Tyrvaya is a brand-name prescription medication. It’s FDA-approved to treat the symptoms of dry eye disease.

With dry eye disease, your eyes don’t make enough tears, or your tears don’t keep your eyes moist enough. This can cause uncomfortable symptoms, such as burning and pain.

Drug details

Tyrvaya is the first dry eye medication that comes as a nasal spray.

Tyrvaya is available in one strength of 0.6 milligrams (mg) per milliliter (mL) of solution. Each actuation (spray) delivers 0.03 mg of varenicline.

The active drug in Tyrvaya is varenicline. Tyrvaya belongs to a class of drugs called partial nicotinic receptor agonists.

Effectiveness

For information about the effectiveness of Tyrvaya, see the “Tyrvaya uses” section below.

Tyrvaya is available only as a brand-name medication. It’s not currently available in generic form.

A generic drug is an exact copy of the active drug in a brand-name medication. Generics usually cost less than brand-name drugs.

As with all medications, the cost of Tyrvaya nasal spray can vary. To find current prices for Tyrvaya in your area, check out GoodRx.com.


The cost you find on GoodRx.com is what you may pay without insurance. The actual price you’ll pay depends on your insurance plan, your location, and the pharmacy you use.

Keep in mind that you may be able to get a 90-day supply of Tyrvaya. If approved by your insurance company, getting a 90-day supply of the drug could reduce your number of trips to the pharmacy and help lower the cost. If you’re interested in this option, check with your doctor, pharmacist, or insurance company.

Before approving coverage for Tyrvaya, your insurance company may require you to get prior authorization. This means that your doctor and insurance company will need to communicate about your prescription before the insurance company will cover the drug. The insurance company will review the prior authorization request and decide if the drug will be covered.

If you’re not sure if you’ll need to get prior authorization for Tyrvaya, contact your insurance company.

Financial and insurance assistance

If you need financial support to pay for Tyrvaya, or if you need help understanding your insurance coverage, help is available.

Tyrvaya has a savings program and patient support program called TEAMTyrvaya. For more information and to find out if you’re eligible for support, call 877-EYE-0123 or visit the drug website.

To learn more about saving money on prescriptions, check out this article.

Mail-order pharmacies

Tyrvaya may be available through a mail-order pharmacy. Using this service may help lower the drug’s cost and allow you to get your medication without leaving home.

If recommended by your doctor, you may be able to receive a 90-day supply of Tyrvaya, so there’s less concern about running out of the medication. If you’re interested in this option, check with your doctor, pharmacist, or insurance company. Some Medicare plans may help cover the cost of mail-order medications.

If you don’t have insurance, you can ask your doctor or pharmacist about online pharmacy options.

Generic version

Tyrvaya is not available in a generic form. A generic drug is an exact copy of the active drug in a brand-name medication. Generics tend to cost less than brand-name drugs.

Tyrvaya nasal spray may cause mild side effects. The following lists contain some of the key side effects that may occur with Tyrvaya. Other side effects are possible.

For more information about the possible side effects of Tyrvaya, view the drug’s prescribing informationor talk with your doctor or pharmacist. They can give you tips on how to manage any side effects that may be concerning or bothersome.

Note: The Food and Drug Administration (FDA) tracks side effects of drugs it has approved. If you’d like to notify the FDA about a side effect you’ve had with Tyrvaya, you can do so through MedWatch.

Mild side effects

Mild side effects* of Tyrvaya can include:

Most of these side effects may go away within a few days to a couple of weeks. However, if they become more severe or don’t go away, talk with your doctor or pharmacist.

* For more information about this side effect, see “Allergic reaction” below.

Serious side effects

No serious side effects have been reported with Tyrvaya. However, like other drugs, it’s possible that serious side effects such as the following could still occur:

  • severe allergic reaction*

Call your doctor right away if you think you have serious side effects. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

* For more information about this side effect, see “Allergic reaction” below.

Allergic reaction

As with most drugs, some people can have an allergic reaction after taking Tyrvaya. Allergic reactions weren’t reported in the drug’s clinical trials.

