Update:
As of December 2018, I have prescribed thousands of prescriptions of Xiidra. The biggest complaint is the taste. About 2% complain of allergy. 10% complain it did not help at all. The cost for self pay patients is extreme $500-1000/month: crazy.
Most patients said it helped within 3 weeks.
Punctal Plugs help with taste.
Had 5 cases of mild allergic dermatitits due to the Xiidra.
Had 1 case of possible severe contact dermatitis and Angioedema due to oral Doxycyline 20mg combined with Xiidra and it is not clear by his internist, dermatologist, and me if it was the Doxycyline which he had been on for 6months before he moved his hypertensive medication to take at a different time from the Doxy or if it was the Xiidra, which he had also been using for 6mo without an issue. He is off both until we can figure out what caused his dermatitis and angioedema.
I will be keeping track to see how our patients are doing on this drug.
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As of December 2018, I have prescribed thousands of prescriptions of Xiidra. The biggest complaint is the taste. About 2% complain of allergy. 10% complain it did not help at all. The cost for self pay patients is extreme $500-1000/month: crazy.
Most patients said it helped within 3 weeks.
Punctal Plugs help with taste.
Had 5 cases of mild allergic dermatitits due to the Xiidra.
Had 1 case of possible severe contact dermatitis and Angioedema due to oral Doxycyline 20mg combined with Xiidra and it is not clear by his internist, dermatologist, and me if it was the Doxycyline which he had been on for 6months before he moved his hypertensive medication to take at a different time from the Doxy or if it was the Xiidra, which he had also been using for 6mo without an issue. He is off both until we can figure out what caused his dermatitis and angioedema.
Dr. Cremers' Experience with Xiidra
As of today, I have prescribed Xiidra on at least 100 patients. I have had 12 come back thus far. Only 1 so far has said that Xiidra did not help at all. I do know that this patient has Sjogrens Syndrome and Stage 3 on Meibomian Gland Loss on LipiView.
The rest of the patients have been plesantly surprised: so have I!
I do not stop Restasis before starting Xiidra if they have been doing well on Restasis with no complaints as Restasis and Xiidra work on two separated pathways of imflammation. Of the 12 patients that have come back thus far, 4 were also on Restasis and felt and improvement with Xiidra.
I will be keeping track to see how our patients are doing on this drug.
What is Xiidra?
Xiidra is Lifitegrast which is a new T-cell integrin antagonist that is designed to mimic the binding epitope of ICAM-1. It serves as a molecular decoy to block the binding of LFA-1/ICAM-1 and inhibits the downstream inflammatory process. In vitro studies have demonstrated that lifitegrast inhibits T-cell adhesion to ICAM-1-expressing cells and inhibits secretion of pro-inflammatory cytokines including interferon gamma, tumor necrosis factor alpha, macrophage inflammatory protein 1 alpha, interleukin (IL)-1α, IL-1β, IL-2, IL-4, and IL-6, all of which are known to be associated with DED. Lifitegrast has been FDA approved for the treatment for the symptoms and signs of Dry Eye Disease.
Restasis is only FDA approved for the signs of Dry Eye Disease.
Restasis vs Xiidra: 4 big differences
Until July 11, 2016, Restasis was the only topical eyedrop approved by the FDA to treat patients with dry eye which was approved 13 years ago. More than 30 million Americans suffer from dry eye symptoms of some sort.
In the last 13 years we have learned that Dry Eye, Dry Eye Syndrome, and Dry Eye Disease (which are essential stagees of the same underlying beast) if largely due to an inflammatory condition affecting all the layers of the eye that produce the tear: the Lacrimal Gland, the Goblet Cells that produce Mucin, and the Meibomian Glands that produce oil.
Especially in patients with rheumatoid arthritis and Sjogren's syndrome, if the dry eye is left untreated, the inflammation will worse and I have found such disease to decimate the Meibomian Glands, likely from a cycle of inflammation that affects all cells of the eye's surface and glands. If left untreated, the symptoms and signs of the dry eye will worsen over time.
We know understand why artificial tears, punctual plugs and warm compresses may not be enough to help those who suffer from dry eye.
