Xiidra Interactions: Drugs, Alcohol, and What You Need to Know

You're using Xiidra. Your eyes are tired, dry, maybe even feel like they're sandpaper with every blink. But now you're wonderingcan I still have that glass of wine? What if I'm taking fish oil? Could something I'm already using react badly with this drop?

I've been there. You're not alone.

And here's the immediate relief: According to the FDA and current medical knowledge, there are no known major drug interactions with Xiidra (lifitegrast). It doesn't clash with most medications, supplements, or alcoholat least, not in the way some prescription drugs do.

Butand this is a big "but"that doesn't mean you're in the clear. Because you're not just a data point. You're a real person with a real body, real habits, and a real life. And dry eye isn't just an inconvenienceit's exhausting.

So let's talk about this honestly. No panic. No scare tactics. Just the facts, wrapped in warmth and a little empathy. Let's walk through what we know, what we don't, and what you really need to consider before blinking in another drop.

No Proof Isn't Safety

Here's something most labels don't say: "No known interactions" does not equal "zero risk."

Xiidra is a topical eye drop. That means it's applied directly to your eye, not swallowed or injected. Most of it stays right where you put it. But tiny amounts can get absorbed into your bloodstream through the tear ductsespecially if you don't press on the corner of your eye after use. Ever wonder why that weird, bitter taste shows up minutes after using it? That's the medication draining into your throat. So yeah, a little does travel.

Which means, even low-risk drops like Xiidra can potentially interact with other things in your system. Not because they clash chemicallybut because your body processes things in complex ways.

Take a patient I read about once: she was using Xiidra, CBD oil for sleep, and a low-dose antidepressant. All "safe," right? But over time, she started feeling dizzy and noticed her eyes stung more. Her doctor looked at her full picturenot just Xiidra's labeland realized CBD can affect liver enzymes that metabolize certain drugs. Nothing directly interacted with Xiidrabut her body's chemistry was shifting.

That's why talking to your doctor matters so much. Even if a drug database says "no interaction," your whole story matters more.

Other Medications

Right now, there's no strong evidence that Xiidra interacts with other medications. Not blood pressure drugs, not diabetes meds, not even antihistamines. But here's where it gets tricky: eye drops.

Say you're using steroid eye drops for inflammationor another dry eye treatment like Restasis. Both can be used with Xiidra if your doctor says it's okay. But tossing drops willy-nilly into your eyes without spacing them out? That's asking for trouble.

Think of your eye like a tiny, crowded room. You wouldn't shove three people through the door at once and expect them all to get in smoothly, right? Same idea here.

A 2021 review in Ocular Surface pointed out that simultaneous use of multiple eye drops can reduce absorption and increase irritation. One drop might wash out the one before it. Or, more seriously, they might react on the surface of your eyeespecially if one is preservative-free and another isn't.

So if you're using another dropRestasis, steroid, glaucoma medask your eye doctor: "Can I use this with Xiidra? And if so, how long should I wait between them?" A good rule of thumb? Wait at least 10 to 15 minutes between applications. This isn't written in stonebut it's a smart, safe buffer.

Alcohol and Xiidra

Can you drink while using Xiidra? Technically, yes. There's no known chemical interaction between alcohol and lifitegrast.

Butand this is where we get practicalalcohol dries you out. It pulls water from your system, including your eyes. And if you're already battling dry eye? That glass of red wine or pint of beer might leave your eyes feeling worse the next morning.

I remember a friend of minea nurse who's had dry eye for yearstold me she noticed her symptoms flared up every time she had a few drinks at weekend dinners. She wasn't drinking heavily. But even moderate drinking made her eyes feel gritty by Sunday.

So while Xiidra won't "react" with alcohol, alcohol may worsen your symptoms. And that feels like an interaction, even if it's not one on paper.

Try this: If you do drink, go slow. Hydrate with water alongside your drink. And pay attentionyour body will tell you if it's too much. If your eyes feel like they've been rubbing against desert sand the next day? That's your clue.

Supplements and Vitamins

What about that multivitamin you take every morning? Or fish oil? CBD gummies? Are they safe with Xiidra?

Good news: there are no reported interactions between Xiidra and common supplements like vitamin D, B12, fish oil, or probiotics.

Fish oil, in fact, is often recommended for dry eye because of its anti-inflammatory omega-3s. One study published in Cornea found that patients using omega-3 supplements saw modest improvements in dry eye symptoms. So if your doctor supports it, that bottle on your counter might actually be helpingright alongside Xiidra.

But again: just because something "doesn't interact" doesn't mean it's risk-free. Herbal supplements like turmeric, echinacea, or high-dose CBD can affect your immune system or liver function. And since tiny amounts of Xiidra reach your bloodstream, could there be an unseen ripple effect?

Probably not. But we just don't know for sure. That's why honesty with your doctor is key. Don't assume supplements are "harmless" just because they're natural.

CBD and Cannabis

This one comes up a lot. CBD is everywhere nowoils, gummies, creams. People use it for sleep, anxiety, even inflammation.
And if you're on it, you're probably wondering: does it mess with Xiidra?

Currently, there's no evidence of a direct interaction. Butbig caveatCBD is metabolized by liver enzymes, and it can slow or speed up how your body processes other substances.