Symptoms of a mild allergic reaction can include:

A more severe allergic reaction is rare but possible. Symptoms of a severe allergic reaction can include:

  • swelling under your skin, typically in your eyelids, lips, hands, or feet
  • swelling of your tongue, mouth, or throat
  • trouble breathing

Call your doctor right away if you have an allergic reaction to Tyrvaya, as the reaction could become severe. Call 911 or your local emergency number if your symptoms feel life threatening or if you think you’re having a medical emergency.

The following information describes Tyrvaya dosing that’s commonly used or recommended. However, be sure to take the Tyrvaya nasal spray dosage your doctor prescribes for you. Your doctor will determine the best dosage to fit your needs.

Drug forms and strengths

Tyrvaya comes as a clear liquid solution in a nasal spray bottle.

This medication is available in one strength of 0.6 milligrams (mg) per milliliter (mL) of solution. Each actuation (spray) delivers 0.03 mg of varenicline in 0.05 mL of solution. Varenicline is the active drug in Tyrvaya.

Dosage for dry eye

Your doctor will likely recommend spraying Tyrvaya one time into each nostril twice per day. Your doses should be about 12 hours apart.

What if I miss a dose?

If you miss a dose of Tyrvaya, skip the missed dose. You can then continue using the medication at the next scheduled time. You should not use extra sprays of the medication to make up for missed doses.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Will I need to use this drug long term?

Tyrvaya is meant to be used as a long-term treatment. If you and your doctor determine that Tyrvaya is safe and effective for you, you’ll likely take it long term.

You should use Tyrvaya according to how your doctor advises.

Even if you’ve used other nasal sprays before, carefully review Tyrvaya’s instructions before using the medication. Step-by-step directions are included in the drug’s packaging. The manufacturer’s website also offers a helpful video and an illustrated guide on how to use Tyrvaya.

Here’s a short list of important “don’ts” to keep in mind with Tyrvaya nasal spray:

  • Don’t shake the bottle.
  • Don’t spray it into your eyes.
  • Don’t sniff hard as you take each dose. Instead, breathe in gently.

Also, once you open a bottle of Tyrvaya, you should discard of any unused medication 30 days later. This means you’ll want to use up one bottle before you open the second bottle. (Two bottles of Tyrvaya come in one package.)

When to use

You’ll likely use Tyrvaya twice per day, about 12 hours apart. For example, at about 8 a.m. and again around 8 p.m.).

Taking the medication at about the same times each day helps keep a steady level of the drug in your body. This helps Tyrvaya work effectively.

To help make sure that you don’t miss a dose, try using a medication reminder. This can include setting an alarm or using a timer. You could also download a reminder app on your phone.

Accessible labels and containers

If your prescription label is hard to read, talk with your doctor or pharmacist. Some pharmacies offer labels that have large print, braille, or a code you scan with a smartphone to convert text to speech. If your local pharmacy doesn’t have these options, your doctor or pharmacist may be able to direct you to one that does.

The Food and Drug Administration (FDA) approves prescription drugs such as Tyrvaya to treat certain conditions.

Tyrvaya for dry eye

Tyrvaya is FDA-approved to treat the symptoms of dry eye disease. This is a chronic (long-term) condition that’s also called dry eye syndrome or simply “dry eye.”

Dry eye explained

When you blink, a layer of tears should spread across the surface of your eyes. With dry eye disease, your eyes don’t make enough tears, or your tears don’t hold enough moisture. This can lead to uncomfortable symptoms, such as:

Dry eye disease can make it difficult to read or view computer screens for long periods. Dry eyes may be more likely to develop bacterial infections and inflammation (swelling and damage).

In addition, having dry eye disease may make it too uncomfortable to wear contact lenses. Common types of eye surgery, such as LASIK* and cataract surgery, may make dry eye symptoms worse.

There currently isn’t a cure for dry eye disease. However, several treatment options are available that may help manage this condition, including Tyrvaya.

* LASIK is short for laser-assisted in situ keratomileusis.

Effectiveness for dry eye

In clinical trials, Tyrvaya nasal spray was shown to be an effective treatment for dry eye. The drug was found to increase tear production in people with dry eye disease.

