How Xiidra and Refresh Tears Work Differently
To understand why you need to space out your drops, it's essential to recognize their different mechanisms. Xiidra is not just a lubricant; it's a targeted prescription medication, while Refresh Tears is an over-the-counter (OTC) supplement for moisture.
Xiidra: Targeting Inflammation
Xiidra (lifitegrast) is a prescription ophthalmic solution that treats the underlying inflammation of dry eye disease. It belongs to a class of drugs called LFA-1 antagonists. In dry eye, inflammatory proteins can become overactive on the surface of the eye. Xiidra works by blocking the interaction between the protein LFA-1 and its receptor ICAM-1, which prevents T-cell activation and subsequent inflammatory responses. By reducing this inflammation, Xiidra helps restore the eye's natural ability to produce tears and improves the long-term health of the ocular surface. It is a treatment for the cause of chronic dry eye, not just a temporary fix for symptoms.
Refresh Tears: Providing Lubrication
Refresh Tears is a brand of over-the-counter artificial tears, which are designed to provide temporary relief from the burning, irritation, and discomfort of dry eyes. The active ingredients typically include lubricating agents like carboxymethylcellulose sodium. Unlike Xiidra, artificial tears do not treat the underlying cause of dry eye. They function by supplementing the natural tear film, providing a temporary shield of moisture to soothe and protect the eye surface from irritation. For this reason, they are excellent for managing flare-ups or providing immediate comfort while Xiidra works over the long term.
Can I Use Refresh Tears with Xiidra? Yes, With Proper Spacing
Yes, combining an OTC lubricant like Refresh Tears with your Xiidra prescription is generally safe and often recommended by eye care professionals. However, applying them too close together can cause one drop to wash out the other, reducing the effectiveness of your treatment. The accepted rule is to wait at least 10 to 15 minutes between applications of different eye drops.
Why Proper Timing Matters
The 10-15 minute waiting period allows Xiidra to be properly absorbed into the eye's tissues and start its work on the inflammatory cycle. If you were to immediately follow Xiidra with a lubricating drop, the lubricating drop would dilute and potentially flush out the active ingredient of Xiidra before it has had a chance to work. By spacing them out, you ensure each medication performs its intended function without interference.
A Typical Dosing Schedule
For someone using both, a typical routine might look like this:
- Morning: Instill one drop of Xiidra in each eye. Wait at least 15 minutes. Then, you can use Refresh Tears if needed for temporary relief.
- Throughout the Day: Use Refresh Tears as often as needed for comfort.
- Evening: Instill one drop of Xiidra in each eye, ensuring it is approximately 12 hours after the morning dose.
- Before Bed: Wait another 15 minutes after Xiidra before applying Refresh Tears for nighttime lubrication, if desired.
Comparison: Xiidra vs. Refresh Tears
| Feature | Xiidra (Lifitegrast) | Refresh Tears (Artificial Tears) |
|---|---|---|
| Classification | Prescription medication | Over-the-counter (OTC) lubricant |
| Mechanism of Action | Targets underlying inflammation via LFA-1 antagonism | Provides temporary moisture and lubrication to the eye surface |
| Onset of Action | Works over time; full effects take 12 weeks or more | Provides immediate, temporary relief of symptoms |
| Primary Goal | Treat the root cause of chronic dry eye | Relieve short-term dryness and discomfort |
| Cost | Can be expensive; often requires insurance | Generally inexpensive and widely available |
| Availability | Requires a doctor's prescription | No prescription required |
| Formulation | Preservative-free single-use vials | Available in multi-dose bottles or preservative-free options |
Best Practices and Important Considerations
- Consult Your Doctor: Before combining any new eye drops, always talk to your eye care provider. They can confirm that both medications are appropriate for your condition and recommend the best schedule for your specific needs.
- Mind the Order: It is generally recommended to apply the prescription medication (Xiidra) first, followed by the OTC lubricant (Refresh Tears), with the required waiting period in between. This ensures the more specific and potent medication has the first chance to be absorbed.
- Use Proper Technique: Always wash your hands before applying eye drops. Tilt your head back, pull down the lower eyelid to create a small pocket, and instill one drop. Do not touch the tip of the vial to your eye to avoid contamination.
- Contact Lenses: If you wear contact lenses, remove them before using Xiidra. Wait at least 15 minutes before reinserting your lenses.
- Monitor for Side Effects: Combining drops, particularly if not properly spaced, can increase the risk of side effects like eye irritation or a stinging sensation. If you notice any increased irritation, blurred vision, or an unusual taste sensation, contact your doctor.
- Listen to Your Body: Using Refresh Tears can help with immediate comfort, but remember that Xiidra is addressing the long-term issue. Pay attention to how your eyes feel over time to gauge the effectiveness of your combined therapy.
Conclusion
For many individuals with dry eye disease, a combination approach using both a prescription treatment like Xiidra and an OTC lubricant such as Refresh Tears is a safe and effective strategy for managing both the underlying inflammation and day-to-day symptoms. The primary rule for success is to always maintain a minimum 10 to 15-minute gap between applications. This method ensures each medication has the opportunity to work as intended, leading to better long-term eye health and more comfortable vision. Always seek personalized advice from your eye care provider before beginning any new treatment plan.
For more detailed information on proper application technique, you can consult the official patient resources on the XIIDRA® website.
