Dry Eye Syndrome Drug Summary

Last updated: 11 December 2025

Eye Corticosteroids*


Drug Available Strength Dosage Remarks
Betamethasone 0.1% ophthalmic drops

Adjusted based on the severity of symptoms. Should be tapered appropriately.



 
 

Adverse Reactions

  • Ocular effects (conjunctival hyperemia, conjunctivitis, corneal ulcers, delayed wound healing, glaucoma, increased intraocular pressure [IOP], keratitis, loss of accommodation, optic nerve damage, mydriasis, posterior subcapsular cataract formation, ptosis, secondary ocular infection)
Special Instructions
  • Avoid use in patients with viral diseases of the cornea and conjunctiva (eg acute superficial herpes simplex keratitis), mycobacterial or fungal infections of the eye
  • Monitor IOP of patients receiving treatment for ≥10 days
  • Withdraw therapy with gradual dose tapering

 
 
 
Dexamethasone 0.5 mg/1 mL ophthalmic drops;
0.1% ophthalmic gel; 0.1% ophthalmic suspension/drops/ointment
Fluorometholone 0.02% ophthalmic suspension;
0.1% ophthalmic suspension/drops
Loteprednol etabonate 0.2% ophthalmic suspension;
5 mg/1 mL ophthalmic solution
Prednisolone
 0.5% ophthalmic drops;
1% ophthalmic drops 
Rimexolone
 1% ophthalmic drops
*Combination with various antibiotics are available. Please see the latest MIMS for specific formulations.

Ophthalmic Anti-Inflammatories


Drug Available Strength Dosage Remarks
Ciclosporin (Cyclosporine) 0.05% ophthalmic solution;
0.1% ophthalmic emulsion

Instill 1 drop 12 hourly in each eye

Adverse Reactions

  • Ocular effects (ocular burning, conjunctival hyperemia, discharge, epiphora, eye pain, photophobia, foreign body sensation, visual disturbance)
Special Instructions
  • Avoid use in patients with ocular infection or known hypersensitivity to any components
  • Avoid eyedropper tip to come in contact with the eyes
  • Avoid use while wearing contact lenses
    • Lenses may be reinserted after 15 minutes
  • May give concomitantly with artificial tears with 15-minutes interval
Lifitegrast 5% ophthalmic solution

Instill 1 drop 12 hourly in each eye

Adverse Reactions

  • GI effect (dysgeusia); Ocular effects (blurred vision, conjunctival hyperemia, irritation, discharge, pruritus, increased lacrimation); Other effects: (headache, sinusitis)
Special Instructions
  • Avoid use while wearing contact lenses
    • Lenses may be reinserted after 15 minutes
  • Avoid the eyedropper tip to come in contact with the eyes

Ophthalmic Lubricants*


Drug Available Strength Dosage Remarks
Carbomer
(Polyacrylic acid)
 0.3% ophthalmic gel

Instill 1 drop 8-12 hourly as needed

Adverse Reactions

  • Temporary visual disturbances, allergic reactions
Special Instructions
  • Use with caution when driving or operating machines
  • Avoid use while wearing contact lenses