If you’re interested in knowing if Tyrvaya may work for you, talk with your doctor.

Tyrvaya and children

It isn’t known whether Tyrvaya is safe and effective for children with dry eye disease. This medication is FDA-approved for use only in adults.

No interactions are known to occur between alcohol and Tyrvaya.

If you have questions about drinking alcohol during Tyrvaya treatment, talk with your doctor.

Tyrvaya isn’t known to interact with other medications, herbs, supplements, or foods. However, it’s possible that drug interactions with Tyrvaya could be recognized in the future. For example, new drugs may be approved that interact with Tyrvaya.

Because of this, it’s still important totalk with your doctor and pharmacist before starting Tyrvaya treatment. Tell them about all prescription, over-the-counter, and other drugs you take. Also tell them about any vitamins, herbs, and supplements you use. Sharing this information can help you avoid potential interactions.

If you have questions about drug interactions that may affect you, ask your doctor or pharmacist.

Tyrvaya is approved to treat dry eye disease. If you have dry eye, your eyes don’t make enough tears, or your tears don’t hold enough moisture.

Experts don’t know exactly how Tyrvaya works to treat dry eye disease. The drug is thought to work by stimulating the nerve endings in your nose. These nerve endings are part of a nerve pathway called the trigeminal parasympathetic pathway.

Stimulation of this pathway causes the cells and glands around your eyes to increase production of certain substances. These substances include water, oil, and mucin (a type of protein), which combine to form natural tears. Tears provide a layer of moisture on the surface of your eye.

How long does it take to work?

Tyrvaya starts working to increase tear production after your first dose. In clinical trials, some people with dry eye disease had increased tear production within 1 to 4 weeks after starting Tyrvaya treatment.

It isn’t known whether Tyrvaya is safe to use while pregnant. The drug’s effects on pregnancy have not been studied.

Because Tyrvaya is a nasal spray, very little of the drug is absorbed into your bloodstream. This means that Tyrvaya isn’t likely to affect a developing fetus. However, this isn’t known for sure.

If you’re pregnant or planning to become pregnant, talk with your doctor. They can help you decide on the right treatment for your dry eye disease at this time.

It’s not known whether Tyrvaya is safe to take during pregnancy. If you’re sexually active and you or your partner can become pregnant, talk with your doctor about your birth control needs during Tyrvaya treatment.

For more information about Tyrvaya treatment during pregnancy, see the “Tyrvaya and pregnancy” section above.

It isn’t known whether Tyrvaya is safe to use while breastfeeding. Researchers haven’t studied the drug’s effects on breast milk or children who are breastfed.

Because Tyrvaya is given as a nasal spray, very little of the drug is absorbed into your bloodstream. This means that significant amounts of the drug aren’t likely to pass into breast milk or affect a child who’s breastfed. However, this isn’t known for sure.

If you’re breastfeeding or planning to do so, talk with your doctor. They can help you decide on the right treatment for your dry eye disease at this time.

Here are answers to some frequently asked questions about Tyrvaya.

Can I use an allergy nasal spray during Tyrvaya treatment?

Yes, however, be sure to talk with your doctor first. You should ask them for their advice regarding the timing of your doses. They may recommend spacing out the doses of your allergy nasal spray and Tyrvaya or using the medications in a specific order.

Keep in mind that Tyrvaya was not studied in people with severe seasonal allergies, rhinitis, or sinusitis. It’s possible that the drug may not work as well in people with nasal congestion due to these conditions. More research is needed to know for sure.

If you have additional questions about allergy nasal sprays and Tyrvaya, talk with your doctor.

Why can’t I spray Tyrvaya directly in my eyes for dry eye?

Tyrvaya is not meant to be used directly in the eyes. It’s believed the drug works by stimulating nerves in your nose. This helps your eyes produce tears and other moistening substances. (To learn more, see the “How Tyrvaya works” section above.)

Many other dry eye treatments come as eye drops, which can be difficult to use. It’s often tricky to feel whether you put the right number of drops into your eye. It’s also possible that you might miss your eye or blink at the wrong time.

