What is Lifitegrast: Uses, Dosage, Side Effects and More

Lifitegrast is a prescription eye drop medication that helps treat dry eye disease by reducing inflammation on the surface of your eyes. This medication works differently from artificial tears by actually addressing one of the root causes of dry eye rather than just providing temporary moisture.

If you've been dealing with persistent dry, irritated eyes that don't seem to get better with over-the-counter drops, your eye doctor might have recommended lifitegrast as a more targeted treatment option. Let's walk through everything you need to know about this medication in simple terms.

What is Lifitegrast?

Lifitegrast is an anti-inflammatory eye drop that belongs to a class of medications called lymphocyte function-associated antigen-1 (LFA-1) antagonists. In simpler terms, it's a specialized medication that blocks certain immune system signals that contribute to eye inflammation and dryness.

Unlike regular artificial tears that just add moisture to your eyes, lifitegrast actually works to calm down the inflammatory process that's causing your dry eye symptoms. Think of it as treating the underlying problem rather than just masking the symptoms.

This medication comes as a clear, sterile solution that you apply directly to your eyes using single-use vials. Each vial contains exactly one dose, which helps prevent contamination and ensures you're getting the right amount of medication.

What is Lifitegrast Used For?

Lifitegrast is primarily used to treat dry eye disease, also known as keratoconjunctivitis sicca. This condition occurs when your eyes don't produce enough tears or when the tears evaporate too quickly, leaving your eyes feeling dry, scratchy, and uncomfortable.

Your doctor might prescribe lifitegrast if you experience persistent symptoms that haven't improved with artificial tears or other basic treatments. These symptoms often include a gritty or sandy feeling in your eyes, burning or stinging sensations, redness, and sometimes even excessive tearing as your eyes try to compensate for the dryness.

The medication is specifically designed for moderate to severe dry eye disease where inflammation plays a significant role. It's particularly helpful for people whose dry eyes are caused by conditions like Sjögren's syndrome, meibomian gland dysfunction, or other inflammatory conditions affecting the eye surface.

How Does Lifitegrast Work?

Lifitegrast works by blocking specific immune system pathways that contribute to eye inflammation. It targets something called LFA-1, which is a protein that helps immune cells stick to and damage the surface of your eyes during inflammatory responses.

When inflammation occurs in your eyes, certain immune cells become overactive and start attacking healthy eye tissue. Lifitegrast acts like a gentle brake on this process, preventing these immune cells from causing further damage to your tear-producing glands and eye surface.

This medication is considered moderately strong in terms of its anti-inflammatory effects. It's more targeted than general anti-inflammatory drugs, which means it can be effective while typically causing fewer side effects than stronger medications. Most people start noticing improvements in their symptoms within 2-4 weeks of regular use.

How Should I Take Lifitegrast?

Lifitegrast should be used exactly as prescribed by your eye doctor, typically one drop in each affected eye twice daily, about 12 hours apart. The medication comes in small, single-use vials that you'll need to open fresh for each dose.

Here's how to apply the drops safely and effectively:

1. Wash your hands thoroughly before handling the medication
2. Remove contact lenses if you wear them (wait at least 15 minutes after using the drops before putting them back in)
3. Open a new vial by twisting off the top
4. Tilt your head back slightly and gently pull down your lower eyelid
5. Hold the vial above your eye and squeeze gently to release one drop
6. Close your eye for about 30 seconds to help the medication spread
7. Discard the vial after use, even if there's medication left

You can use lifitegrast with or without food, as it's applied directly to your eyes rather than taken by mouth. If you need to use other eye medications, wait at least 5 minutes between different drops to prevent them from washing each other out.

Try to use your doses at roughly the same times each day to maintain consistent levels of the medication in your eyes. Many people find it helpful to tie their doses to daily routines like brushing their teeth in the morning and evening.

How Long Should I Take Lifitegrast For?

The length of treatment with lifitegrast varies from person to person, but most people need to use it for at least 3-6 months to see significant improvement in their dry eye symptoms. Some people may need to use it long-term to maintain their results.

Your eye doctor will typically want to see you after about 6-8 weeks of treatment to assess how well the medication is working for you. During this visit, they'll check for improvements in your symptoms and examine your eyes to see if the inflammation is decreasing.

It's important to continue using lifitegrast even if you don't notice immediate improvement. Unlike artificial tears that provide instant relief, anti-inflammatory medications like lifitegrast work gradually to address the underlying causes of your dry eyes. Most people start experiencing noticeable benefits after 2-4 weeks of consistent use.

