Tyrvaya for Dry Eyes
Some people with dry eye don’t produce enough tears to keep their eyes wet. This can often be treated with eye drops. Some eye drops, called artificial tears, are available over the counter (OTC) and help to wet the eyes. Other eye drops, which are available by prescription, work by helping the eyes produce more of their own tears.
In 2021, Tyrvaya became the first nasal spray for treating dry eyes. This medicine works in a different way than eye drops to help the eyes produce more of their own tears.
How Does Tyrvaya Work for Dry Eyes?
When a person’s eyes do not make enough tears to stay wet, or when tears don’t work the way they should, this can cause dry eye. People with dry eyes often have a scratchy feeling in the eye, as though there is something 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 eyes will depend on what is causing your symptoms. For example, in some cases, dry eyes are caused or worsened by your environment. 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 eyes, the body may need help making more tears to keep the eyes wet. The active ingredient in Tyrvaya is a medicine called varenicline, which binds with certain receptors in the nose, called nicotinic receptors. By binding with these receptors, the medicine activates a specific nerve pathway (the trigeminal parasympathetic pathway), which increases the amount of tear film produced by the eye. This can help you form more of your own tears and reduce symptoms of dry eye.
The ONSET Studies for Dry Eyes
Two clinical studies were done to evaluate if Tyrvaya was safe and effective for treating dry eyes. Everyone in these studies had moderate or severe dry eye and had used artificial tears to manage their symptoms at some point in the past 6 months. The people in these studies were at least 22 years old, with an average age of 58-65 years. Most of the people in the study were White (81%-86%) and most were female (about 75%).
Efficacy was evaluated by a specific test called the Schirmer test, which measures the amount of tears produced by the eyes. The Schirmer test was done before the study started and again after people had been in the study for 4 weeks.
Tyrvaya was compared with a placebo nasal spray. The people in the studies did not know whether they were receiving the medicine or the placebo. Everyone was asked to use their nasal spray twice each day for 4 weeks.
What Benefits Were Seen in These Clinical Studies?
After 4 weeks of treatment, the amount of tears produced by the eye increased more in people who used Tyrvaya than people who used the placebo. One study also looked at the number of people that had a large enough increase in tears that their eyes were producing an almost normal or normal amount of tears. Almost half of the people who used Tyrvaya (47%) had an increase of this amount, compared with about a quarter (28%) of the people that used the placebo.
How Quickly Will Tyrvaya Work?
If Tyrvaya is working, you may notice a change in your symptoms within the first week. Most people will notice their symptoms improve or continue to improve within the first 2 to 4 weeks.
Tell your health care provider if Tyrvaya does not seem to be improving your dry eye symptoms after about a month. Your health care provider may discuss other options for treating your dry eye.
How Do I Use It?
Tyrvaya is a liquid that is sprayed into the nose (nasal spray). It should be sprayed into each nostril two times every day, with each dose given about 12 hours apart.
It is important to know that Tyrvaya is not like most nasal sprays. If you have used other nasal sprays before, you will need to learn to use Tyrvaya differently than these other nasal sprays. For example, most other nasal sprays are sprayed up into the nose so that they reach the spaces around the nose (sinuses). This is not the case with Tyrvaya.
Before using Tyrvaya, follow these steps:
- Blow your nose to clear out your nostrils.
- Remove the cap and the clip from the spray bottle. (Do not throw these away.)
- Hold the spray bottle in your hand by placing your thumb under the bottle and placing one finger on each side of the sprayer.
- Tilt your head back a small amount, but do not lie down.
To make sure that you receive the full dose of Tyrvaya, follow these steps closely:
- Insert the narrow part of the sprayer into one of your nostrils.
- Tilt the sprayer so that the tip is pointed toward the top of the ear on that side of the head. For example, if you are spraying into your right nostril, it should be pointed at the top of your right ear.
- Leave space between the tip of the sprayer and the wall of your nose. Do not press the sprayer against the wall of your nose.
- Place your tongue on the roof of your mouth.
- Start breathing in gently.
- Press the spraying device all the way down and then let it come all the way back up to its normal position as you continue to breathe in gently and keep your tongue on the roof of your mouth.
- Remove the sprayer from your nostril.
You will then follow all of these same steps to deliver a dose into your other nostril. It doesn’t matter if you spray into your right or left nostril first. But make sure that you spray exactly one dose into each nostril.
When you are done spraying a dose into each nostril, wipe the sprayer with a clean tissue. Then place the cap and the clip back onto the bottle.
It is very important to spray the drug correctly so that you get the right dose. Your prescription should come with “Instructions for Use,” which explains all of the steps required to prepare and give a dose. Ask your pharmacist or other health care provider if you are unsure how to use Tyrvaya.
Do I Need to Do Anything Differently the First Time I Use It?
Tyrvaya must be “primed” before it is used the first time. “Priming” a nasal spray pulls the liquid up into the spraying part of the device so that it delivers the right dose into the nose each time.
To prime Tyrvaya, pump the spray bottle seven times into the open air, away from your face and anyone near you. You will need to press all the way down on the sprayer each time, even if you feel it push back on you while pressing down. You should see a spray come out of the sprayer by the final (seventh) pump. Never shake the bottle when priming it.
If you have not used your Tyrvaya nasal spray for more than 5 days, you will need to re-prime it. To do this, pump the sprayer one time into the open air, away from your face or anyone near you. Then you can go back to using it the way that you normally would.
Make sure that you don’t prime the spray bottle more often than this. Priming it more often will use up doses, which will cause you to run out of medicine sooner.
How Can I Prevent or Manage Side Effects?
The most common side effect seen with Tyrvaya is sneezing. It isn’t clear if there is a way to prevent this from happening, but this side effect doesn’t last very long. It usually happens within the first minute after using the spray and then goes away on its own.
Other common side effects from Tyrvaya include coughing and irritation of the throat. Some people may also have an irritated nose. For the most part, these side effects are mild and go away on their own soon after the spray is used.
These are not all of the possible side effects of Tyrvaya. 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 Tyrvaya, you can also report side effects to the FDA at 800-FDA-1088 (800-332-1088).
Are There Any Interactions With Other Medicines?
There are no known interactions between Tyrvaya 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.
Are There Any Special Steps Required to Get Tyrvaya?
Tyrvaya requires a prescription from a health care provider. You can get it at any pharmacy or through a special program called TEAMTyrvaya. With this special program, the medicine is shipped directly to you. You can find out more about this at https://www.tyrvaya.com/savings-and-support#team-tyrvaya.
Is There a Coupon Card Available?
There is a savings coupon available from the drugmaker that may allow you to pay $10 or less for your prescription. Whether you are eligible depends on whether you have prescription insurance and what type of insurance you have. You can find out more at https://www.tyrvaya.com/savings-and-support.
For questions about cost, insurance coverage, or anything else, you can contact the drugmaker at 877‑EYE‑0123 (877‑393‑0123) or visit www.tyrvaya.com.
