Restasis is a prescription eye drop used to treat chronic dry eye disease. Specifically, it’s approved for people whose eyes don’t produce enough tears because of ongoing inflammation on the eye’s surface, a condition called keratoconjunctivitis sicca. Unlike over-the-counter artificial tears that temporarily lubricate the eye, Restasis works to help your eyes produce more of their own natural tears over time.
How Restasis Works
The active ingredient in Restasis is cyclosporine, a compound that calms overactive immune responses. In dry eye disease, inflammation on the surface of the eye suppresses the glands responsible for making tears. Cyclosporine acts as a partial immunomodulator, dialing down that inflammation so your tear glands can function more normally. The exact biological pathway isn’t fully understood, but the end result is measurable: treated eyes produce more tears than they did before.
This is a fundamentally different approach from artificial tears, which add moisture from the outside. Restasis addresses one of the underlying causes of dryness rather than masking the symptom. That distinction matters because chronic dry eye tends to be self-reinforcing. Less tear production leads to more surface irritation, which leads to more inflammation, which further suppresses tear production. By interrupting the inflammation piece of that cycle, Restasis can help break it.
What to Expect When Starting Treatment
Restasis is not a quick fix. It can take several weeks before you notice any improvement, and full benefit may not arrive for up to six months. This long ramp-up is one of the most common reasons people stop using it prematurely, so knowing the timeline going in helps set realistic expectations.
The standard regimen is one drop in each eye, twice a day, roughly 12 hours apart. If you wear contact lenses, you need to remove them before applying the drops and wait at least 15 minutes before putting them back in. The drops come in both single-use vials and a multidose bottle.
Most people experience some stinging or burning right after putting the drops in. This is the most commonly reported side effect and is considered normal. Eye pain, itching, and general discomfort around the eye are also reported. These sensations are usually brief and tend to become less noticeable as your eyes adjust to the medication over the first few weeks.
Who Should Not Use Restasis
Restasis is contraindicated if you have an active eye infection. The medication suppresses part of the local immune response, which could allow an existing infection to worsen. It’s also not appropriate for anyone with a known allergy to cyclosporine or any of the other ingredients in the formulation. Once an infection clears, treatment can typically begin or resume.
How Restasis Compares to Xiidra
Xiidra is the other major prescription dry eye drop, and the two work through different mechanisms. Restasis is a calcineurin inhibitor, meaning it suppresses certain immune cells that drive inflammation. Xiidra blocks a protein called LFA-1, which prevents the body from producing some of the inflammatory chemicals that contribute to dry eye in the first place. Both reduce inflammation, but they target different steps in the process.
In practice, some people respond better to one than the other. If you’ve tried Restasis without adequate relief, switching to Xiidra (or vice versa) is a reasonable next step because the different mechanisms mean a non-responder to one may still benefit from the other.
Cost and Generic Availability
Restasis was a brand-only product for years, but generic versions of cyclosporine ophthalmic emulsion 0.05% are now available. The FDA approved the first generic from Mylan in February 2022, with additional manufacturers following in 2023 and 2024. Despite generic competition, the medication remains expensive. Current pricing for a 30-count supply of generic cyclosporine eye drops starts around $265, while some 60-count generic options are listed near $523. Insurance coverage and manufacturer savings programs can significantly reduce out-of-pocket costs, but it’s worth checking your specific plan before filling the prescription.