Dr. Callahan has been thoughtful, kind, and informative for my entire family. Her care is excellent, and we highly recommend her to anyone seeking compassionate, professional eye care.
Jaclyn Jenkins
Xiidra for Dry Eye Disease
Who May Benefit from Xiidra
Not every patient with dry eye symptoms needs a prescription treatment, but for many people, over-the-counter options are simply not enough. Our eye doctors evaluate your symptoms, risk factors, and eye health findings to determine whether Xiidra is appropriate for you.
During your appointment, we ask about the specific sensations you experience throughout the day, especially during activities that stress the eye surface, like reading or prolonged screen use. These symptoms help us assess the severity of your condition.
- Burning or stinging in one or both eyes
- Persistent redness or irritation
- Sensitivity to light or wind
- Blurred vision that clears temporarily after blinking
- Excessive tearing, which can be your eyes overcompensating for chronic dryness
Some people are more likely to develop dry eye disease that requires prescription treatment. We factor in your personal history when deciding which therapies to recommend.
- Age over 50, particularly for women going through menopause
- Autoimmune conditions such as Sjogren syndrome, rheumatoid arthritis, or lupus
- Long-term contact lens wear or previous eye surgery
- Medications including antihistamines, decongestants, or antidepressants that can reduce tear production
- Environmental exposures such as dry indoor air, air conditioning, or long hours in front of screens
We use a combination of tests during your comprehensive eye exam to confirm dry eye disease and measure its severity. These findings help us determine whether Xiidra or another treatment is the best fit.
We may measure the volume and quality of your tears, examine the eye surface under magnification for signs of inflammation or tissue damage, and evaluate how quickly your tear film breaks down. Special dyes can also be used to highlight areas of the cornea, the clear front layer of the eye, that have been affected by chronic dryness.
We typically suggest Xiidra when your dry eye symptoms are moderate to severe and have not responded well to over-the-counter treatments such as artificial tears, warm-compress therapy, or basic lifestyle adjustments. A prescription becomes especially worth considering when we can see visible signs of inflammation or surface damage during your exam.
We may also discuss other options such as Restasis, punctal plugs, or, in some cases, amniotic membrane therapy, depending on your specific situation and how your eyes respond over time.
How to Use Xiidra Correctly
Getting the most out of Xiidra depends on using it properly and consistently. Our eye doctors will walk you through the technique at your appointment, but understanding what to expect before you start can make the process easier.
Proper drop technique reduces the risk of contamination and helps ensure the medication reaches the eye surface where it is needed. Following these steps each time will help you build a reliable routine.
- Wash your hands thoroughly before handling the drops
- Tilt your head back and gently pull down your lower eyelid to form a small pocket
- Hold the vial upside down and squeeze one drop into the pocket without letting the tip touch your eye or eyelid
- Close your eye gently for a moment to allow the drop to spread across the surface
- Repeat in your other eye using a fresh single-use vial
Xiidra is used twice daily, approximately 12 hours apart. Most people find it easiest to use the drops once in the morning and once in the evening, making it part of their regular daily routine.
Consistency is important. Using Xiidra at roughly the same times each day helps maintain steady levels of the medication on the eye surface and supports better long-term results.
Some patients begin to feel relief within two weeks of starting Xiidra, but the full benefits may take up to 12 weeks to develop. Everyone responds differently, and it is important not to judge the medication too quickly.
We encourage you to continue using Xiidra as prescribed even if early improvement is modest. The medication needs time to reduce the cycle of inflammation and allow the eye surface to heal.
If you forget a dose, use it as soon as you remember. If it is close to the time for your next scheduled dose, simply skip the missed one and continue with your regular schedule going forward.
Do not use two doses at the same time to make up for a missed one. This does not improve results and may increase the likelihood of side effects.
Side Effects and Safety Considerations
Like all prescription medications, Xiidra can cause side effects, though most are mild and tend to improve as your eyes adjust. We review your full medical history before prescribing to make sure this treatment is safe for you specifically.
The most frequently reported side effect of Xiidra is a temporary taste disturbance, an unusual or bitter taste that can occur shortly after instilling the drops. This happens because a small amount of the medication can travel through the tear duct to the back of the throat.
- Temporary stinging or discomfort when the drops are applied
- Brief blurred vision that clears within a few minutes
- Unpleasant taste in the mouth
- A mild sensation that something is in the eye
These effects are generally short-lived and do not require stopping the medication. They often become less noticeable over the first few weeks of use.
Serious side effects from Xiidra are uncommon, but certain symptoms should prompt a prompt call to our office. You should not ignore worsening eye pain, significant vision changes, increased discharge, or swelling around the eye after starting treatment.
These symptoms could indicate an allergic reaction, an eye infection, or another condition that needs evaluation. If you experience signs of a severe allergic reaction, including rash, swelling, or difficulty breathing, seek emergency care right away.
Xiidra is not appropriate for everyone, and we will review your history carefully before prescribing it. There are specific situations where this medication should be avoided or used only with extra caution.
