What is Xiidra?

Reviewed by: HU Medical Review Board

Xiidra® (lifitegrast ophthalmic solution) 5 percent is the first drug of its kind to treat the signs and symptoms of chronic dry eye. Chronic dry eye may also be called dry eye, dry eye syndrome, or keratoconjunctivitis sicca.1-3

What are the ingredients?

The active ingredient in Xiidra is lifitegrast.1

How does Xiidra work?

Xiidra is a type of immune-modulating (anti-inflammatory) eye drop. Inflammation is a major factor in developing chronic dry eye symptoms. If the surface of the eye is inflamed, damage can happen to the glands that make tears, the tissues on the surface of the eye, and even the eyelids. Immune-modulating eye drops work to stop this inflammation.1,3

Decreasing inflammation can help the glands that make tears work better and help the overall eye surface heal. Anti-inflammatory eye drops can be especially helpful for dry eye associated with autoimmune diseases, such as Sjogren’s syndrome.3

Xiidra is thought to work on the immune system response by decreasing inflammation. Xiidra attaches to a specific protein found on the surface of blood cells that are important to the immune system. The drug then interferes with how the protein attaches to specific cells and proteins in the body. By changing the protein interaction, Xiidra decreases inflammation the body creates with chronic dry eye. Reduced inflammation on the surface of the eye leads to fewer signs and symptoms of dry eye disease.1

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Doctors know that Xiidra works on certain cells and proteins to decrease inflammation. However, the exact way it works is not well known.1

What are the possible side effects?

The most common side effects of Xiidra include:1,4

  • Irritation of the eyes when applied
  • Changes in taste, including a metallic or salty taste
  • Decreased vision

Other less common side effects include:1,5-7

  • Blurred vision
  • Red eyes
  • Irritation of the eyes
  • Headache
  • Increased tearing or discharge of the eyes
  • General eye discomfort
  • Itchy eyes
  • Inflammation and swelling of the sinuses, the air-filled spaces in the skull

Rare side effects have been reported with Xiidra, including:1

  • Hypersensitivity, including severe allergic reaction requiring medical treatment
  • Tightening or narrowing of the smooth muscles of the airway
  • Difficulty breathing
  • Swelling of the face and upper airway
  • Eye swelling
  • Allergic rash of the skin or eye

If you experience any difficulty breathing or other side effects that you think may be life-threatening, immediately contact 911 to report a medical emergency.

These are not all the possible side effects of Xiidra. Talk to your doctor about what to expect or if you experience any changes that concern you during treatment with Xiidra.

Things to know

Immune hypersensitivity is when your immune system “overreacts” to a drug or other substance. The immune overreaction causes more problems than the benefits of the drug itself. If you have a known hypersensitivity to lifitegrast, the ingredient in Xiidra, you should not take Xiidra.8

Xiidra comes in single-use containers, which you can use in both eyes. Use immediately after opening and throw away any amount left in the container.1

Because Xiidra is applied directly to the surface of the eye, there is a risk of eye injury and contamination. Try not to touch the vial tip to your eye or other surfaces to avoid injury or contamination.1

Doctors are not sure if Xiidra is effective or safe to use in children under 17 or those who are pregnant or breastfeeding. If you are pregnant or breastfeeding, talk to your doctor about the risks and benefits of this drug.1

Xiidra should not be used when wearing contact lenses or if there are any signs of an eye infection. If you choose to wear contact lenses, your lenses should be removed before using Xiidra. You may reinsert your contact lenses 15 minutes after using Xiidra.1

Before beginning treatment for chronic dry eye, tell your doctor about all your health conditions and any other drugs, vitamins, or supplements you are taking. This includes over-the-counter drugs.

For more information, read the full prescribing information for Xiidra.