1. Xiidra Works Faster than Restasis. Restasis can take up to 16 weeks to see a difference. Xiidra was able to show improvements within 2 to 12 weeks of treatment. Most of my 12 patients that have returned that found it helpful said it improved their symptoms within 2-3 weeks. Xiidra works affects the T-cells earlier in its binding and in the inflammatory cycle than Restasis, so it makes sense to me that patients would respond sooner.
2. Xiidra is approved by the FDA to treat both the signs and symptoms of dry eye. . Why is this important? The reason it’s been 13 years since any drop was approved for dry eye is because dry eye notoriously complex to study. The signs don’t always match the symptoms and showing improvements in both was basically a statistical nightmare. Restasis could not show improvement in both, but Xiidra did after conducting one of the largest studies of its kind, looking at over 2500 eyes.
3. Xiidra Stings Less than Restasis. 6 of my 12 patients did not notice stinging. All 4 patients on Restasis also said Xiidra stings less than Restasis. All eye surgeons have patients who stopped Restasis because of the terrible pain. Often we had to give a low dose steroid like Lotemax, so Restasis could be tolerable. For some patients, the burning from Restasis never got better and they had to stop completely even though studies showed inflammatory scores would be better for them 3 years down the line. Xiidra caused less stinging and burning and does not require additional medications for tolerability.
4. Xiidra can Taste Worse than Restasis: Punctal Occulusion helps prevent this mild side effect. Non of my patients complained about it as I taught every one how to apply punctal occulsion.
5. Xiidra costs about $500 per month which is about the same as Restasis out of pocket. For now Xiidra is giving away free samples so I would jump on this if I had dry eye.
Sandra Lora Cremers, MD, FACS
I have no stock in this company.
Xiidra™ (lifitegrast ophthalmic solution) 5% is a prescription eye drop used to treat the signs and symptoms of dry eye disease.
Select Important Safety Information
The most common side effects of Xiidra include eye irritation, discomfort or blurred vision when the drops are applied to the eyes, and an unusual taste sensation (dysgeusia).
Give your eye doctor a riing and ask if
Xiidra could be right for you
Xiidra is the first prescription eye drop approved by the FDA for both the signs and symptoms of dry eye disease.
HOW
EXCIITING!
Select Important Safety Information
To help avoid eye injury or contamination of the solution, do not touch the container tip to your eye or any surface.
FIIVE FAST FACTS
ABOUT XIIDRA
The most common side effects of Xiidra include eye irritation, discomfort or blurred vision when the drops are applied to the eyes, and an unusual taste sensation – which doctors call “dysgeusia."
Use Xiidra twice per day
Use one drop of Xiidra in each eye, two times a day, about 12 hours apart.
Wear contact lenses?
Take ’em out before using Xiidra and wait at least 15 minutes before popping them back in.
Single-dose containers
Each Xiidra container has enough medicine to treat both of your eyes once. So you’ll be using two containers each day, about 12 hours apart.
Scrub those hands
To avoid contamination, wash your hands first & don’t let the tip of the container touch your eye or any surface.
Have bad aim? It’s ok!
Each container has some extra solution in case you miss. Throw it out when you’re done – don’t save it.
Complete instructions for use are included with your prescription, but you can also find them in this pdf.
OOH,
LIITERATURE!
Want a little extra Xiidra reading material? Download our friendly brochure to print, enjoy, and share.
WHY TALK TO YOUR
EYE DOCTOR?
GOOD QUESTIION
First of all, it’s good to know that you can talk to an optometrist or an ophthalmologist. Either one can diagnose and treat dry eye disease.
They’ll want to hear all about your symptoms. They can also do some tests that reveal even more details about your symptoms. Isn’t technology amazing?
FUN FACT:
If eye symptoms keep bugging you, getting your eyes checked every year is a good idea. Don’t worry, a standard eye exam causes no pain or discomfort. That’s a win!
Select Important Safety Information
If you wear contact lenses, remove them before using Xiidra and wait for at least 15 minutes before placing them back in your eyes.
It is not known if Xiidra is safe and effective in children under 17 years of age.