Now, since Xiidra is mostly topical, the risk is low. But if you're using high-dose CBD or medical marijuana, your doctor should know. Especially if you're taking other meds, too.

Also, let's be real: cannabis causes dry eyes. That dry mouth you get? Your eyes get it too. So while CBD may not interfere with Xiidra, it might make your symptoms feel worse.

And here's something no one talks about: being under the influence can mess up your routine. Ever forget to take a medication when you're high? You're not alone. Consistency matters with Xiidrayou need to use it twice a day, every day, to see results.

If your routine gets shaky, so do your results.

Foods and Drinks

Nopeno food interactions with Xiidra. You don't need to avoid coffee, spicy food, or red wine pasta because of chemical clashes. But just like with alcohol, certain foods can influence dry eye symptoms.

Too much salt? Can lead to dehydration. Too much caffeine? Might reduce tear production over time. And a diet low in omega-3s? That's been linked to worse dry eye symptoms in some studies.

So eat what makes you happy. Just aim for balance. Load up on leafy greens, fatty fish, and hydrating fruits. And for every cup of coffee, maybe pour yourself a glass of water, too.

Vaccines and Xiidra

Can you get vaccinated while using Xiidra? Absolutely.

There's no known interaction between Xiidra and vaccinesflu, shingles, COVID, or otherwise. Xiidra works locally in the eye and doesn't suppress your immune system like systemic drugs (such as immunosuppressants) might.

That said, if you feel unwell after a vaccinesay, you get a fever, fatigue, or body achesit's worth mentioning to your eye doctor. They might suggest pausing Xiidra for a day or two if your eyes feel more irritated. But in general? Shots are totally fine.

Health Conditions That Matter

Even if a drug doesn't interact, your health can change the game.

The biggest red flag? Allergy to lifitegrast or any ingredient in Xiidra. If you've ever broken out in hives, felt your throat tighten, or had swelling after using Xiidraeven oncestop using it. Don't try it again without talking to your doctor.

Pregnancy and breastfeeding? Now that's a gray zone.

There just isn't enough data. Animal studies showed some risk at very high doses, but we don't know how it affects humans. The FDA labels it as "Category C," meaning: potential risk, but not enough info to say for sure.

If you're pregnant, trying to conceive, or nursing, have that conversation with both your OB/GYN and eye doctor. Maybe you switch to a different treatment temporarily. Maybe you continue with careful monitoring. But don't make that call alone.

Contacts and Xiidra

Can you wear contacts? Yes. But not while using the drops.

Here's the routine:

1. Take your contacts out.
2. Use one drop of Xiidra in each eye.
3. Wait at least 15 minutes.
4. Put your contacts back in.

Why? Xiidra can stick to soft lenses. That might trap the medicationor bacteriaagainst your eye. Plus, some people find it more irritating when the drop hits their lens instead of their eye.

And pleasedon't reuse Xiidra vials. Each little single-use container is meant for one dose, even if it looks half-full. Reusing it increases infection risk. Not worth it.

Side Effects vs. Interactions

Sometimes, what feels like a "bad reaction" isn't an interaction at allit's a side effect.

Common ones with Xiidra:

• Blurred vision right after use (goes away in minutesdon't drive right after).
• Bitter or weird taste (thanks to the tear duct drainagesuper common).
• Eye irritation, redness, or burning (usually mild and fades).

Rarer, but serious: allergic reactionsswelling, rash, trouble breathing. If that happens, stop using Xiidra and get medical help immediately.

Track what you feel. Write it down if you need to. That way, when you talk to your doctor, you're not guessingyou're sharing facts.

Stay Safe, Stay Smart

Here's how to protect yourselfeven when interactions seem unlikely:

5 Precautions First

1. Make a full list of every medication, supplement, and OTC product you takeeven that occasional melatonin gummy.
2. Mention alcohol and CBD use. Seriously. No judgmentjust clarity.
3. Be upfront about pregnancy, breastfeeding, or allergies. Your doctor can't help you if they don't know.
4. Read the patient guide that came with Xiidra. Small print? Yes. Important? Absolutely.
5. Stick to the dose. One drop, twice a day. No more, no less.

Build a Routine That Sticks

Think of it like a morning ritual:Wash hands Remove contacts Apply Xiidra Wait 15 minutes Contacts Breakfast.

Nighttime? Same thing:Wash hands Remove contacts Xiidra Wait Restasis (if prescribed) Sleep.

Little systems like this make consistency easier. And consistencywith Xiidrais everything.

Final Thoughts

So, do Xiidra interactions with other drugs, alcohol, or supplements exist?

The short answer: No clear ones.

But the real answer? There's no substitute for your doctor knowing your whole story.

You might be one of the thousands for whom Xiidra works beautifullyno issues, just relief. Or you might be someone whose body reacts differently. Either way, being informed, honest, and proactive is your best defense.

So next time you're on a call with your eye doctor, don't hesitate to say: "Hey, I've been drinking a little wineshould I cut back? I just started a new supplementcould that affect this?"

They're not there to judge. They're there to help you live more comfortably.

And that's what this is really aboutnot just avoiding interactions, but feeling better, seeing clearer, and getting your life back from dry, tired eyes.

You've got this. And now? You've got the knowledge to back it up.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.