It belongs to a class of medications known as calcineurin inhibitors, which are thought to work by suppressing the immune system. Because Restasis is administered locally into the eye, it helps to reduce eye swelling (inflammation) and relieve dryness in that area.
As an eye medication for dry eyes, cyclosporine is available by prescription as Restasis (0.05%) emulsion and Cequa (cyclosporine 0.09%) solution. Cyclosporine is also available by prescription as a Verkazia (cyclosporine 0.1%) emulsion for another eye condition called vernal keratoconjunctivitis, a chronic (long-term) severe eye allergy.
What Is Restasis Used For?
The Food and Drug Administration (FDA) approved Restasis to help increase tear production in people with dry eyes (keratoconjunctivitis sicca). Dry eye disease is a common medical condition that can cause the following symptoms:
Brand Name(s): Restasis
Drug Availability: Prescription
Administration Route: Ophthalmic (eyes)
Therapeutic Classification: Calcineurin inhibitor
Available Generically: No
Controlled Substance: N/A
Active Ingredient: Cyclosporine 0.05%
Dosage Form(s): Ophthalmic (eye) emulsion
Blurry visionBurning sensation in your eyesEye sensitivity to lightGritty or scratchy sensation in your eyesItchy eyesRed eyes
Restasis’ anti-inflammatory effects bring down the inflammation in the eye, often caused by dry eye disease. Eye inflammation is thought to block tear production in people with this condition.
How to Take Restasis
Before using Restasis, let your healthcare provider instruct you on how to take the medication. Carefully read your container’s directions and packaging label to ensure you administer the drops correctly.
You will squeeze one drop from the Restasis vial in each eye twice daily, about 12 hours apart. After administering the drops, keep your eyes closed and place pressure on the inside corner of the eye (tear duct). This helps ensure that the medication stays in the eye.
Also, keep the following in mind when using Restasis:
Do not administer while wearing contact lenses: Remove your contact lenses before using Restasis and wait at least 15 minutes before putting them back in. To prevent injury and contamination, do not touch the tip of the vial to your eye. Make sure to wash your hands before administering the eye drops. Wait at least 15 minutes before using other eye medications.
Storage
Restasis is packaged in single-use vials. It is also available as a MultiDose container. Keep the medication in a cool, dry place. Generally, it is important to store medication away from areas exposed to high temperatures or humidity, like your kitchen or bathroom. Keep the vials away and out of reach of children and any pets to prevent accidental consumption.
What Are the Side Effects of Restasis?
This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your healthcare provider. You may report side effects to the FDA at fda.gov/medwatch or 1-800-FDA-1088.
Common Side Effects
The most common side effects that you may experience with Restasis are:
Burning in your eye Eye pain Foreign body sensation, or feeling like there’s something in your eyes Itching Stinging Blurry vision
Severe Side Effects
Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or if you think you’re having a medical emergency. Serious side effects can include the following:
Eye swelling Face swelling Tongue swelling or angioedema as signs of a severe allergic reaction Shortness of breath as signs of a severe allergic reaction Change in eyesight Eye injury due to the tip touching the eye
Dosage: How Much Restasis Should I Take?
Modifications
The dosages of Restasis generally don’t require changes based on your health condition.
If you experience a serious side effect, you or your healthcare provider may send a report to the FDA’s MedWatch Adverse Event Reporting Program or by phone (800-332-1088).
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
To increase tear production: For ophthalmic emulsion dosage form (eye drops): Adults and children 16 years of age and older—One drop in the affected eye(s) 2 times a day (every 12 hours). Children younger than 16 years of age—Use and dose must be determined by your doctor. For ophthalmic solution dosage form (eye drops): Adults—One drop in the affected eye(s) 2 times a day (every 12 hours). Children—Use and dose must be determined by your doctor.
To treat vernal keratoconjunctivitis: For ophthalmic emulsion dosage form (eye drops): Adults and children 4 years of age and older—One drop in the affected eye(s) 4 times a day (morning, noon, afternoon, and evening). Children younger than 4 years of age—Use and dose must be determined by your doctor.
However, you may need to modify (change) how you use Restasis based on the following circumstances:
If you wear contact lenses: Remove your contact lenses before using Restasis. After using Restasis, wait at least 15 minutes before putting them back in. If you use other eye medications: Separate Restasis use from other eye medications by at least 15 minutes.
Missed Dose
If you miss a dose of Restasis, administer a Restasis drop in each eye as soon as you remember. If it is close to the next dose, skip the missed dose and return to your normal schedule.
Overdose: What Happens If I Take Too Much Restasis?
It is unlikely that you would overdose from Restasis. However, if you accidentally use more drops than prescribed, you may be more likely to experience side effects such as:
Burning in your eyeEye painStinging
Precautions
What Are Reasons I Shouldn’t Take Restasis?
You should not take Restasis if you have ever had an allergic reaction to cyclosporine or any of the ingredients in Restasis.
If someone collapses or isn’t breathing after using Restasis, call 911 immediately.
If your or your child’s symptoms do not improve or if they become worse, check with your doctor.
This medicine may cause blurred vision or other vision problems. If any of these occur, do not drive or do anything else that could be dangerous until you know how this medicine affects you.
While applying this medicine, your eyes will probably sting or burn for a short time. This is to be expected.
What Other Medications Interact With Restasis?
Restasis generally does not have many interactions. When used correctly, eye drops do not enter the bloodstream, which reduces the likelihood of drug interactions.
If you have multiple eye medications, don’t immediately use one after another. Separate Restasis from other eye medications by at least 15 minutes.
If you have questions or concerns about medication interactions with Restasis, talk with your pharmacist or healthcare provider.
What Medications Are Similar?
Other therapies that help improve eye dryness are available, including over-the-counter (OTC) products and prescription eye drops or procedures.
These include:
OTC artificial tears Punctal plug, a procedure in which the tear drainage pipe is blocked Steroid eye drops, such as Eysuvis (loteprednol) Non-steroid eye drops, such as Xiidra (lifitegrast)
Xiidra works differently than cyclosporine eye medications. It might also work a little faster, with some users noticing an improvement in dry eye symptoms after weeks.
As for the different cyclosporine products, cyclosporine is available as Cequa and Restasis for dry eyes. Compared to Restasis, studies suggest that Cequa might be more effective—with fewer side effects.
This is a list of other options that may be used for dry eyes. It is NOT a list of drugs recommended to take with Restasis. You should always ask your pharmacist or healthcare provider if you have any questions or concerns.
How Can I Stay Healthy While Taking Restasis?
Dry eye disease can be uncomfortable and irritating to deal with. It’s important to take your medication exactly as prescribed by your healthcare provider to help ease your symptoms.
In addition to using your Restasis drops, the following are general tips for preventing and relieving eye dryness:
Stay hydrated by drinking at least eight glasses of water a day. Reduce screen time on your electronic devices. Eat a healthy diet with sufficient vitamins, including vitamin A, vitamin D, and omega-3 fatty acids. Avoid wearing contact lenses when you can, especially if your eyes are irritated. Wear sunglasses and/or a sunhat to protect your eyes from sunny, windy, or dry environments.
Talk to your healthcare provider if you consistently have dry eyes or if your symptoms do not let up after regular use of your prescribed treatment.
The author of this article would like to recognize and thank Chong Yol Gacasan Kim for contributing.