- Children under 17, as safety and effectiveness have not been established in this age group
- Anyone with a known allergy to lifitegrast or any component of Xiidra
- Patients with an active eye infection, which must be treated and resolved before starting Xiidra
Because Xiidra works directly on the eye surface and very little enters the bloodstream, it has few known interactions with other medications. That said, we still need a complete picture of everything you use, including other eye drops, oral medications, and supplements.
If you use multiple eye drops, we will advise you to wait at least 5 to 10 minutes between each medication so that one does not wash out the other before it has time to work.
The safety of Xiidra during pregnancy and breastfeeding has not been fully established. If you are pregnant, planning a pregnancy, or currently breastfeeding, please let us know so we can thoughtfully weigh the potential benefits and risks together.
In some cases, we may recommend alternative dry eye management strategies during this period, and we will work closely with you to keep your eyes as comfortable and healthy as possible.
Getting the Most from Your Xiidra Treatment
Xiidra is most effective when it is part of a broader, consistent dry eye care routine. Simple habits and follow-up care can meaningfully enhance your results and help you maintain them over time.
Proper storage keeps Xiidra effective and safe. Store the single-use vials at room temperature, away from direct sunlight and extreme heat or cold.
- Keep bottles in a clean, dry location
- Do not freeze Xiidra
- Keep the packaging sealed until you are ready to use each vial
- Discard opened single-use vials promptly and follow the expiration date on the packaging
Many patients use artificial tears or other supportive treatments alongside Xiidra. This combination approach can provide faster symptom relief, especially in the early weeks before Xiidra's anti-inflammatory effects are fully established.
Depending on your needs, our eye doctors may also incorporate punctal plugs, which are small devices placed in the tear drainage canal to slow tear loss, or warm-compress therapy to improve the quality of your tear film. We will coordinate your full plan so everything works together effectively.
Lifestyle habits play a meaningful role in managing dry eye disease alongside your prescription treatment. These steps will not replace Xiidra, but they can make a noticeable difference in your day-to-day comfort.
- Practice the 20-20-20 rule during screen time: every 20 minutes, look at something 20 feet away for 20 seconds
- Use a humidifier in dry indoor spaces, especially during winter months
- Wear wraparound sunglasses outdoors to shield your eyes from wind and sun
- Stay well hydrated throughout the day
- Consider omega-3 supplements, which some patients find supportive for tear quality
We schedule follow-up appointments after you start Xiidra to assess how your eyes are responding and make sure the treatment is on track. These visits allow us to repeat the same objective tests we used during your initial evaluation so we can measure real progress, not just how you feel.
If you are experiencing side effects or your symptoms are not improving as expected, your follow-up visit is the right time to discuss adjustments to your plan. We may modify the approach based on your response, and we want to hear about any concerns you have along the way.
Frequently Asked Questions
Here are answers to questions our patients commonly ask about Xiidra that go beyond the basics covered above.
Coverage varies by plan, and some insurers require prior authorization or documentation that you have already tried other dry eye treatments before approving Xiidra. We recommend contacting your insurance provider directly to ask about your specific benefits and any step-therapy requirements. Our office can help provide clinical documentation to support the authorization process if needed.
You should remove your contact lenses before instilling Xiidra and wait at least 15 minutes before reinserting them. Many patients find that lens wear becomes more comfortable as their dry eye symptoms improve with treatment. Talk with our eye doctors about whether continuing contact lens wear is a good fit for your eyes during and after treatment.
Mild stinging when the drop goes in is one of the most common early experiences with Xiidra, and it usually lessens over the first few weeks. If the discomfort is significant, chilling the vial in the refrigerator (without freezing it) for a few minutes before use may help. If stinging remains severe or does not improve, contact us so we can evaluate whether this is a normal adjustment or a reason to consider a different treatment.
Because dry eye disease is a chronic, ongoing condition, symptoms often return if treatment is stopped. Feeling better is a sign that Xiidra is working, not necessarily that the underlying inflammation has been permanently resolved. If you want to explore reducing your use, talk with us first so we can build a monitoring plan and catch any changes before they become significant.
As of 2026, no generic form of Xiidra is commercially available. If cost is a concern, it is worth asking our office about manufacturer assistance programs or patient savings cards, which can sometimes significantly reduce out-of-pocket expenses. We can also discuss other prescription dry eye options that work through different pathways if Xiidra is not a practical fit for you financially.
Both Xiidra and Restasis are prescription treatments that address inflammation in dry eye disease, but they work through different mechanisms. Restasis contains cyclosporine and helps increase natural tear production over time, while Xiidra contains lifitegrast and blocks the specific inflammatory proteins involved in dry eye. Some patients respond better to one than the other, and our eye doctors will help you determine which option makes the most sense based on your history, symptoms, and exam findings.
Schedule Your Dry Eye Evaluation at NewView Eye Center
If persistent dry eye symptoms are affecting your comfort and quality of life, our team is here to help with a thorough evaluation and a personalized treatment plan. NewView Eye Center serves patients throughout Northern Virginia with experienced, physician-led eye care designed to address the full range of dry eye severity. We look forward to helping you find lasting relief and keeping your eyes as healthy as possible.
What our Patients Says
Explore More
Find more information about our doctors, services, and technology that keep your eyes healthy and your vision at its best.