Restasis 4 Times A Day! Working Wonders!

[BillyBoy]

My doc has prescribed me Restasis 4 times a day after using it twice a day for 2 years with some improvement in my dry eyes and posterior bleph. Now, after 40 days of using Restasis 4 times per day (7 AM, 1PM, 5 PM and 10 PM) my eyes are MUCH Improved! My doc said I should continue to see improvement for a few more months then my improved eyes will level off and hopefully feel fairly normal every day. I've also reduced the heat and massage from 3 times a day average to once every day. My lids were probably inflamed from TOO MUCH heat and massage.

More Restasis and less physical contact = Better, wetter eyes for me :-)

Bill

[indrep]

This is interesting to me. I have been told by several university/research oriented physicians that too many lipids can be toxic to the ocular surface. I have never really inquired beyond the statement as I have never encountered someone with naturally occuring over production of lipids.

[willwork4tears]

High-frequency topical cyclosporine 0.05% in the treatment of severe dry eye refrac

This doesn't surprise me at all.

Increasing the frequency or increasing the dose (concentration) of cyclosporin often decreases dry eye symptoms in those not seeing relief with traditional Restasis dosing.

I use 1% cyclosporin 2x daily and love it.


Here is a published research article abstract about increasing frequency.

Cornea. 2009 Dec;28(10):1091-6.
High-frequency topical cyclosporine 0.05% in the treatment of severe dry eye refractory to twice-daily regimen.

Dastjerdi MH, Hamrah P, Dana R.

Massachusetts Eye & Ear Infirmary, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Abstract

PURPOSE: The purpose of this study was to report the efficacy of topical cyclosporine 0.05% at a frequency of 3 to 4 times daily in severe dry eye disease. METHODS: We retrospectively identified a cohort of patients with severe dry eye disease who had shown inadequate response to at least a 4-month course of treatment with twice-daily use of topical cyclosporine 0.05% but who showed significant improvement to more frequent dosing. RESULTS: Twenty-two patients, including 13 patients with ocular graft-versus-host disease and 9 patients with primary or secondary Sjögren's syndrome, were included. After a minimum of a 2-month course of treatment with more frequent dosing of cyclosporine 0.05% (3 times a day in 7 patients and 4 times a day in 15 patients), overall dry eye symptoms were improved in 15 (68.2%) patients (9 patients with ocular graft-versus-host disease and 6 patients with Sjögren's syndrome). Mean corneal fluorescein staining scores (National Eye Institute scale of 0-15) improved (decreased) from the baseline (precyclosporine use) by -3.5 (range, 0 to -7) in patients with ocular graft-versus-host disease (P < or = 0.0008) and -2.8 (range, 0 to -5) in patients with Sjögren's syndrome (P < or = 0.001). After treatment with high-frequency use of cyclosporine 0.05%, the global physician assessment of dry eye status was favorable (improved) in 16 (72.7%) patients. Three (13.6%) patients reported new-onset symptoms of burning or irritation with the use of high-frequency dosing of topical cyclosporine. No other associated adverse effect was reported. CONCLUSION: These data suggest that patients with severe dry eye may require more frequent dosing of topical cyclosporine 0.05% than twice daily.

[grandsporta]

I tried Restasis two different times, each time it made my eyes burn really bad throughout the whole day. I couldn't take it anymore so I had to stop. It was unfortunate but I couldn't handle the burning all day.

[Ctane]

likewise grand, i've tried restasis for months and it only seems to make things worse. i heard great things about it, but oh well lol.

[Jumpy]

Restasis

I was put on restasis 4x a day and after 3 wks a had HUGE floaters in one eye, more like an explosion!!! took many months to fade away and there is still some of it left!!! Maybe it was, maybe it wasn't restasis but I won't go near it now, but am glad others get releif.

[sporta]

4x a day Restasis

My doctor also put me on Restasis 4x a day (I use 2 vials in a day, as I can get two doses out of each one...and the dr. said that was ok) , since January and it has seemed to help. I keep it in the refrigerator and that really helps with the burning. For me I only seem to get the burning more towards the evening when my eyes are getting tired.

[Maria1972]

when I first started Restasis it was 4x a days for 1 month or so. My eyes improved A LOT. The I was on 2x a day and 3 months later on that regime my eyes got bad again ,as if Restasis wasn't working anymore. Still I continue using Restasis for 5+ years and my doctor told me that I could use it up to 4x a day. I do it sometimes but I don't think it makes a difference. It seems that my eyes got use to the drug and it doesn't react other than to give me a mild burning feeling...
I don't want to stop using it bc I don't know if it'll be worse without it.

[buntbean]

is it really safe?

I've been on restasis 2X/day for 5+years and I've often wondered if it's really safe for such long term use. Now to go up to 4X/day?? I haven't heard of this before. Is this coming from Mass Eye and Ear? I go to Tufts in Boston.

[nitrodrops]

Hi All,

I have been using Retasis for almost a year now

July 2010 - Nov 2010 : Retasis x 2 times per day with Refresh Plus
Nov 2010 - July 2011 : Retasis x 4times per day, Systane x 4times per day
July 2011 : 2 x lower plugs inserted, Retasis x 4times per day, Systane x 4times per day, Refresh+

I noticed with plugs inserted, Retasis seems to be retained much better, feeling much more burning sensation. With this burning/dry sensation, i have to use Systane and Refresh+ more often than before without plugs inserted.

Googled and found this

The active agent in Restatsis is cyclosporine – published reports suggest that cyclosporine can reduce cell inflamation. Thus, Restasis is applied in the eye primarily as an anti-inflammatory and may work for some patients whose tear production has been reduced or eliminated due to ocular inflammation. It may require several months of Restasis' treatments before patients feel any significant results. The side effects of Restasis are similar to the symptoms of dry eye themselves – red, sandy gritty feeling, pain and tired eyes. When dry eye symptoms persist for patients on Restasis, it is sometimes difficult to determine whether the drug itself didn’t work, or the patient is simply experiencing the side effects of the Restasis treatment.

Q1.) If i feel that Retasis is burning more, but ended up using more Systane and Refresh+, does it means i am still not producing enough tears? Should i revert back to Retasis x 2 times/per day instead since i use lesser Systane and Refresh=?

Q2.) If the eyes are feeling more burning sensation, is that a good sign? Burning sensation means the drug is taking effects?

Q3.) Normally, after using Retasis, it lasted for 2hrs, before i start to feel the dry sensation again, not sure if this is the side effects of Retasis or my real DES.


Much appreciated for any kind replies.

Cheers
Nitro
Post-Lasik DES

[Trac]

Because of this thead I asked my doctor if I could increase my Restasis use to 4 x day and he said yes. I find that my eyes actually somtimes feel moist when I use Restasis 4 times a day instead of twice. Sometimes it does burn a little, but not like other drops that I take.