Restasis effectiveness

[mspirk]

I’ve been on Restasis for a little over four years—probably longer than anyone else on this site (that I’m aware of). My new ophthalmologist is not an advocate for long-term medication use, and suggested that I try to get off the medication at this point and see how I do.

My eyes have been pretty good for several years (lasik in 2001)—no burning or excessive dryness, so I was curious myself to find out for sure whether the Restasis was doing its job. I started to wean myself off by cutting my usage in half—I skipped the morning doses and just administered the drops in the evenings. I was fine for exactly one week, and then slowly, I could feel the old burning sensation start to rear its ugly head. I let it go for a day, and then couldn’t tolerate it anymore, so reluctantly got back on my twice-a-day schedule.

So I guess that proves Restasis is making a significant difference in my dryness problems. It’s a bittersweet discovery—I’m glad there is something out there that will help, but now I realize that I am dependent on this drug, probably for the rest of my life.

Just thought I’d share this with those who are wondering about the effectiveness of Restasis. I also want to mention that I have four plugs, so they haven’t made any difference in how well Restasis works, at least in my case.

[indrep]

mspirk,
According to the FDA submission by Allegan the plugs might be the reason for your success with Restasis.

[sparrow]

What is the FDA submission by Allergen?

mspirk,
According to the FDA submission by Allegan the plugs might be the reason for your success with Restasis.

[indrep]

That is the submission Allergan made to the FDA seeking approval of the drug. You can review most of it at www.fdarestasisdata.org. You can see Allergan was awarded approval after lowering the number of patients studied to 43% of the Intended to Treat group and using punctal plugs and waiting six months instead of two months to determine efficacy.

[sparrow]

But how does it work?

Just got a perscription for Restasis. My eye dr said it actually stimulates the Melbomian (sp) gland to produce more tears. How does cyclosporine do that? I just thought it would clear up inflammation (which I don't have) and so just kind of get rid of a hinderance rather than actually act as a stimulant for more tear production.

[indrep]

Sparrow,
The meibomian glands don't make tears, the lacrimal glands make tears. The meibomian glands secrete lipids which act on the tear film to slow evaporation. In the FDA submission for Restasis it was determined that there was no clinically significant increase in tear production EXCEPT when Restasis was combined with punctal occlussion.

I am not sure, but I think the Restasis is supposed to reduce the inflammation along the lid margin allowing more lipids to be secreted. The FDA submission doesn't mention meibomian gland stimulation. I have only read 148 pages of the submission and do not have access to all of the pages.

[kitty]

I started to wean myself off by cutting my usage in half—I skipped the morning doses and just administered the drops in the evenings. I was fine for exactly one week, and then slowly, I could feel the old burning sensation start to rear its ugly head.

That is interesting. When I was trying Restasis, I found the side effects intolerable. My doc put me on Restasis with a once daily dosing pattern. He said he often prescribes once daily dosing as a maintenance dose.

[mspirk]

Maybe in the beginning, if I had been started on a once-daily regimen, that would have been enough to take care of the dryness. But doing it twice-daily for all those years may have possibly "conditioned" my eyes to respond to that amount, and anything less would not be effective. Just a theory. Everybody's different.

[SusieD]

Sparrow,
The meibomian glands don't make tears, the lacrimal glands make tears. The meibomian glands secrete lipids which act on the tear film to slow evaporation. In the FDA submission for Restasis it was determined that there was no clinically significant increase in tear production EXCEPT when Restasis was combined with punctal occlussion.

I am not sure, but I think the Restasis is supposed to reduce the inflammation along the lid margin allowing more lipids to be secreted. The FDA submission doesn't mention meibomian gland stimulation. I have only read 148 pages of the submission and do not have access to all of the pages.

So going on this, people are better trying restasis when they have plugs/cautery as opposed to just restasis alone?

[indrep]

Yes. That is according to the company's own studies measured at six months.