Carrie Yuan PharmD is a board-certified ambulatory care pharmacist. She is a clinical pharmacist in the Family Medicine Clinic at Harborview Medical Center in Seattle and a clinical associate professor at the University of Washington School of Pharmacy.
Alex Yampolsky, PharmD, is a clinical pharmacist at Elizabeth Seton Children’s Center, a pediatric long-term care facility in Yonkers, New York.
Xiidra (lifitegrast ) is an eye drop solution used to treat the symptoms of dry eye disease in adults.
Xiidra belongs to a class of medications called lymphocyte function-associated antigen-1 (LFA-1) antagonists. It works by reducing the swelling in the eye tissues.
It is available as a prescription eye drop solution.
The Food and Drug Administration (FDA) approved Xiidra to treat the signs and symptoms of dry eye disease (DED).
A 2017 study suggested that around 16 million adults in the United States have been diagnosed with DED. DED usually happens more in women than men and tends to increase with age.
Common dry eye symptoms can include:
To use Xiidra, instill one drop in each eye twice daily, approximately 12 hours apart, and throw out the single-use container immediately after using it in each eye. If you wear contact lenses, remove them before using Xiidra. You can put your contact lenses back in 15 minutes after.
Store Xiidra at room temperature and keep the single-use containers in their foil packet to protect them from light. Do not open the foil packet until ready to use, and return unopened single-use containers to the foil packet, folding over the packet to protect them from light until use.
Keep your medications out of the reach of children and pets, ideally locked in a cabinet or closet.
If you plan to travel with Xiidra, get familiar with your final destination's regulations. In general, be sure to make a copy of your Xiidra prescription. If possible, keep your medication in its original container from your pharmacy with your name on the label. If you have any questions about traveling with your medicine, be sure to ask your pharmacist or healthcare provider.
Discard all unused and expired drugs, but do not pour them down the drain or in the toilet. Ask your pharmacist or healthcare provider about the best ways to dispose of this medicine. And check out drug take-back programs in your area.
Some people notice an improvement in dry eye symptoms after two weeks of use. However, it can take longer for some. Contact your eye doctor (optometrist or ophthalmologist) or other healthcare provider if your symptoms don’t improve in six to 12 weeks.
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 pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.
Common side effects of using Xiidra can include:
Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or think you have a medical emergency.
Serious side effects can include hypersensitivity reactions such as anaphylaxis (severe allergy) and angioedema (swelling under the skin).
Xiidra may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.
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 dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.
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.
The following modifications (changes) should be kept in mind when using Xiidra:
Severe allergic reaction: Avoid using Xiidra if you have a known allergy to it or any of its ingredients. Ask your pharmacist or healthcare provider for a complete list of the ingredients if you're unsure.
Pregnancy: The safety of Xiidra has not been studied in pregnant people. Since Xiidra is administered as an eye drop, it is thought to have low absorption into systemic circulation. Let your healthcare provider know if you are pregnant or plan to become pregnant.
Breastfeeding: It is not known if Xiidra is excreted in breastmilk, though it would not be expected to cause adverse effects in breastfed infants due to minimal absorption from the eye.
Children: The safety and efficacy of Xiidra have not been established in people under 17 years of age.
Take a missed dose as soon as you remember. If it’s almost time for the next dose, skip the missed dose and take the next regularly scheduled dose. Do not double up to make up for the missed dose as this may increase the possibility of severe side effects.
Try to find ways that work for you to help yourself remember to routinely keep your appointments and take your medication. If you miss too many doses, Xiidra might be less effective at treating your condition.
There is no information on overdoses with Xiidra. Using too much Xiidra in the eye is not expected to cause serious or life-threatening adverse effects.
Your eye doctor will want to examine your eyes at regular visits to make sure that this medicine is working properly and is not causing unwanted effects.
If your symptoms do not improve within a few days or if they become worse, check with your doctor.
Xiidra is generally safe to use in most cases. However, you should not use Xiidra if you have a known hypersensitivity (allergy) to the drug or any of its ingredients.
Additionally, Xiidra is not approved for use in people younger than 17 years.
There is no information on drug interactions with Xiidra, including other eye drops. Because it is an ophthalmic (eye) drop, it is not expected to interact with other medications. If using with other eye medications, space them out from Xiidra by at least five to 10 minutes.
Other medications commonly used to treat dry eye disease include:
Xiidra helps ease the symptoms of dry eye disease by reducing inflammation. It binds to special cells and stops others (T-cells) from binding in corneal and conjunctival tissue. Xiidra may also inhibit white blood cells from secreting inflammatory cytokines.
The most common side effects of Xiidra are eye irritation, reduced visual acuity, and an altered taste sensation. Less common side effects are blurred vision, conjunctival redness, increased tearing, headache, and eye discharge.
Some people notice an improvement in dry eye symptoms after two weeks of use. For others, it can take longer. If your symptoms don’t improve in six to 12 weeks, talk with your eye doctor (optometrist and ophthalmologist) or other healthcare provider about whether you should continue this medication.
You should try to space out different eye medications throughout the day. If you must take Xiidra at the same time as another eye medication, wait at least five to 10 minutes between medications.
Medications, such as Xiidra, can help bring your dry eye symptoms under control.
Before administering Xiidra, wash hands thoroughly with soap and water. To avoid contamination and infection, do not touch the tip of the single-use container with your hands or on any surface, including your eye, eyelids, or face. Throw away your single-use container after putting one drop of Xiidra into each eye. Do not attempt to save the rest of the drops for later use. This means you'll likely use two single-use containers per day.
If you wear contact lenses, remove them before using Xiidra. You may reinsert your contact lenses 15 minutes after using Xiidra.
Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some drug content, as indicated on the page.
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Food and Drug Administration. Xiidra label.
Farrand KF, Fridman M, Stillman IÖ, Schaumberg DA. Prevalence of diagnosed dry eye disease in the United States among adults aged 18 years and older. Am J Ophthalmol. 2017;182:90-98. doi:10.1016/j.ajo.2017.06.033
National Eye Institute. Dry eye.
Haber SL, Benson V, Buckway CJ, et al. Lifitegrast: a novel drug for patients with dry eye disease. Therapeutic Advances in Ophthalmology. 2019. doi:10.1177/2515841419870366
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