Don't stop using lifitegrast suddenly without talking to your doctor first. If you discontinue the medication abruptly, your dry eye symptoms may return as the inflammation comes back.

What Are the Side Effects of Lifitegrast?

Most people tolerate lifitegrast well, but like all medications, it can cause side effects in some individuals. The most common side effects are generally mild and tend to improve as your eyes adjust to the medication.

Here are the most frequently reported side effects:

• Temporary burning or stinging when you first apply the drops
• Blurred vision for a few minutes after application
• Eye irritation or redness
• Unusual taste in your mouth (this happens because the medication can drain through your tear ducts)
• Headache
• Increased tearing initially

These common side effects usually become less noticeable as you continue using the medication. The burning sensation, in particular, tends to decrease significantly after the first few days of use.

Less common but more serious side effects can include severe eye pain, vision changes, or signs of an allergic reaction such as swelling around your eyes, difficulty breathing, or widespread rash. If you experience any of these symptoms, contact your doctor immediately.

Some people may also experience discharge from their eyes or increased sensitivity to light. While these aren't dangerous, they can be uncomfortable and warrant a conversation with your eye care provider.

Who Should Not Take Lifitegrast?

Lifitegrast isn't suitable for everyone, and your doctor will consider several factors before prescribing it. The medication is generally not recommended for people who have shown allergic reactions to lifitegrast or any of its ingredients.

You should tell your doctor if you have any of the following conditions before starting lifitegrast:

• Active eye infections (bacterial, viral, or fungal)
• Recent eye surgery or injury
• Pregnancy or plans to become pregnant
• Breastfeeding
• Other serious eye conditions beyond dry eye disease

The safety of lifitegrast during pregnancy and breastfeeding hasn't been fully established, so your doctor will weigh the potential benefits against any possible risks. If you're trying to conceive or discover you're pregnant while using lifitegrast, discuss this with your healthcare provider right away.

Children and teenagers under 18 should not use lifitegrast, as its safety and effectiveness haven't been established in younger age groups. The medication is specifically approved for adult use only.

Lifitegrast Brand Names

Lifitegrast is available under the brand name Xiidra, which is manufactured by Novartis. This is currently the only brand name version of lifitegrast available in the United States.

Xiidra comes in single-use vials containing 5% lifitegrast solution. Each box typically contains 60 vials, which provides a one-month supply when used twice daily as prescribed.

Generic versions of lifitegrast are not yet available, which means Xiidra is the only option for this specific medication. However, your insurance may have preferred alternatives or your doctor might suggest other dry eye treatments if cost is a concern.

Lifitegrast Alternatives

If lifitegrast isn't right for you or isn't providing adequate relief, several alternative treatments are available for dry eye disease. Your eye doctor can help you explore these options based on your specific symptoms and needs.

Other prescription eye drops for dry eyes include:

• Cyclosporine (Restasis) - another anti-inflammatory drop that works differently than lifitegrast
• Varenicline (Tyrvaya) - a nasal spray that stimulates tear production
• Cequa - a newer formulation of cyclosporine

Non-prescription alternatives include preservative-free artificial tears, warm compresses, omega-3 fatty acid supplements, and lifestyle modifications like using a humidifier or taking breaks from screen time.

Some people benefit from procedures like punctal plugs, which are tiny devices inserted into tear ducts to help retain moisture in the eyes. Your doctor might also recommend treating underlying conditions like blepharitis or meibomian gland dysfunction.

Is Lifitegrast Better Than Cyclosporine?

Both lifitegrast and cyclosporine are effective treatments for dry eye disease, but they work through different mechanisms and may be better suited for different people. Neither medication is universally "better" than the other - the choice depends on your individual situation.

Lifitegrast tends to work faster than cyclosporine, with many people noticing improvements within 2-4 weeks compared to 3-6 months with cyclosporine. However, cyclosporine has been available longer and has more extensive long-term safety data.

Some people respond better to one medication than the other, and occasionally doctors may recommend using both together for severe cases. The side effect profiles are somewhat different - lifitegrast more commonly causes taste changes, while cyclosporine may cause more burning initially.

Your eye doctor will consider factors like the severity of your dry eyes, your medical history, other medications you're taking, and your insurance coverage when deciding which treatment might work best for you.