If you have dry eyes, you may be interested in learning about Xiidra and its possible side effects.

Xiidra is a prescription drug used to treat dry eye disease in adults and some children. It’s usually used long term to treat the symptoms of this condition. Besides dryness, dry eye disease symptoms can include stinging, burning, pain, itching, or feeling like you have something in your eye.

Xiidra comes as a liquid eye drop in single-use vials. It contains the active ingredient lifitegrast. (An active ingredient is what makes a drug work.)

For more information about Xiidra, see this in-depth article on the drug.

Like other drugs, Xiidra can cause mild to serious side effects (also called adverse effects). Keep reading to learn more.

Some people may experience mild to serious side effects during their Xiidra treatment. The more common side effects include:

  • eye irritation
  • metallic or bad taste in your mouth*
  • reduced visual acuity (sharpness of vision)†

* To learn more about this side effect, see the “Side effects explained” section below.
† To learn more, see “Does Xiidra cause any long-term side effects?” in the FAQ section below.

Xiidra may cause mild side effects in some people. Examples that have been reported with this drug include:

  • eye irritation
  • eye redness
  • producing more tears than usual
  • eye discharge
  • eye itching or discomfort
  • headache*
  • metallic or bad taste in your mouth*
  • blurry vision*
  • sinusitis (sinus infection)*
  • mild allergic reaction*
  • reduced visual acuity (sharpness of vision)†

* To learn more about this side effect, see the “Side effects explained” section below.
† To learn more, see “Does Xiidra cause any long-term side effects?” in the FAQ section below.

In most cases, these side effects should be temporary. And some may be easily managed. But if you have symptoms that are ongoing or bother you, talk with your doctor or pharmacist. And do not stop using Xiidra unless your doctor recommends it.

Xiidra may cause mild side effects other than those listed above. See the drug’s prescribing information for details.

Note: After the Food and Drug Administration (FDA) approves a drug, it tracks side effects of the medication. If you’d like to notify the FDA about a side effect you’ve had with Xiidra, visit MedWatch.

Xiidra doesn’t usually cause serious side effects, but it could possibly cause severe allergic reaction.

An allergic reaction is possible after using Xiidra but wasn’t reported in studies. (See “Allergic reaction” in the “Side effects explained” section below.)

If you develop serious side effects while using this drug, call your doctor right away. If the side effects seem life threatening or you think you’re having a medical emergency, immediately call 911 or your local emergency number.

Xiidra is used to treat dry eye disease in adults and in children ages 17 years and older. The possible side effects of the drug are expected to be the same in adults and children.

Below are answers to some frequently asked questions about Xiidra’s side effects.

Is hair loss a side effect of Xiidra?

No. Hair loss wasn’t a side effect seen in studies of Xiidra.

Some research suggests a link between dry eye disease and alopecia areata (AA), a condition that causes hair loss. It’s thought that the inflammation involved in AA may trigger dry eye disease, or vice versa, in some people.

If you have hair loss that concerns you, talk with your doctor. They can help you try to find out the reason for your hair loss and suggest ways to manage it.

Does Xiidra cause any long-term side effects?

Xiidra isn’t known to cause any serious long-term side effects. Most of the side effects reported in the drug’s studies were temporary and went away on their own.

But one side effect of Xiidra that may affect you long term is reduced visual acuity (sharpness of vision). This is measured with an eye exam that determines how well you can see details from a certain distance. Eye doctors often use letter charts to measure a person’s visual acuity. For example, having “20/20” vision means you can see the letters clearly when you’re 20 feet from the chart.

People using Xiidra in studies commonly reported reduced visual acuity. But vision can be corrected with glasses, contacts, or surgery. Your eye doctor can check your vision and recommend the best ways to correct your reduced visual acuity if it occurs.

If you develop side effects that are bothersome or seem severe while using Xiidra, tell your doctor. They can recommend whether you should continue using the eye drop.

Could I get a sore throat from using Xiidra?

It’s possible. In studies, a small percentage of people had sinusitis (a sinus infection) during Xiidra treatment. And sinusitis may cause a sore throat, among other symptoms.

To learn more about sinusitis as a side effect of Xiidra, see the “Side effects explained” section below.

Can Xiidra cause diarrhea?

No. Diarrhea wasn’t reported during studies of Xiidra. Since Xiidra is an eye drop, it’s not expected to affect your digestion or cause stomach upset.

There’s a rumor that swallowing eye drops containing the drug tetrahydrozoline (such as Visine and Clear Eyes) may cause diarrhea. While this rumor isn’t true, ingesting eye drops is known to be dangerous and may cause harmful effects, especially in young children.

Xiidra is only meant for use in the eye. All medications, including eye drops, should be stored out of reach of children and pets.

If you have diarrhea that’s bothersome or seems severe, talk with your doctor. They can suggest ways to treat it.

Learn more about some of the side effects Xiidra may cause.

