Can I use other eye drops with Miebo? A Guide to Combining Medications

October 9, 2025 •

4 min read

Miebo (perfluorohexyloctane ophthalmic solution) is designed to stabilize the tear film and is indicated for the treatment of evaporative dry eye disease. Because it works by forming a protective layer over the tear film, the precise timing and order of application are crucial when asking, 'Can I use other eye drops with Miebo?' to ensure all medications work as intended.

Quick Summary

Yes, you can often use other eye drops with Miebo by following a specific order and waiting period between applications. Miebo should typically be applied last to prevent other drops from washing it away. An ophthalmologist can help coordinate your full eye care regimen for maximum benefit and safety.

Key Points

Timing is Critical: Wait at least 5 to 10 minutes between different types of eye drops to prevent dilution and ensure each medication is fully absorbed.
Miebo Last: When using multiple drops, Miebo should always be instilled last to avoid having its protective, evaporation-blocking layer washed away.
Order Matters: Follow a specific regimen, typically applying other medicated or lubricating drops before Miebo, and reserving ointments for last.
Contact Lenses Out: Remove contact lenses before using Miebo and wait at least 30 minutes after application before putting them back in.
Consult Your Doctor: Always discuss your complete eye drop regimen with an ophthalmologist to confirm compatibility and timing, especially when combining with other prescription DED treatments.
Technique Maximizes Absorption: Applying pressure to the inner corner of the eye for 1-2 minutes after instilling a drop helps maximize its effectiveness.
Preservative-Free Options: If using other lubricants frequently, consider preservative-free artificial tears to minimize irritation.

Understanding Miebo's Unique Mechanism

Miebo is different from many other dry eye treatments because it targets the evaporative component of dry eye disease (DED). It is a clear, colorless liquid that helps to prevent tear evaporation, which is often the cause of DED symptoms. Unlike medicated drops that affect tear production (like Restasis or Xiidra), Miebo is an ocular surface protectant that acts as a film. This is why proper timing is essential when combining it with other drops; if you use another drop immediately after Miebo, it can wash away the protective layer before it has a chance to work effectively.

The Importance of Timing and Order

When using multiple types of eye drops, the order and waiting time can significantly impact their efficacy. The standard practice for most eye drops is to wait at least 5 minutes between different medications to allow each one to be fully absorbed. However, with Miebo, there are specific recommendations to follow:

Miebo should always be the last drop you instill. This prevents other eye drops from diluting or washing away the stabilizing film that Miebo creates on the surface of your eye.
Wait at least 5 to 10 minutes between applying any other eye drops and Miebo.
If you are using an eye ointment or gel, it should always be applied last, after all liquid drops.

Combining Miebo with Other Prescription Dry Eye Drops

Many patients with DED require more than one type of treatment. The combination of Miebo with other medicated drops, such as immunomodulators, can be part of a comprehensive management plan for mixed aqueous-deficient and evaporative dry eye.

It is important to discuss combination therapy with a doctor, as there is some conflicting information. While some reports suggest Miebo can work with anti-inflammatory drops like cyclosporine (Restasis®, Cequa™) or lifitegrast (Xiidra®), a document from Medical Mutual specifically states there are "no data to support the concomitant use" with these other DED medications. This highlights the need for your ophthalmologist's guidance when creating a personalized treatment plan.

Using Miebo with Over-the-Counter (OTC) Drops

Using OTC lubricating or artificial tears with Miebo also requires careful consideration. According to some eye care professionals, artificial tears should not be used along with Miebo, but rather spaced out in your regimen. Your doctor can help you determine the best way to incorporate them, if necessary.

Proper Administration Techniques

To ensure all drops are absorbed properly, follow these steps:

Wash your hands before and after handling eye drops.
Tilt your head back or lie down flat for better positioning.
Pull your lower eyelid down to create a small pocket.
Instill one drop without the tip of the bottle touching your eye, eyelid, or lashes.
Gently close your eye and apply pressure to the inner corner (the tear duct) for 1-2 minutes. This is called punctal occlusion and helps prevent the medication from draining too quickly.
Wait 5 to 10 minutes before applying the next type of eye drop.
Apply Miebo last if using other drops.

