Xiidra®
lifitegrast ophthalmic solution 5%
Clinical Snapshot
Xiidra is an LFA-1 antagonist that interrupts the T-cell–mediated inflammatory cycle central to dry eye disease. It is the first ophthalmic drug approved with this mechanism of action and the first approved for both signs and symptoms of DED.
Mechanism of Action
Lifitegrast blocks the interaction between lymphocyte function-associated antigen-1 (LFA-1) on T cells and intercellular adhesion molecule-1 (ICAM-1) on ocular surface cells. This prevents T-cell activation and migration, interrupting the inflammatory cascade that drives dry eye disease at the ocular surface.
Common Clinical Applications
- Signs and symptoms of dry eye disease
Typical Dosing Principles
One drop in each eye twice daily (approximately 12 hours apart). Consistent twice-daily dosing supports sustained anti-inflammatory effect.
Dosing information is provided for educational purposes. Always consult current prescribing information for specific dosing protocols.
Important Precautions
- Contraindicated in patients with known hypersensitivity to lifitegrast or any component of the formulation.
- Patients should not wear contact lenses during instillation; lenses may be reinserted 15 minutes after dosing.
- Transient blurred vision and instillation site discomfort (including dysgeusia) are common.
Clinical Pearls
- Symptom improvement may be seen as early as 2 weeks; sign improvement typically requires longer treatment.
- Dysgeusia (altered taste) is a distinctive adverse effect — proactive counseling improves adherence.
- This is a long-term maintenance therapy, not a rescue agent.
- Mechanism is complementary to cyclosporine — combination use is clinically reasonable in refractory cases.
Commonly Associated Disease States
Select any disease state to explore its full entry in the Disease State Library.
Dry Eye Disease
One of the most prevalent conditions in optometric practice; a leading cause of patient dissatisfaction and reduced quality of life, with significant implications for contact lens wear, surgical candidacy, and systemic disease management.
Meibomian Gland Dysfunction
The leading cause of evaporative dry eye disease; present in the majority of dry eye patients and a critical target in comprehensive ocular surface management.
This entry is an educational reference designed to support clinical reasoning and therapeutic awareness. It does not constitute medical advice, establish a standard of care, or replace individualized patient assessment. Clinicians should consult current prescribing information before initiating any therapy.