Blurry vision

Blurred vision was one of the less common side effects reported in people who used Xiidra in studies. This side effect may occur when you apply the drops to your eyes, but it should go away shortly afterward.

What might help

If your blurry vision doesn’t go away, talk with your doctor. They may recommend an eye exam to check your vision. They can also advise on whether you should continue using Xiidra.

Metallic or bad taste in your mouth

In Xiidra’s studies, one of the more common side effects was taste changes. This side effect may cause certain foods to taste bad or bitter. Or it may cause a metallic or unusual taste in your mouth.

What might help

Maintaining proper dental hygiene or brushing more frequently may help make the taste in your mouth less noticeable. Some other tips to try include:

  • limiting alcohol intake
  • chewing sugar-free gum
  • sucking on mints or lozenges
  • drinking plenty of water
  • adding lemon to your water

If this side effect bothers you, talk with your doctor. They may recommend another treatment for dry eye disease instead.


Xiidra may cause headache as a side effect. Headache was reported as a side effect in the drug’s studies, but it wasn’t common.

What might help

Headaches usually go away within a few hours. Try to rest if you can. It can also be helpful to take an over-the-counter pain reliever, such as ibuprofen (Advil, Motrin) or acetaminophen (Tylenol).


Sinusitis (sinus infection) is a possible side effect of Xiidra. It’s one of the less common side effects reported by people in the drug’s studies.

Symptoms of sinusitis may include:

What might help

In some cases, sinusitis goes away on its own. Over-the-counter treatments — including saline nasal rinses and steroid nasal sprays, such as fluticasone (Flonase) — are available to help ease your symptoms. Talk with your doctor if you think you have a sinus infection. It’s possible you may need an antibiotic prescription from your doctor in order to treat this condition.

Allergic reaction

Like most drugs, Xiidra can cause an allergic reaction in some people. This side effect wasn’t seen in studies but was reported after the drug came on the market.

Symptoms can be mild to serious and can include:

  • skin rash
  • itchiness
  • flushing (temporary warmth, redness, or deepening of skin color)
  • swelling under your skin, usually in your eyelids, lips, hands, or feet
  • swelling of your mouth, tongue, or throat, which can make it hard to breathe
  • swelling of your eyes

What might help

If you have mild symptoms of an allergic reaction, such as a mild rash, call your doctor right away. They may suggest a treatment to manage your symptoms. Examples include:

  • an antihistamine you swallow, such as Benadryl (diphenhydramine)
  • a product you apply to your skin, such as hydrocortisone cream

If your doctor confirms you’ve had a mild allergic reaction to Xiidra, they’ll decide whether you should continue using it.

If you have symptoms of a severe allergic reaction, such as swelling or trouble breathing, call 911 or your local emergency number right away. These symptoms could be life threatening and require immediate medical care.

If your doctor confirms you’ve had a serious allergic reaction to Xiidra, they may have you switch to a different treatment.

Keeping track of side effects

During your Xiidra treatment, consider taking notes on any side effects you’re having. You can then share this information with your doctor. This is especially helpful when you first start taking new drugs or using a combination of treatments.

Your side effect notes can include things such as:

  • what dose of the drug you were taking when you had the side effect
  • how soon you had the side effect after starting that dose
  • what your symptoms were
  • how it affected your daily activities
  • what other medications you were taking
  • any other information you feel is important

Keeping notes and sharing them with your doctor will help them learn more about how Xiidra affects you. They can then use this information to adjust your treatment plan if needed.

Xiidra may not be right for you if you have certain medical conditions. (This is known as a drug-condition interaction.) Other factors may also affect whether this drug is a good treatment option for you. Talk with your doctor about your health history before starting Xiidra. Factors to consider include those described below.

Allergic reaction. If you’ve had an allergic reaction to Xiidra or any of its ingredients, your doctor will likely not prescribe it for you. Ask them about other medications that might be better options.

Alcohol and Xiidra

Xiidra should not interact with alcohol. If you have questions about drinking alcohol while using Xiidra, talk with your doctor.

Pregnancy and breastfeeding while taking Xiidra

It’s not known whether Xiidra is safe to use during pregnancy. Researchers haven’t studied the drug’s use in pregnant people.

Xiidra isn’t expected to affect breast milk or a breastfed child. This is because the drug is an eye drop and works in your eye. Not much of it absorbs into your blood, so it likely wouldn’t pass into breast milk. But this is not known for sure because researchers haven’t studied it.

Before using Xiidra, talk with your doctor if you’re pregnant, breastfeeding, or considering either.

Xiidra may cause side effects, but they’re usually mild. Talk with your doctor about any concerns you have about side effects of this drug. Examples of questions you might want to ask include:

  • Am I at an increased risk of any rare side effects of Xiidra?
  • Do my other medications increase my risk of side effects?
  • Can I use an over-the-counter eye drop to ease any eye irritation I may have from Xiidra?
  • How do the side effects of Xiidra compare with other drugs used to treat dry eye disease?

To learn more about Xiidra, see these articles:

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Disclaimer: Healthline has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.