Alternatives to Lacrisert If You Can't Fill Your Prescription

Lacrisert (hydroxypropyl cellulose ophthalmic insert) is a one-of-a-kind dry eye treatment. When it is unavailable — whether due to a pharmacy shortage, insurance issues, or stocking problems — patients with moderate to severe dry eye often feel they have nowhere to turn. The reality is that while no product provides an identical replacement, several prescription and over-the-counter options can help bridge the gap or even provide long-term relief. Here is what you need to know about Lacrisert alternatives.

Understanding What Lacrisert Does (and Why It's Unique)

Lacrisert works by physically supplementing and thickening the tear film. Placed once daily into the lower eyelid pocket, it dissolves slowly throughout the day, providing sustained lubrication. It does not treat the underlying cause of dry eye — it is not anti-inflammatory — but for patients whose eyes simply do not retain enough moisture, Lacrisert's sustained-release mechanism is uniquely effective.

Because it works differently from prescription anti-inflammatory drops, a true substitute does not exist in a single product. However, combinations of other therapies can approximate similar benefits.

Prescription Alternatives to Lacrisert

1. Restasis (Cyclosporine 0.05%)

Restasis is one of the most widely prescribed dry eye medications. It is an immunosuppressant eye drop that works by reducing inflammation on the ocular surface and stimulating your eyes' natural tear production. It is dosed twice daily (one drop in each eye, 12 hours apart). A generic version (cyclosporine ophthalmic emulsion 0.05%) is now FDA-approved, which can significantly reduce cost compared to Lacrisert's cash price of roughly $578–$691 per package.

Key difference: Restasis takes 3–6 months to achieve full benefit by rebuilding natural tear production. It is not a same-day substitute for Lacrisert's mechanical lubrication. Most insurance plans cover Restasis or its generic.

2. Xiidra (Lifitegrast 5%)

Xiidra is an LFA-1 antagonist eye drop that blocks a protein involved in the inflammatory cycle of dry eye disease. It acts faster than Restasis — some patients notice improvement in dryness symptoms within 2 weeks, and significant improvement by 12 weeks. Xiidra is also dosed twice daily and is available as a brand-name product only (no generic as of 2026). It can cause a temporary unusual taste in the mouth (dysgeusia) and eye irritation.

3. Cequa (Cyclosporine 0.09%)

Cequa is a higher-concentration cyclosporine eye drop (0.09%) that uses NCELL technology for improved corneal penetration. Like Restasis, it increases tear production by reducing ocular inflammation, but the higher concentration and delivery system may benefit patients who have not responded adequately to Restasis. It is also dosed twice daily and is approved only for adults. Note that some insurers require failure of both Restasis and Xiidra before approving Cequa.

4. Miebo (Perfluorohexyloctane)

Miebo is a newer FDA-approved dry eye eye drop that targets evaporative dry eye by reducing tear evaporation from the ocular surface. It is a perfluorohexyloctane solution applied four times daily. Miebo does not treat inflammation directly but can be useful for patients whose primary issue is aqueous evaporation rather than inflammation or insufficient tear production.

Over-the-Counter Alternatives

For patients who cannot access a prescription alternative quickly, OTC options can provide partial relief:

Preservative-free artificial tears (Refresh Optive, Systane Ultra PF, TheraTears): Apply as often as needed (every 1–2 hours for severe cases). Preservative-free options are preferred for frequent use as preservatives can irritate the eye with repeated application.

Lubricating eye gels and ointments (Genteal Gel, Refresh Celluvisc, Systane Gel): Thicker than drops, these provide longer-lasting lubrication and are often used at bedtime or during extended low-blink activities.

Warm compresses: Applied to closed eyelids for 5–10 minutes, warm compresses help loosen meibomian gland secretions and improve the lipid layer of tears, reducing evaporation.

Comparing Lacrisert to Its Alternatives

Duration of action: Lacrisert provides up to 24-hour lubrication from a single insertion. Drops typically last 1–4 hours.

Dosing frequency: Lacrisert is once daily. Prescription drops (Restasis, Xiidra, Cequa) are twice daily. OTC drops are multiple times daily.

Mechanism: Lacrisert directly supplements the tear film. Restasis/Xiidra/Cequa reduce inflammation and rebuild tear production (takes months). OTC drops temporarily supplement tears.

Availability: Restasis (generic available), Xiidra, and OTC drops are widely stocked. Lacrisert and Cequa have more limited availability.

Still Trying to Find Lacrisert?

If your goal is to get back on Lacrisert rather than switch permanently, use medfinder to check which pharmacies near you have it in stock. See also: How to Find Lacrisert in Stock Near You.