Is Tyrvaya Available Over the Counter? A Guide to This Prescription Nasal Spray

October 10, 2025 •

3 min read

Affecting an estimated 20 million people in the United States, dry eye disease is a common and growing condition. If you're seeking treatment, you may wonder, is Tyrvaya available over the counter? The answer is no; it requires a doctor's prescription.

Quick Summary

Tyrvaya (varenicline) is a prescription-only nasal spray used to treat dry eye disease. It is not sold over the counter due to its mechanism of action and the need for medical supervision. It works by stimulating natural tear production.

Key Points

Prescription Required: Tyrvaya is not available over the counter and must be prescribed by a doctor.
Unique Mechanism: It's a nasal spray that stimulates your body's own natural tear production, unlike OTC drops that add artificial moisture.
Active Ingredient: The medication contains varenicline, a cholinergic agonist that activates a nerve in the nose to increase tear film.
FDA Approved: Tyrvaya was approved by the FDA in October 2021 as the first and only nasal spray for dry eye disease.
Administration: It is used twice daily, with one spray in each nostril, and should not be sprayed directly into the eyes.
Main Side Effect: The most common side effect is sneezing, reported by 82% of users in clinical trials, along with less common cough and throat irritation.
OTC Alternatives: Over-the-counter options like artificial tears, gels, and ointments provide temporary relief but work by lubricating the eye surface.

Understanding Tyrvaya and its Prescription Status

Dry eye disease is a chronic condition impacting millions in the U.S. While over-the-counter (OTC) artificial tears offer relief for many, some require more advanced treatment. Tyrvaya (varenicline solution) nasal spray is a prescription medication and is not available over the counter. It was approved by the FDA in October 2021 as the first and only nasal spray for dry eye disease. Its active ingredient, varenicline, is a cholinergic agonist that acts differently from traditional eye drops. Due to its potent nature and potential side effects, medical supervision is essential for its safe and effective use.

How Does Tyrvaya Work?

Tyrvaya stimulates the body's natural tear production rather than just adding moisture to the eye's surface. Administered as a nasal spray, it targets the trigeminal parasympathetic pathway in the nose, which controls tear film production. Varenicline, the active ingredient, binds to specific nasal receptors, activating this pathway to signal the lacrimal glands to produce more basal tear film. This helps restore all three layers of the tear film (aqueous, lipid, and mucin), improving tear quality and alleviating symptoms.

Proper Usage and Administration

Correct usage is vital for Tyrvaya's effectiveness. The recommended dose is one spray in each nostril, twice daily, about 12 hours apart. It is not an eye drop and should not be sprayed into the eyes. Before the first use, prime the bottle with seven sprays away from the face. If unused for over five days, re-prime with one spray. To administer, slightly tilt your head back, aim the spray tip towards the top of the ear on the same side, press your tongue to the roof of your mouth, and breathe gently. Avoid deep inhalation as the medication is absorbed by the nasal wall.

Potential Side Effects

Tyrvaya is generally well-tolerated, but side effects can occur. The most common is sneezing, reported by 82% of patients in clinical trials, often described as mild and temporary. Other common side effects (5-16% of patients) include cough, throat irritation, and nose irritation. While there are no listed contraindications, discuss any concerns with your doctor. Rare serious allergic reactions require immediate medical attention.

Tyrvaya vs. Over-the-Counter (OTC) Options

Patients have numerous OTC dry eye options, mainly artificial tears. Understanding the differences between these and prescription Tyrvaya is crucial for informed decisions.


Feature	Tyrvaya (Varenicline Nasal Spray)	Over-the-Counter Artificial Tears
Availability	Prescription-only	Available over the counter
Mechanism of Action	Stimulates the body's natural production of all three tear film layers via a nerve pathway.	Supplements existing tears by adding moisture and lubrication to the eye's surface.
Application Method	Nasal spray, administered into each nostril.	Eye drops, applied directly to the eyes.
Primary Function	A long-term treatment to increase basal tear production.	Provides temporary, symptomatic relief from dryness and irritation.
Active Ingredients	Varenicline (a cholinergic agonist).	Varies; typically includes lubricants like carboxymethylcellulose, glycerin, polyethylene glycol, or lipid-based oils.
Cost	List price is around $685 for a 30-day supply, though insurance and savings programs can significantly lower the cost.	Generally low to moderate cost, with many affordable options available.

Exploring OTC Alternatives

For mild to moderate dry eye, OTC products are often the initial treatment. These include various formulations:

Lubricating Eye Drops (Artificial Tears): Common for quick, temporary relief (e.g., Systane, Refresh, TheraTears).
Gel Drops: Thicker consistency for longer hydration, used for moderate to severe symptoms or overnight.
Ointments: Thickest formulation, creates a protective barrier for nighttime use.
Lipid-Based Drops: Address evaporative dry eye by stabilizing the tear film's oily layer (e.g., Systane Complete, Retaine MGD).

While effective for some, these OTC options don't stimulate tear production like Tyrvaya. Patients not finding sufficient relief with OTC products may need prescription treatment.

How to Obtain Tyrvaya

To get Tyrvaya, consult an eye doctor who will diagnose your dry eye and determine if Tyrvaya is suitable. If prescribed, you can fill it at a local pharmacy or through mail-order programs like TEAMTyrvaya, which may offer support and savings.

Conclusion

Tyrvaya is a prescription-only nasal spray, not available over the counter. It offers a distinct, neurologically-based approach to dry eye by stimulating natural tear production, unlike OTC artificial tears which provide temporary lubrication. If you have persistent dry eye symptoms, consult a healthcare professional to discuss the best treatment for your needs.

For additional information, you can visit the official product website: https://www.tyrvaya.com.

Frequently Asked Questions

No, Tyrvaya is not available over the counter (OTC). It is a prescription-only medication that requires a consultation and prescription from a healthcare provider.

Tyrvaya requires a prescription because it contains the active ingredient varenicline, a cholinergic agonist that affects nerve pathways to stimulate tear production. Medical supervision is necessary to ensure it's appropriate for the patient and to monitor for side effects.

Tyrvaya is a nasal spray that stimulates your body to produce its own natural tears. Artificial tears are eye drops that provide temporary, external lubrication to the eye's surface.

The most common side effect, reported by 82% of patients in clinical trials, is sneezing. Other common side effects include cough, throat irritation, and irritation at the application site in the nose.

Currently, there is no generic form of Tyrvaya available in the United States.

The standard dose is one spray in each nostril twice a day, about 12 hours apart. The spray should be aimed towards the ear on the same side of the nostril, and you should not inhale the mist deeply.

The list price for a 30-day supply is approximately $685. However, with commercial insurance and savings programs, many patients may pay as little as $0 to $10 for their prescription.