Xiidra, containing the active ingredient lifitegrast, is a prescription eye drop used to treat the signs and symptoms of dry eye disease by targeting inflammation. While effective for many, it's important to understand potential drawbacks, including side effects and cost.
The Most Common Negatives of Xiidra
Common side effects are often mild and temporary but can be bothersome.
- Eye Irritation: Many users experience burning, stinging, or discomfort upon application, which usually subsides quickly.
- Dysgeusia (Altered Taste Sensation): Up to 25% of users may notice an unpleasant taste, often metallic or bitter, as the medication drains into the throat.
- Blurred or Reduced Vision: Temporary blurred vision can occur immediately after using the drops, requiring a short wait before activities like driving.
Less Common and Serious Side Effects
Other potential negatives include:
Mild to Moderate Side Effects
Less frequent side effects can include headache, watery eyes, eye discharge or itching, and sinusitis.
Potential for Serious Allergic Reactions
Rare but serious allergic reactions have been reported, including hives, difficulty breathing, and swelling of the face, tongue, or throat. Seek immediate medical attention if these occur.
Financial & Accessibility Negatives
The cost of Xiidra is a major issue for many, with a 30-day supply often exceeding $700 without insurance.
- High Out-of-Pocket Costs: The cash price can range from about $748 to $863 without insurance or discounts.
- Insurance Variability: Coverage varies, and patients may face high deductibles or copays. Medicare coverage can also vary by plan.
- Prior Authorization: Many insurers require prior authorization, potentially delaying treatment while doctors justify the need for Xiidra over alternatives.
Comparison of Negatives: Xiidra vs. Other Dry Eye Treatments
Here's a comparison of Xiidra with other common prescription dry eye treatments:
| Feature | Xiidra (lifitegrast) | Restasis (cyclosporine) | Cequa (cyclosporine) |
|---|---|---|---|
| Primary Side Effects | Eye irritation, unusual taste (dysgeusia), blurred vision | Burning sensation, eye pain, feeling of sand in eyes | Pain on instillation, conjunctival hyperemia (redness) |
| Onset of Action | May provide relief in as little as 2 weeks for some patients | Can take 3 to 6 months to experience maximum benefit | May take several weeks to months to see effects |
| Cost Profile | High brand-name cost, generic not yet available | Brand-name and generic versions available, potentially lower cost | High brand-name cost, often more expensive |
Managing the Downsides of Xiidra
Strategies can help mitigate some negative aspects:
- For Bad Taste (Dysgeusia): Drinking water, chewing sugar-free gum, or sucking on mints can help. Pressing on the inner corner of the eye after application can also reduce drainage into the throat.
- For Eye Irritation: Proper application technique is important. Some doctors may suggest initial use of other anti-inflammatory drops.
- For Blurred Vision: Use drops when you can rest briefly to allow vision to clear.
- For Contact Lens Wearers: Lenses must be removed before using Xiidra and can be reinserted after 15 minutes.
Conclusion
Xiidra can be effective for dry eye disease, but its negatives are noteworthy. Common side effects like eye irritation, unusual taste, and temporary blurred vision can be disruptive. The high cost and potential insurance issues are significant barriers. Though rare, serious allergic reactions are a risk. Discussing these negatives with an eye care professional is crucial to determine if Xiidra is the right choice.
