Eysuvis Drug Interactions: What to Avoid and What to Tell Your Doctor

Eysuvis (loteprednol etabonate ophthalmic suspension 0.25%) is applied topically to the eye and has minimal systemic absorption — plasma concentrations following bilateral 4-times-daily dosing for 14 days were below detectable limits in clinical studies. This means the risk of traditional drug-drug interactions (where one systemic drug affects how another is metabolized) is very low. However, there are important local interactions and precautions to know about.

Most Important: Other Eye Drops

If you use other eye drops in addition to Eysuvis, the most important rule is timing: wait at least 5 minutes between instilling Eysuvis and any other eye medication. Here's why:

Instilling multiple drops back-to-back causes the first drop to be washed out before it can be absorbed properly.

The eye can only hold about 1 drop of fluid at a time — excess overflows and reduces effectiveness.

If you use artificial tears, glaucoma medications, or other ophthalmic drugs — always separate them from Eysuvis by at least 5 minutes.

Eysuvis With Specific Dry Eye Medications

Eysuvis + Restasis or Cequa (Cyclosporine)

Eysuvis is often prescribed alongside cyclosporine eye drops (Restasis or Cequa) intentionally — Eysuvis provides rapid short-term relief during a flare while cyclosporine builds its long-term effect over months. There is no known interaction between topical loteprednol and topical cyclosporine. When using both, apply them at least 5 minutes apart. Eysuvis is typically discontinued after 2 weeks while cyclosporine continues long-term.

Eysuvis + Xiidra (Lifitegrast)

No direct drug interaction is documented between topical loteprednol and lifitegrast. Some providers combine them for comprehensive dry eye management — Xiidra for long-term anti-inflammatory control and Eysuvis for acute flares. Wait 5 minutes between drops when using both simultaneously.

Eysuvis + Glaucoma Medications

This is where extra caution is needed. Eysuvis, like all ophthalmic corticosteroids, can potentially raise intraocular pressure (IOP). If you're already taking eye drops for glaucoma (prostaglandin analogs like latanoprost, beta-blockers like timolol, or others), your eye doctor needs to closely monitor your IOP during Eysuvis treatment. The two drugs don't directly interact, but Eysuvis's potential to raise IOP could counteract or complicate your glaucoma management.

Always tell your ophthalmologist if you are using glaucoma medications before starting Eysuvis.

Eysuvis + Artificial Tears

Artificial tears are commonly used alongside Eysuvis for additional comfort. There is no drug interaction, but timing matters: use artificial tears at a separate time from your Eysuvis dose, waiting at least 5 minutes. Many patients find it practical to use artificial tears for comfort between their 4 daily Eysuvis doses.

The Contact Lens / BAK Interaction

The preservative in Eysuvis — benzalkonium chloride (BAK) at 0.01% — can be absorbed by soft contact lenses. If BAK accumulates in the lens material, it can release slowly onto the eye surface over time, potentially causing irritation. To prevent this: always remove your soft contact lenses before instilling Eysuvis, and do not reinsert them for at least 15 minutes after each dose. This allows the BAK from the drop to disperse from the eye before lens contact.

Conditions That Change Eysuvis's Risk Profile

These aren't traditional drug interactions, but they significantly affect how Eysuvis should be used:

Herpes simplex, vaccinia, varicella eye infection: CONTRAINDICATED. Corticosteroids can worsen viral eye infections dramatically. Do not use Eysuvis if you have any active viral infection of the eye.

Fungal or mycobacterial eye infection: CONTRAINDICATED. Do not use Eysuvis with these infections.

Glaucoma or elevated IOP history: Use with caution. IOP must be monitored during treatment.

Thin corneas (post-LASIK or other corneal surgery): Extra caution needed — corticosteroids can delay corneal healing and in very thin corneas, may increase perforation risk.

Pregnancy: No adequate human studies; animal studies showed teratogenicity at high oral doses. Use only if benefit outweighs risk.

What to Tell Your Doctor Before Starting Eysuvis

All eye drops you currently use, including OTC artificial tears, vitamins, and supplements (some eye health supplements contain components that may affect the ocular surface)

Any history of eye infections, particularly herpes simplex eye infections

Any history of glaucoma, elevated eye pressure, or eye surgery

Whether you wear soft contact lenses

If you are pregnant, planning to become pregnant, or breastfeeding

Accessing Eysuvis

If you have questions about drug interactions for your specific situation, always ask your pharmacist or eye doctor. Once you've cleared your safety questions and have a prescription, use medfinder to find a pharmacy near you with Eysuvis in stock.