Many people with dry eye don’t make enough tears to keep their eyes wet. This can often be treated with over-the-counter (OTC) eye drops called artificial tears, which help to wet the eyes. Other eye drops, which are available by prescription, work by helping the eyes make more of their own tears.
One of these prescription eye drops, Cequa, has been approved for use in people with dry eye since 2018.
How Does Cequa Work for Dry Eye?
When a person’s eyes do not make enough tears to stay wet, or when tears don’t work the way that they should, they can get dry eye. People with dry eye often have a scratchy feeling in the eye, as though there is something in there. The eye may also sting, burn, or turn red. Dryness in the eye can cause vision to become blurry or make the eye more sensitive to light.
The best treatment for dry eye will depend on what is causing your symptoms. For example, in some cases, dry eye is caused or worsened by the environment around you. When this is the case, certain lifestyle changes can improve your symptoms, such as avoiding dry air, limiting time in front of a screen, and drinking more water. Some people are also able to manage their symptoms by using over-the-counter eye drops that help keep the eyes wet. These drops are often called artificial tears.
In people with severe dry eye, the body may need help making more tears to keep the eyes wet. The active ingredient in Cequa is a medicine called cyclosporine, which helps to reduce swelling (inflammation) in the eye. This may help you to form more of your own tears and reduce symptoms of dryness.
How Was It Studied?
Two clinical studies were done to evaluate if Cequa was safe and effective for treating dry eye. Everyone in these studies was at least 18 years old and had dry eye disease for at least 6 months before the study started. The average age was about 59, and most (82%) of the people in the study were female. Most (83%) of the people were White, about 11% were Black, and about 3% were Asian. The races of the other people in the studies were not provided. About 16% of people identified as Hispanic or Latino.
Cequa was compared with a placebo eye drop. Everyone was asked to use their eye drop twice daily for 12 weeks, and no one knew whether they were receiving the medicine or the placebo. They were not allowed to use any other eye drops, including artificial tears, during the study.
Efficacy was evaluated by measuring dry eye symptoms with various tests before the study started and again after 12 weeks in the study. Both studies used the Schirmer test, which measures the amount of tears produced by the eyes. One study also used tests that assess the condition of different parts of the eye, including the cornea and the conjunctiva, which is the membrane that covers the front of the eye. These parts of the eye can become damaged when the eye dries out too quickly.
What Benefits Were Seen in These Clinical Studies?
Tears produced by the eye. After 12 weeks of treatment, the people who used Cequa had a bigger increase in the number of tears produced by the eye than the people who used placebo. The studies also counted the number of people who had a large enough increase in tears that their eyes were producing an almost normal or normal amount of tears. About 17%-18% of people who used Cequa produced this many tears, compared with about 7%-9% of the people who used placebo.
Other measures of dry eye. After 12 weeks of treatment, a number of tests were performed on different parts of the eye, including the cornea and conjunctiva. When compared with the tests that were given before the study started, bigger improvements occurred in the people who used Cequa than the people who used placebo. This means that the eyes were staying wetter for longer in people who used Cequa.
How Quickly Does Cequa Work for Dry Eye?
If Cequa is working, you may notice your symptoms begin to improve within the first 2 weeks. Most people will see the biggest improvements after using the drops for 2-3 months. Symptoms may continue to improve for the first 6 months.
Tell your health care provider if Cequa does not seem to improve your dry eye symptoms after about 2 months. Your health care provider may discuss other options for treating this condition.
How Do I Use It?
Cequa is a drop that is placed directly into the eye. One drop should be placed into each eye twice each day, about every 12 hours. The medicine comes in single-use vials, which are stored in a foil package until use. Do not open the vials before you are ready to use them; once a vial has been opened, it must be used immediately.
When you are placing the drops in the eye, be careful not to touch the vial to the eye. It is also important not to use a vial more than once. This will help to reduce the risk of injury or infection in the eye. Once you have used a dose of Cequa, throw away the vial and any medicine left inside of it.
It is important not to use Cequa while wearing contact lenses. Wait at least 15 minutes after using Cequa to place your contact lenses back into your eyes. If you use artificial tears, do not use these drops within 15 minutes before or after using Cequa eye drops.
Your prescription should come with “Instructions for Use,” which explains all of the steps required to use a dose. Ask your pharmacist or another health care provider if you are unsure how to use Cequa.
How Can I Prevent or Manage Side Effects?
The most common side effect seen with Cequa is eye pain. To help reduce the risk of any pain or redness, be sure not to touch the vial to the eye while you are using the drops. For most people, the pain is mild and goes away soon after the dose.
These are not all of the possible side effects. Talk with your health care provider if you are having symptoms that bother you. If you experience anything that you think may be caused by Cequa, you can also report side effects to the FDA at 800-FDA-1088.
Are There Any Interactions With Other Medicines?
There are no known interactions between Cequa and other medicines. But it is still important for your health care provider to be aware of all the prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, or other supplements you take or have recently taken.
Is There a Savings Program Available?
There is a special program available that may allow you to pay as little as $0 for your prescription. If you enroll in this program, your prescription will be filled by a specific pharmacy and mailed directly to you. Whether you are eligible for the program depends on whether you have prescription insurance and what type of insurance you have. If your insurance does not cover the medicine, there is a discount program available that may allow you to purchase Cequa directly for $89 per month. You can find out more about both of these programs at www.cequa.com/cost.
