xiidra vs restasis
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Pros and Cons of Xiidra vs Restasis for Dry Eye Treatment

Many people struggle with dry eyes every now and then. But did you know that having chronic dry eyes is a medical condition? Known as dry eye disease, people diagnosed with this condition do not produce enough tears.

Dry eye symptoms include burning eyes, sensitivity to light, red eyes, and blurred vision. These symptoms can happen due to age, autoimmune diseases, allergies, or hormonal fluctuations.

The good news about dry eye disease is that there are medications to treat it. Xiidra and Restasis are two popular brand-name prescriptions for chronic dry eyes. But there are many differences between Xiidra vs Restasis.

How do these medications differ, and how do you know which one is right for you? Your doctor can help you understand which prescription is right for you. Or you can keep reading this guide to learn more.

Xiidra vs Restasis: What’s the Difference?

Xiidra and Restasis are two brand-name drugs prescribed to treat dry eye disease. They both come in eyedrop form for easy application. You can only use these medicated eyedrops if you have a doctor’s prescription.

Xiidra and Restasis are long-term solutions to chronic dry eye symptoms. And neither of these prescriptions has a lower-cost generic. Other similarities between the two drugs include the following:

  • Similar benefits (e.g., relieves itchiness, redness, and blurry vision)
  • Similar side effects (e.g., irritation, burning, redness, blurred vision, eye discharge, eye pain)
  • Similar dosages (i.e., one drop per eye per 12 hours or up to twice daily)

But this is about where the commonalities between the two medications end. Xiidra and Restasis have two completely different mechanisms of action.

Xiidra’s generic name is lifitegrast. Lifitegrast is a lymphocyte function-associated antigen-1 antagonist.

These medications block inflammation in the eyes to treat dry eye symptoms. But Xiidra, in particular, also helps ramp up tear production to healthier levels. Having inadequate tears is one of the top causes of dry eye symptoms.

Restasis, on the other hand, has the generic name cyclosporine. Cyclosporine is a calcineurin inhibitor, also known as an immunosuppressant.

As the name suggests, immunosuppressants decrease immune system function. One of the functions of the immune system is to regulate swelling, which is correlated with dry eye symptoms.

Xiidra Pros and Cons

When it comes to Xiidra vs Restasis, there are quite a few reasons to choose one over the other. Check out our top pros and cons of Xiidra for dry eyes below.

Pro: Faster Results

In clinical studies of Xiidra and Restasis, the former may relieve dry eye symptoms faster. Xiidra may start working within as few as two weeks. It is more common for Xiidra to show maximum benefits by the end of 12 weeks.

Restasis, on the other hand, can take months to work.

Con: More Side Effects

Xiidra tends to have more side effects than Restasis. The most commonly reported side effect of Restasis is a burning sensation upon application.

Xiidra may cause additional symptoms like a strange taste in the mouth and blurry vision.

Pro: More Effective

Xiidra may be more effective at relieving the signs and symptoms of dry eye disease. Restasis, meanwhile, may only be less effective at dealing with symptoms.

What do we mean? The signs of dry eye disease include observable effects of dry eyes, such as redness and inflammation.

However, symptoms of dry eye disease are those you experience subjectively. These symptoms include pain, itchiness, blurry vision, and photosensitivity.

Con: It Can Be Expensive

Xiidra is a newer drug, and newer drugs typically come with higher price tags. Xiidra costs nearly twice as much as Restasin at most locations where prescriptions are sold.

Pro: Newer Technology

Xiidra may have only come out a few years ago, making it a much younger medication with less research into its benefits. But being a newer drug gives Xiidra the advantage of having newer technology.

Restasis Pros and Cons

Restasis is typically the first medicated eyedrop brand a doctor will recommend. Why? As we mentioned earlier, insurance usually covers this prescription medication.

Here are some more advantages to using Restasis, as well as some reasons why you might want to consider an alternative. 