In addition, many medicated eye drops commonly cause eye-related side effects, such as stinging or burning. These effects can be uncomfortable when your eyes are already irritated from dry eye disease.

Tyrvaya is the first dry eye medication that comes as a nasal spray. A key advantage of it is that the drug does not cause further discomfort to your eyes. It’s also easy to use.

If you’d like to learn more about Tyrvaya and other dry eye treatments, talk with your doctor or pharmacist.

If I sneeze after using Tyrvaya, should I take another dose?

No. People who participated in clinical trials of Tyrvaya for dry eye were told not to repeat their dose after sneezing. The drug was still shown to be an effective treatment for dry eye in these trials.

Sneezing is the most common side effect of Tyrvaya. If you have questions about this or any other side effects of the medication, ask your doctor or pharmacist.

Is Tyrvaya used to help people quit smoking?

No, Tyrvaya is used to treat the symptoms of dry eye disease. It’s not approved to help with quitting smoking.

Tyrvaya contains the active drug varenicline, which is also the active drug in Chantix. This is an oral tablet used to help people quit smoking. The manufacturer of Chantix recently recalled all Chantix tablets because they contained an impurity called a nitrosamine. High levels of nitrosamines may increase the risk of cancer. Tyrvaya nasal spray is not included in this recall, and the drug is not known to contain nitrosamines.

Because Tyrvaya is a nasal spray, very little of its active drug is absorbed into your bloodstream. This means that Tyrvaya is not likely to have any effect on whether or not you successfully quit smoking.

Your doctor and pharmacist should be able to provide you with helpful suggestions about how to quit smoking.

This drug comes with several precautions. Before starting Tyrvaya treatment, talk with your doctor about your health history. Tyrvaya may not be right for you if you have certain medical conditions or other factors affecting your health. These include:

  • Allergic reaction. If you’ve had an allergic reaction to Tyrvaya or any of its ingredients, your doctor will likely not prescribe Tyrvaya. Ask your doctor what other medications may be better options for you.
  • Pregnancy. It isn’t known whether Tyrvaya is safe to use during pregnancy. For more information, see the “Tyrvaya and pregnancy” section above.
  • Breastfeeding. It isn’t known whether Tyrvaya is safe to use while breastfeeding. For more information, see the “Tyrvaya and breastfeeding” section above.

Note: For more information about the potential negative effects of Tyrvaya, see the “Tyrvaya side effects” section above.

Do not use more Tyrvaya than your doctor recommends. For some drugs, doing so may lead to unwanted side effects or overdose.

What to do in case you take too much Tyrvaya

If you think you’ve taken too much of this drug, call your doctor. You can also call the American Association of Poison Control Centers at 800-222-1222 or use its online tool. If your symptoms are severe, call 911 or your local emergency number, or go to the nearest emergency room right away.

When you get Tyrvaya from the pharmacy, the pharmacist will add an expiration date to the label on the packaging. This date is typically 1 year from the date they dispensed the medication.

The expiration date helps guarantee that the medication is effective during this time. The current stance of the Food and Drug Administration (FDA) is to avoid using expired medications. If you have unused medication that has gone past the expiration date, talk with your pharmacist about whether you might still be able to use it.

Keep in mind that two bottles of nasal spray come in one package of Tyrvaya. Be sure to finish one bottle before you open the other. This is because you should discard any unused medication 30 days after opening a bottle.

Storage

How long a medication remains good to use can depend on many factors, including how and where you store the medication.

You should store Tyrvaya at a room temperature of 68°F to 77°F (20°C to 25°C) in a tightly sealed container away from light. It’s important that you do not freeze the drug. Avoid storing Tyrvaya in areas where it could get damp or wet, such as bathrooms.

Disposal

If you no longer need to take Tyrvaya and have leftover medication, it’s important to dispose of it safely. This helps prevent others, including children and pets, from taking the drug by accident. It also helps keep the drug from harming the environment.

This article provides several useful tips on medication disposal. You can also ask your pharmacist for information about how to dispose of your medication.

Disclaimer: Medical News Today has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.