either Restasis or Xiidra is a first-line topical immunomodulating agent used for dry eye disease,” says Dr. Brocks. “Some patients are more responsive to one or the other, and some require both.” According to the American Academy of Ophthalmology, clinical trial results indicate that none of the available treatments have demonstrated clear superiority. 

In other words, it may take some trial and error to find which eye drop works best. The most effective treatment for you may take into account how quickly it works, insurance coverage, and cost. It may also involve a combination of eye drops and lifestyle changes like taking regular breaks from screens to blink or using warm compresses.

If the cost of Xiidra is a factor, SingleCare coupons can help reduce the price since there is no generic form available. 

The bottom line

Xiidra is a commonly prescribed dry eye treatment. It’s usually prescribed for eight to 12 weeks, but many people who use Xiidra experience symptom relief within a couple of weeks of using it. However, it’s not necessarily the right choice for everyone. If you are noticing that your eyes are often dry, gritty, itchy, or painful, contact a healthcare professional to ask for an evaluation for dry eye syndrome. If Xiidra doesn’t work for you, there are other treatment options that can relieve symptoms of dry eye disease.