Comparison of Combination Regimens


Eye Drop Type	Purpose	Recommended Order with Miebo	Minimum Waiting Time	Special Considerations
Miebo	Stabilize tear film, prevent evaporation (preservative-free)	Always last	Not applicable	Remove contact lenses; wait 30+ minutes to reinsert.
Prescription Anti-inflammatories (e.g., Restasis, Xiidra)	Increase tear production, reduce inflammation	Before Miebo	5-10 minutes	Consult your doctor, as clinical data for concomitant use can vary.
OTC Artificial Tears	Lubricate the eye surface	Before Miebo	5-10 minutes	Should be spaced out, not used with Miebo. Use preservative-free if sensitive.
Ointments/Gels	Thicker, long-lasting lubrication	Always last (after Miebo)	5-10 minutes	Use overnight formulations after all other drops.
Glaucoma Drops	Lower intraocular pressure	Before Miebo	5-10 minutes	Use as prescribed, often at specific times.

Important Precautions and Your Eye Doctor

Before combining any new medications, always consult your ophthalmologist. They can provide a personalized treatment plan that accounts for your specific condition and any potential interactions. It's crucial to inform your healthcare provider about all prescription and over-the-counter (OTC) medicines, vitamins, and supplements you are using.

Contact Lenses

As per the manufacturer, Miebo should not be administered while wearing contact lenses. Patients should be advised to remove their contact lenses before application and wait at least 30 minutes before reinserting them. This precaution helps ensure the medication is not absorbed by the contact lens and that the eye's surface can properly absorb the treatment.

Monitoring Side Effects

While Miebo is generally well-tolerated, the most common reported side effects are blurred vision and conjunctival redness. If you experience any persistent or concerning side effects, especially when combining medications, contact your doctor immediately.

Conclusion

In summary, it is possible to use other eye drops with Miebo, but it requires careful timing and coordination. To achieve the best therapeutic results, Miebo should be instilled as the final drop in your liquid regimen, with a waiting period of 5 to 10 minutes following any other drops. Always consult with your ophthalmologist to create a safe and effective regimen, especially if you are using other prescription medications for your dry eye disease. Consistent adherence to your doctor's instructions, particularly regarding timing and contact lens use, will ensure you get the maximum benefit from your treatment.

For more information on dry eye management and eye health, consult resources such as the National Eye Institute.

Frequently Asked Questions

You should wait at least 5 to 10 minutes between applying different types of eye drops to allow each medication to be absorbed effectively. Miebo should be applied as the last liquid drop in your regimen.

You should use any other eye drops, such as anti-inflammatory or lubricating drops, before Miebo. Miebo should be the last drop you instill to ensure its protective film is not washed away.

Yes, you can use artificial tears with Miebo, but they should be used at different times. An ophthalmologist has noted that artificial tears should not be used along with Miebo, but should be spaced out in your dosing schedule. Ask your doctor for a specific recommendation.

If you are prescribed an eye ointment, it should always be applied last, after all liquid drops, including Miebo. This is because ointments can create a barrier that prevents other drops from penetrating the eye's surface.

The manufacturer advises that you should not use Miebo while wearing contact lenses. Remove your lenses before applying Miebo and wait at least 30 minutes before reinserting them.

Miebo has no known severe, serious, moderate, or minor interactions with other drugs. However, the interaction is not a chemical one but a physical one related to dilution, which is why proper timing is so important. Always tell your doctor about all medications you use.

Some eye care professionals discuss combining Miebo with drops like Xiidra or Restasis in a broader dry eye management strategy. However, a specific report from Medical Mutual indicates a lack of data to support their concomitant use. This underscores the importance of consulting with your ophthalmologist to determine the safest and most effective combination for your specific case.

To maximize absorption, apply one drop into the pocket of your lower eyelid. After instilling the drop, gently close your eye and apply pressure to the inner corner for 1-2 minutes. This technique, called punctal occlusion, helps prevent the drop from draining away too quickly.