What is the treatment regimen for Restasis (cyclosporine ophthalmic emulsion) in patients with dry eye syndrome?

From the Guidelines

The standard treatment regimen for Restasis (cyclosporine ophthalmic emulsion 0.05%) in patients with dry eye syndrome is one drop in each affected eye twice daily, approximately 12 hours apart, as supported by the most recent study from 2024 1. This regimen is based on the understanding that cyclosporine works by reducing inflammation on the ocular surface through T-cell inhibition and increasing tear production. Before instilling Restasis, patients should remove contact lenses (which can be reinserted 15 minutes after application) and gently invert the emulsion a few times to obtain a uniform, white mixture. After application, patients should close their eyes for 1-2 minutes to allow absorption and minimize systemic absorption through the tear ducts. It's crucial not to touch the dropper tip to any surface to prevent contamination. While patients can use artificial tears for immediate symptomatic relief, they should wait at least 15 minutes between Restasis and other eye drops. Side effects may include temporary burning or stinging upon application, which typically diminishes with continued use, as noted in studies 1. The dose can be decreased to once a day in a portion of the patients after 1 full year of twice-daily therapy without a decrease in beneficial effects, according to the evidence 1. This approach prioritizes the reduction of morbidity and improvement of quality of life for patients with dry eye syndrome. Key points to consider in the treatment regimen include:

• Consistent application to achieve maximum therapeutic effect
• Potential for temporary side effects
• Importance of proper administration technique to minimize contamination and systemic absorption
• Consideration of adjunctive therapies, such as artificial tears, for symptomatic relief. The most recent and highest quality study from 2024 1 supports the efficacy and safety of this treatment regimen, making it the recommended approach for managing dry eye syndrome with Restasis.

From the FDA Drug Label

Invert the unit dose vial a few times to obtain a uniform, white, opaque emulsion before using. Instill one drop of RESTASIS® ophthalmic emulsion twice a day in each eye approximately 12 hours apart. Usual Dosage: Twice daily approximately 12 hours apart.

The treatment regimen for Restasis (cyclosporine ophthalmic emulsion) in patients with dry eye syndrome is:

• Twice daily administration, approximately 12 hours apart.
• One drop of RESTASIS® ophthalmic emulsion in each eye.
• The vial should be inverted before using to obtain a uniform emulsion.
• The vial should be discarded immediately after use 2, 2.

From the Research

Treatment Regimen for Restasis (Cyclosporine Ophthalmic Emulsion)

The treatment regimen for Restasis (cyclosporine ophthalmic emulsion) in patients with dry eye syndrome involves the use of cyclosporine 0.05% ophthalmic emulsion, which is indicated to increase tear production in patients with dry eye and reduced tear production presumed to be due to ocular inflammation 3.

Administration and Dosage

• The recommended dosage is one drop in each eye twice daily, with a minimum of 12 hours between doses 4.
• Patients are advised to use the medication as directed by their physician and to continue treatment for the recommended duration.

Combination Therapy

• Combination therapy with punctal plugs may be considered for patients with dry eye, as it has been shown to produce the greatest overall improvements in tear volume, ocular surface staining, and artificial tear use 5.
• The use of topical corticosteroids in combination with cyclosporine 0.05% may also be beneficial in some patients 6.

Duration of Treatment

• The duration of treatment with Restasis (cyclosporine ophthalmic emulsion) may vary depending on the individual patient's response to therapy and the severity of their dry eye symptoms.
• Studies have shown that long-term treatment with cyclosporine 0.05% can lead to improved outcomes, with some patients experiencing continued benefits after 12 months of treatment 4.

Adverse Effects

• Common adverse effects associated with the use of Restasis (cyclosporine ophthalmic emulsion) include burning and stinging, which may be more frequent in patients treated with cyclosporine compared to those treated with vehicle or artificial tears 3.
• Other adverse effects may include ocular discomfort, blurred vision, and eye redness.

Patient Education

• Proper patient education is essential to ensure adherence to the treatment regimen and to minimize the risk of adverse effects.
• Physicians and staff should provide patients with clear instructions on the use of Restasis (cyclosporine ophthalmic emulsion) and encourage them to report any concerns or adverse effects promptly 6.