September 1, 2011
Does Restasis work?
Details about restatis
Restasis (cyclosporine ophthalmic emulsion) is the only prescription product for chronic dry eyes. Approved by the Food and Drug Administration in 2002, the drug increases tear production, which may be reduced because of inflammation on the eye surface. In a clinical trial involving 1,200 people, Restasis increased tear production in 15 percent of patients, compared with 5 percent of patients in the placebo group, says Wiley Chambers, M.D., deputy director of the FDA's Division of Anti-Inflammatory, Analgesic and Ophthalmologic Drug Products.
How many people use Restasis?
Allergan's Restasis earned $620 million in 2010. [Source]. Assuming an average user spent $300 per year, this yields 2 million users.
After months of initially hopeful results with honey and aloe vera, and a few other things I tried, I've reached a dead end. The problem went down from a distress level of 8 or 9 out of 10 to 1 or 2, but has returned to 4 or 5 which is not miserable, but quite bad.
I'll go to India next year, and in advance I'm starting to explore Restasis which, if things don't get resolved in the next few months, I'm going to have to perhaps try. So this is a research blog post. Please help by pointing out whether restasis worked for you, and what were your symptoms before you tried it.
Prices in USA
Availability in Australia
There is a doctor who is able to supply this (in NSW).
Restasis is hard to get in Australia. Dr Chan has faxed the restasis prescription to a compounding pharmacy in NSW who I am eagerly awaiting a call from. The pharmacy will send me the restasis via post. The cost of the restasis is going to be about $60 a month. [Source]
You can perhaps get its DOG version.
Under what conditions can Restasis work?
If you are making enough of all three liquids and the dry eye is due to inflammation, Restasis may work quite well. If you do not have inflammation but are simply not producing enough liquids, Restasis is not going to do much of anything. [Source]
Patients with an eye infection, as well as those with a history of herpes viral infection of the eye should not use this drug.
Does Restasis work?
New Study Shows Restasis Offers no Dry-Eye Relief following LASIK (perhaps because goblet cells are damaged through LASIK and restatis works on the mebomian glands)
Goblet Cell Numbers and Epithelial Proliferation in the Conjunctiva of Patients With Dry Eye Syndrome Treated With Cyclosporine Kathleen S. Kunert; Ann S. Tisdale; Ilene K. Gipson [PDF]: "Treatment of dry eye syndrome for 6 months with topical CsA resulted in an increase in goblet cell numbers in patients with NSS-KCS and SS-KCS and a decrease in epithelial turnover in those with NSSKCS. Reducing ocular surface inflammation might have an effect on the proliferative activity of the epithelium."
Effects of sequential artificial tear and cyclosporine emulsion therapy on conjunctival goblet cell density and transforming growth factor-beta2 production. by Pflugfelder SC, De Paiva CS, Villarreal AL, Stern ME.Cornea. 2008 Jan;27(1):64-9.
Cyclosporine emulsion, but not artificial tears, increases goblet cell density and production of the immunoregulatory factor TGF-beta2 in the bulbar conjunctiva in patients with dry eye.
PATIENTS WHO HAVE TRIED IT SAY THIS:
140 user reviews here.
" I went to my eye doctor (I live a couple hours away from my mom) and asked him for advice. He told me that Restasis only works in SOME people (he gave me a percentage but I don't remember it exactly now; some thing like 60%, or less, I think). " [Source]
"I have been using them for two years now and they really work for me. I have allergies to pollen, dust and mold as well as sinus problems and dry and itchy eyes were an annoying symptom. I had tried every over-the-counter eye drop in the drug store to no avail (my eyes were burning and itchy within 10 minutes). Now, I use Restasis twice a day and my eyes feel lubricated and don't burn at all. BTW, I use one application per day. [Source]
"As for how it works for me, I get immediate relief and use one vile for two to three days , then i can go for months without needing" [Source]
"Restatis didn't do much for me" (Source).
"I've gone through 3 trays of Restasis (each tray being 30-days worth, but I use one vial twice a day) and it isnt doing anything for my dryness or redness. Lubricant eye drops have literally no effect on me. " [Source]
"I just wanted to report to you that I have been on RESTASIS for almost seven months…and I am symptom free. I am able to read again, use the computer…I don't even have to use any other drops! " [Source]
"I have been on it for 5 months now and I am not sure if it is doing much for me but I am willing to give it a few more months yet." [Source]
"I think I am a bit over my 6 month period and I just give up on it" [Source]
"trevor how long before restasis worked for you? I am almost 4 months no relief at al" [Source]
"I took Restasis for 7 months that time and did not notice any difference and a rise in my co-pay made my decision for me. I think about one-third to one-half of the people using Restasis are helped. This is my personal observation after reading patient's responses over a period of years." [Source]
I was on Lotemax for a while. I thought it was great as it turned my eyes as white as can be. But this steroid increased my eye pressure a lot, so my doctor took me off and I did the taper thing. Then I was allowed to use the steroid if I had a really bad flare up. Now I use FML ointment at night and it does not even come close to comparing to Lotemax, but I don't have the increase in eye pressure either. I have increased my restasis from 2 x daily to 4 x daily and that seems to help. Sometimes my eyes even feel moist. [Source]
OTHER PATIENT COMMENTS
For about three years, I've been suffering from dry eye and meibomitis (dysfunctional oil glands near the eyelashes). I've had an absolutely miserable time of it. But Restasis has been a huge help.
Here's a bit of pre-Restasis background: For the dry eye, I had punctum plugs inserted in both lower ducts and I used preservative-free drops every hour or so. For the meibomitis, I was given doxycycline (100 mg/day) and I hot-packed my lids several times a day. Even with this treatment combination, I was still suffering from dry eye and visibly inflamed oil glands (they looked like tiny white bumps above the lash line). I also had some general eyelid inflammation due to all of the irritation that both of these conditions cause.
I started on Restasis about 2 months ago, and I am thrilled with the results. The eyelid and oil-gland inflammation has already been noticeably reduced, and my tear production feels much more normal. Every week, my eyes get better. That said, it took several weeks before I noticed _any_ difference. The drops have a gradual effect–I've read that it can take anywhere from 3 to 6 months for the full effect to be felt–so it requires patience and commitment.
I have to use the Restasis drops every morning and night, and they're expensive, but they're very, very worthwhile. The only negative side-effect that I've experienced is a burning sensation when I instill the drops. That sensation goes away after several minutes. Right now, my insurance covers 80 percent of the cost (a 30-day supply is $100), but I would willingly pay the full price for the amount of relief the drops have given me. [Source]
Restasis is cyclosporine, a drug approved in the US in 1983 for suppressing the action of T-cells and preventing transplant rejection. In the eye, it is said to improve tear production by decreasing inflammation
in the lacrimal glands. It should be noted that other agents like Acular and oral flax seed oil are known to have similar action.
Restasis Side Effects
- Restasis is classified by the FDA as pregnancy category C. It is not known whether the drug will harm an unborn child. It is also unknown whether Restasis can past into breast milk and harm children being breastfed.
- Drugs such as amphotericin B (Amphotec, Fungizone), colchicine, fenofibrate (Antara, Lipophen, Tricor), melphalan (Alkeran), nonsteroidal anti-inflammatory drugs like diclofenac (Cataflam, Voltaren) and naproxen (Aleve, Naprosyn), ranitidine (Zantac) and tobramycin (Tobi) may interact with Restasis.
- Cyclosporine may cause an infection or cancer, particularly in those are using drugs that lower the immune system in conjunction with cyclosporine.