New Rx Cequa (SEE-kwah) will compete with Restasis for dry eyes.
Cequa is a 0.09% cyclosporine solution...Restasis is 0.05% emulsion.
Think of Cequa as similar to Restasis...not a step up.
Cequa will be promoted to improve cyclosporine delivery to the eye.
But so far, Cequa only seems to improve MARKERS of tear production, not dry eye SYMPTOMS...blurred vision, gritty sensation, etc. Restasis improves some symptoms. Dosing for either is one drop in each eye BID.
Both cost over $500/month. Expect to see generic Restasis soon.
Don't jump to Cequa OR Restasis for most patients with dry eyes.
Continue to recommend starting with artificial tears and humidifiers, protecting eyes from fans, smoking cessation, etc.
Advise limiting devices and using the "20-20-20" rule...shifting eyes' focus every 20 minutes, to something 20 feet away, for 20 seconds.
If that's not enough, lean toward Restasis over Cequa.
Educate on proper administration...such as removing contact lenses before instilling the drops and waiting 15 minutes before reinserting.
Continue to look for meds that can contribute to dry eyes...tricyclics, first-generation antihistamines, overactive bladder meds, etc.
See our chart, Treatments for Dry Eyes, for how Xiidra (lifitegrast) compares...and share our patient handout, What to Do for Dry Eyes. Also give your techs our tutorial, The Ins and Outs of Eye and Ear Meds.
- Ophthalmology Published online Apr 6, 2019; doi:10.1016/j.ophtha.2019.03.050
- www.aao.org/preferred-practice-pattern/dry-eye-syndrome-ppp-2018
- Ocul Surf Published online Mar 4, 2019; doi:10.1016/j.jtos.2019.02.012
- Clin Ophthalmol 2017;11:1157-66
- Medication pricing by Elsevier, accessed Apr 2019
- Chart: Treatments for Dry Eyes
- Patient Education: What To Do For Dry Eyes
- Technician Tutorial: The Ins and Outs of Eye and Ear Meds