Pro: Tried and True

The FDA approved Restasis as a treatment for dry eye disease all the way back in 2002. But Xiidra has only been around for about half a decade. The FDA approved it for use in 2016.

Con: It Takes Longer to Work

In clinical studies of Restasis, medicated eye drops took up to six months to work. And in the study, only 15% of participants reported any benefits from using Restasis at all.

Pro: Fewer Side Effects

We mentioned that Restasis and Xiidra have similar side effects. But Restasis has fewer overall side effects compared to Xiidra.

For example, Xiidra may cause headaches and changes to taste. Restasis does not come with these two side effects.

Con: Only Treats the Signs of Dry Eyes

As mentioned, Restasis may not be very effective at treating the subjective symptoms of dry eyes. Xiidra, on the other hand, is more effective at treating both the visible signs and the subjective symptoms of dry eye disease.

Pro: Younger Teens Can Use It

Xiidra can only be prescribed to people as young as 17 years old. Alternatively, Restasis is available to people aged 16 years or older.

Con: It Doesn’t Work for Everyone

In the study linked above, 75% of participants in the Restasis group did not experience relief from their treatment.

Some of these individuals experienced some benefits but not a significant reduction in symptoms. Other participants did not experience any benefits at all, meaning Restasis may not work for everyone.

Pro: Insurance Covers It

Another reason why Xiidra is so expensive is that insurance does not typically cover it. Since Restasis has been around so long, insurers typically cover it. This can significantly decrease the cost you pay for your medicated eyedrops.

If you want to get coverage for Xiidra, you may have to experience Restasis treatment failure first.

Other Treatments for Dry Eyes

Xiidra and Restasis are not the only treatments for dry eyes and dry eye disease. In fact, these medicated eye drops are typically the last line of defense against dry eye symptoms.

Most doctors will first recommend steroids and/or artificial tears. If these treatments do not work for you, your doctor may then prescribe Xiidra or Restasis.

If these prescriptions do not work, there are other medicated eyedrop products to consider, including Cequa. Here’s what you need to know about these alternatives to Xiidra and Restasis.


Steroids are a short-term solution for dry eye symptoms. Like other dry eye medications, steroids treat eye inflammation that could be causing your symptoms.

The best thing about steroid treatment for dry eyes is that it works fast. Some doctors even prescribe it alongside medicated eye drops like Xiidra and Restasis because steroids make these treatments more tolerable.

However, as mentioned, steroids are not a long-term treatment for chronic dry eyes. This treatment will only provide short-term relief.

Still, some insurance companies require you to undergo steroid treatments before they cover medicated eyedrops.

Artificial Tears

Another treatment many payors require people with chronic dry eyes to undergo before seeking medication is artificial tears. Artificial tears are over-the-counter eye drops used to moisturize dry eyes.

Like steroids for dry eyes, artificial tears only provide short-term relief. They do not treat the source of the problem for people with dry eye disease. Instead, they replace inadequate amounts of or low-quality tears.


Cequa is the latest dry eye medication to hit shelves. The FDA approved its use at the end of 2019. It falls under the same drug class as Restasis (calcineurin inhibitors) and contains cyclosporine as its active ingredient.

The biggest difference between Cequa and Restasis is the concentration of cyclosporine. Restasis contains 0.05% cyclosporine. Cequa contains almost twice that amount, with 0.09% cyclosporine.

Looking for Dry Eye Medications Online?

Xiidra and Restasis are treatments for people with chronic dry eyes. The most obvious difference between Xiidra vs Restasis is their active ingredients.

Xiidra blocks eye inflammation and increases tear production, while Restasis suppresses the immune system.

Talk to your healthcare provider about these two treatments for dry eye symptoms.

Are you trying to order medicated eyedrops online in Canada? Canadian Pharmacy Online is the cheapest and easiest way to get your medications without having to leave your home.

Learn how to order your prescription from Canadian Pharmacy Online today!

Works Cited