 
2 mg/g ophthalmic gel Instill 1 drop into the conjunctival sac 3-5x/day and 30 minutes prior to bedtime 
0.25% ophthalmic gel
 Instill 1 drop into the lower conjunctival sac 6-24 hourly
Carmellose (Carboxymethylcellulose sodium)
 0.5%, 1% ophthalmic drops; 0.5%, 1% preservative-free ophthalmic drops  Instill 1-2 drops as needed Adverse Reactions
  • Eye irritation and allergic reactions have been reported occasionally
Special Instructions
  • Avoid the eyedropper tip to come in contact with the eyes
  • Discontinue if symptoms persist or worsen >72 hours
Diquafosol Na  3% ophthalmic solution
 Instill 1 drop 4 hourly
 Adverse Reactions
  • Ocular effects (blepharitis, irritation, conjunctival injection, discharge, pruritus, ocular discomfort, foreign body sensation in the eyes)
Special Instructions
  • Avoid the eyedropper tip to come in contact with the eyes
Glycerin/Polysorbate 80  Glycerin 1%/Polysorbate 80 1% ophthalmic drops  Instill 1-2 drops as needed
 Adverse Reactions
  • Eye irritation and allergic reactions have been reported occasionally
Special Instructions
  • Avoid the eyedropper tip to come in contact with the eyes
  • Discontinue if symptoms persist or worsen >72 hours
Hypromellose
(Hydroxypropyl methylcellulose) 		 0.3%, 0.5% ophthalmic drops
Instill 1-2 drops 6-8 hourly or as needed
 Adverse Reactions
  • Temporary burning or stinging sensation, allergic reactions, redness of eyes
Special Instructions
  • Use with caution when driving or operating machines
  • Avoid the eyedropper tip to come in contact with the eyes
  • Discontinue if symptoms persist or worsen
Naphazoline 0.012% ophthalmic drops  Instill 1 drop up to 6 hourly
 Adverse Reactions
  • Ocular effects (temporary visual disturbances, pupil enlargement, eye redness, irritation, eye pain)
Special Instructions
  • Avoid use while wearing contact lenses
Perfluorohexyloctane  1.338 g/mL ophthalmic drops
 Instill 1 drop 6 hourly  Adverse Reactions
  • Ocular effects (blurred vision, conjunctival erythema)
Special Instructions
  • Avoid use while wearing contact lenses
Polyethylene glycol
 0.25% ophthalmic drops
 Instill 1 drop as needed  Special Instructions
  • Avoid eyedropper tip to come in contact with the eyes
  • Blink several times after administration
Polyvinyl alcohol
 1.4% ophthalmic drops  Instill 1 drop as needed  Adverse Reactions
  • Eye irritation and allergic reactions have been reported occasionally
Special Instructions
  • Avoid eyedropper tip to come in contact with the eyes
  • Avoid use while wearing contact lenses
  • Discontinue if symptoms persist or worsen >72 hours
Propylene glycol 0.6% ophthalmic drops  Instill 1-2 drops as needed  Special Instructions
  • Avoid eyedropper tip to come in contact with the eyes
  • Discontinue if symptoms persist or worsen
*Various combination products are available. Please see the latest MIMS for specific formulations.

Other Eye Preparations*


Drug Available Preparation
 Dosage Remarks
Sodium chloride 0.9% ophthalmic drops

Instill 1 drop as needed

  Special Instructions
  • Avoid eyedropper tip to come in contact with the eyes
  • Avoid use while wearing soft contact lenses
Sodium hyaluronate
 0.1% ophthalmic solution

Instill 1 drop 5-6x/day

Adverse Reactions

  • Ocular effects (blepharitis, eyelid dermatitis, itching, irritation, conjunctivitis, conjunctival injection, corneal lesions eg keratitis, superficialis diffusa, eye discharge)
Special Instructions
  • Use 0.3% ophthalmic solution if 0.1% ophthalmic solution is ineffective
  • Avoid the eyedropper tip to come in contact with the eyes
  • Avoid use while wearing soft contact lenses

 
0.3% ophthalmic solution Instill 1 drop 5-6x/day

0.18% , 0.2% ophthalmic drops, 0.18% preservative-free ophthalmic drops
 Instill 1-2 drops as needed 
0.3% preservative-free ophthalmic gel Instill 1-2 drops as needed 
*Various combination products are available. Please see the latest MIMS for specific formulations.

Other Parasympathomimetic
Drug Dosage Remarks
Secretagogue
Pilocarpine Initial dose: 5 mg PO 8 hourly
Maintenance dose: 15-30 mg/day
Max dose: 10 mg/dose		 Adverse Reactions
  • Systemic cholinergic effects (sweating, nausea, intestinal cramping)
Special Instructions
  • Avoid use in patients with hypersensitivity to Pilocarpine or any component of the formulation
  • Use with caution in patients with cognitive or psychiatric disorders, renal impairment, biliary tract disorders
  • Titrate dose according to response and tolerability
Varenicline 1 spray each nostril 12 hourly Adverse Reactions
  • Respiratory effects (cough, sneezing, throat irritation); Other effect (local site irritation)
Special Instructions
  • Avoid shaking the bottle and spraying directly at nasal septum

Disclaimer

All dosage recommendations are for non-pregnant and non-breastfeeding women, and non-elderly adults with normal renal and hepatic function unless otherwise stated.  
Not all products are available or approved for above use in all countries.  
Products listed in the Drug Summary are based on indications stated in the locally approved product monographs.   
Please refer to local product monographs in Related MIMS Drugs for country-specific prescribing information.  

Related MIMS Drugs