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WITH THE XIIDRA
IINSIDER CARD
You could get your first prescription for free.
We want to help keep your out-of-pocket costs for Xiidra low.
If you have commercial insurance (like through your employer) or are paying cash, you may be eligible to receive your first prescription free. Eligible patients will pay the first $20 and receive up to $250 off monthly co-pay or out-of-pocket expenses.*
If you have government insurance like Medicaid or Medicare, you may be eligible to get your first prescription free†
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AND SIGN UP
RIGHT NOW
Start here »Details & Eligibility
*Eligible patients will receive their first prescription free. For uses 2-12, eligible patients will pay as little as $20 and receive up to $250 (for commercially insured patients) or up to $225 (for cash-paying patients) off the patient’s co-pay or out of pocket expenses for Xiidra. Program expires 5/31/2017. Restrictions may apply.
†Free trial offer is valid for up to a 30-day free trial of Xiidra. Card must be presented to your pharmacist along with a valid prescription. One offer per patient. Consumers with questions, please call 1-844-247-4755. Program expires 5/31/2017. Restrictions may apply.
†Free trial offer is valid for up to a 30-day free trial of Xiidra. Card must be presented to your pharmacist along with a valid prescription. One offer per patient. Consumers with questions, please call 1-844-247-4755. Program expires 5/31/2017. Restrictions may apply.
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Ok, so maybe you have a few questions about insurance, benefits, coverage – you know, the fun stuff. What if you could call a number and get help from a real, live person? Just ask iiris – not one person but a whole squad highly trained in helpfulness.
Ok, so maybe you have a few questions about insurance, benefits, coverage – you know, the fun stuff. What if you could call a number and get help from a real, live person? Just ask iiris – not one person but a whole squad highly trained in helpfulness.
Select Important Safety Information
The most common side effects of Xiidra include eye irritation, discomfort or blurred vision when the drops are applied to the eyes, and an unusual taste sensation.
The most common side effects of Xiidra include eye irritation, discomfort or blurred vision when the drops are applied to the eyes, and an unusual taste sensation.
What can you ask iiris?
Your Xiidra coverage know-it-alls
Commercial insurance, government insurance, or no insurance at all? Ask iiris and we’ll help you figure it out. This may sound strange, but we actually like dealing with insurance companies. It’s kind of our thing.
Commercial insurance, government insurance, or no insurance at all? Ask iiris and we’ll help you figure it out. This may sound strange, but we actually like dealing with insurance companies. It’s kind of our thing.
Savings specialists, too
You know what else is our thing? Helping you save on your Xiidra prescription. If you’re eligible for any special offers or assistance programs, we’ll let you know about ’em. And we’ll help you sign up for ’em.
You know what else is our thing? Helping you save on your Xiidra prescription. If you’re eligible for any special offers or assistance programs, we’ll let you know about ’em. And we’ll help you sign up for ’em.
But wait, there’s more!
Info about dry eye disease? Check. Fielding questions from your doctor’s office staff? Check. We can even grant you Xiidra iinsider status for juicy info, special offers, refill reminders, and more beamed to your inbox or phone. All you have to do is ask iiris. Monday through Friday, 9:00 am through 8:00 pm ET.
Info about dry eye disease? Check. Fielding questions from your doctor’s office staff? Check. We can even grant you Xiidra iinsider status for juicy info, special offers, refill reminders, and more beamed to your inbox or phone. All you have to do is ask iiris. Monday through Friday, 9:00 am through 8:00 pm ET.
What is Xiidra?
Xiidra is a prescription eye drop used to treat the signs and symptoms of dry eye disease.
Important Safety Information
The most common side effects of Xiidra include eye irritation, discomfort or blurred vision when the drops are applied to the eyes, and an unusual taste sensation. To help avoid eye injury or contamination of the solution, do not touch the container tip to your eye or any surface. If you wear contact lenses, remove them before using Xiidra and wait for at least 15 minutes before placing them back in your eyes.
It is not known if Xiidra is safe and effective in children under 17 years of age.
For additional safety information, click here for Full Prescribing Information and Patient Information and discuss with your doctor.
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch, or call 1-800-FDA-1088.
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