What is the mechanism of action of Tyrvaya?

Official answer

by Drugs.com

Tyrvaya works by activating a pathway in the nose that is responsible for tear film production. In turn, this signals the body to produce more of your own natural tears. Tyrvaya is the first nasal spray to be approved to treat dry eye disease.

Specifically, Tyrvaya (varenicline 0.03 mg) is thought to work as an agonist by binding to the nicotinic acetylcholine (nACh) receptor.

This binding activates the trigeminal parasympathetic pathway in the nose to increase basal tear production.

The dose of Tyrvaya is one spray in each nostril twice daily (approximately 12 hours apart). Do not shake the bottle. A 1-month supply of Tyrvaya usually will require 2 nasal spray bottles, which you will receive when you fill your prescription. Do not shake the bottles.

How well does Tyrvaya work?

In two clinical research studies in over 1,000 patients with mild to severe dry eye disease, patients showed significant improvements in tear film production as assessed using Schirmer's score (0 to 35 mm) after 4 weeks when compared to the vehicle (an eye drop without the medicine). Use of artificial tears was allowed during the studies.

A Schirmer’s score is a test your eye doctor may use to see if your eyes are making enough tears.

First, your doctor will give you eye drops to numb your eyes. Then they will place small strips of paper on the edge of your eyelids and you will close your eyes.

After 5 minutes, your doctor can see how much moisture (tear production) is on the paper.

In Tyrvaya studies, the mean Schirmer's score for patients at the beginning of the study was 5 to 5.1 mm. For patients treated with Tyrvaya, the mean change in Schirmer’s score was 11.7 mm and 11.3 mm as compared to 3.2 mm and 6.3 mm in the vehicle-treated patients after 4 weeks. Close to half of the patients receiving Tyrvana achieved at least a 10 mm increase in Schirmer’s score after 4 weeks.

Significant Study Results (<0.01): Mean change in Schirmer’s score

Tyrvaya: 47% to 52% achieved ≥10 mm increase in Schirmer’s score from baseline at day 28

Vehicle: 14% to 28% achieved ≥10 mm increase in Schirmer’s score from baseline at day 28

Additional studies have shown continued effectiveness of Tyrvaya for up to 12 weeks (84 days) of treatment.

What are the most common side effects with Tyrvana?

Sneezing is the most common side effect reported in Tyrvaya studies, occurring in 82% of patients. Sneezing is a temporary side effect and has typically occurred within the first minute after administration. Other common side effects were cough (16%), throat irritation (13%), and instillation-site (nose) irritation (8%).

Most side effects have been reported as mild. Less than 2% of patients receiving Tyrvaya stopped treatment due to side effects. Most notably, because Tyrvaya is a nasal spray, no burning or stinging in the eyes was reported (a common side effect with some prescription eye drops used for dry eye disease).

Who makes Tyrvaya?

Tyrvaya is manufactured by Oyster Point Pharma in Princeton, NJ. You can contact them at 1-877-393-0123 (1-877-EYE-0123) or online.

What other options are available for Dry Eye Disease?

While they work differently than Tyrvaya, these medicines are also used to help alleviate the symptoms of dry eye:

Restasis

Xiidra

Eysuvis

cyclosporine ophthalmic (generic)

Systane

Cequa

This is not all the information you need to know about Tyrvaya (varenicline 0.03 mg) nasal spray for safe and effective use and does not take the place of your doctor’s directions. Review the full product information and discuss this information and any questions you have with your doctor or other health care provider.

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