Cequa vs Restasis: Key Differences Explained
Both are prescription cyclosporine eye drops for dry eye. Here’s how Cequa and Restasis compare on strength, formula, dosing, labeled side effects and cost.
The short answer
Cequa vs Restasis: both are prescription cyclosporine eye drops used twice daily to increase tear production in dry eye. Cequa is a 0.09% nanomicellar solution; Restasis is a 0.05% emulsion. Restasis has a generic version, and Cequa does not.
If you’re comparing Cequa vs Restasis, you’ve likely been prescribed a cyclosporine eye drop for chronic dry eye, or your eye doctor has brought one up. Both drops contain cyclosporine, but they differ in strength, formula and cost. Here’s how they compare.
Cequa vs Restasis at a glance
Cequa
- Cyclosporine 0.09%
- Clear nanomicellar solution
- One drop in each eye twice daily
- Single-use, preservative-free vials
- Brand only, no generic
Restasis
- Cyclosporine 0.05%
- Emulsion
- One drop in each eye twice daily
- Single-use vials, plus a multidose bottle (Restasis MultiDose)
- Generic cyclosporine 0.05% available
What is Cequa?
Cequa (cyclosporine ophthalmic solution 0.09%) is a prescription eye drop approved by the FDA in 2018. According to its prescribing information, it is used to increase tear production in people with keratoconjunctivitis sicca, the medical term for dry eye. It comes in preservative-free, single-use vials.
What is Restasis?
Restasis (cyclosporine ophthalmic emulsion 0.05%) is a prescription eye drop used to increase tear production in people whose tear production is thought to be reduced by eye inflammation linked to dry eye. It comes in single-use vials and as Restasis MultiDose, and a generic version, cyclosporine ophthalmic emulsion 0.05%, is also available.
How Cequa and Restasis work
Both drops contain the same active ingredient, cyclosporine, at different strengths: 0.09% in Cequa and 0.05% in Restasis.
The main difference is the formula. Cequa uses a nanomicellar formula that dissolves cyclosporine in a clear solution. Restasis is an emulsion, which looks white and opaque.
Good to know: The Restasis prescribing information says cyclosporine is thought to act as a partial immunomodulator when dry eye is linked to inflammation, and that the exact way it works is not known.
Want to compare cyclosporine with other prescription options? Read our guides to Xiidra eye drops and Miebo eye drops.
How to use Cequa and Restasis
Always follow your eye doctor’s instructions. The labeled directions for both drops are similar:
- Remove contact lenses first. You can put them back in 15 minutes after using the drops.
- Put one drop in each eye. With single-use vials, throw the vial away right after using it in both eyes.
- Repeat about 12 hours later. Both are used twice a day.
- Space out artificial tears. Both labels say they can be used with artificial tears, allowing 15 minutes between products.
Not an “as needed” drop: Cequa and Restasis are meant to be used every day, twice a day, as prescribed. Ask your eye doctor what to expect and when to follow up, and talk with them before stopping.
Cequa vs Restasis side effects
Here’s what each prescribing information lists from clinical trials:
Cequa
- Most common: pain when the drop goes in (22%) and eye redness (6%)
- Also reported in 1% to 5%: eyelid inflammation (blepharitis), eye irritation, headache and urinary tract infection
Restasis
- Most common: eye burning (17%)
- Also reported in 1% to 5%: eye redness, discharge, watery eyes, eye pain, feeling like something is in the eye, itching, stinging and blurred vision
If side effects bother you or don’t go away, contact your eye doctor. For the full lists, see each drop’s prescribing information or ask your pharmacist.
Cost and insurance
- Cequa is brand only. There is no generic version of Cequa.
- Restasis has a generic version, cyclosporine ophthalmic emulsion 0.05%.
- Coverage varies by plan. Some insurance plans require trying generic cyclosporine 0.05% before they cover Cequa.
Your eye doctor, pharmacist and insurance plan can tell you what each option would cost you.
Your daily dry eye routine
Dry eye is rarely caused by just one thing, and a prescription drop is usually one piece of the routine. Both labels allow artificial tears alongside cyclosporine, as long as you wait 15 minutes between them, so ask your eye doctor which artificial tear fits your routine.
If your doctor also recommends daily lid care, a gentle eyelid cleanser makes it easy to clean away oil, makeup and debris along the lash line as part of your morning and evening routine.
Products to ask your doctor about
Systane Complete PFPreservative-free lubricant eye dropsView drop
OPTASE IntensePreservative-free eye dropsView drop
Refresh Optive Mega-3 PFPreservative-free lubricant eye dropsView drop
Peeq Pro Foaming Eyelid & Facial CleanserGentle, tea tree eyelid cleanserView product
See the full lineup in our eye drops collection.
Make lid care part of your routine
Our gentle, tea tree eyelid cleanser fits right into your morning and evening routine, alongside your drops.
Shop the eyelid cleanser Browse eyelid hygieneCequa vs Restasis FAQs
What is the difference between Cequa and Restasis?
Both are prescription cyclosporine eye drops. Cequa contains cyclosporine 0.09% in a clear nanomicellar solution. Restasis contains cyclosporine 0.05% in an emulsion. Restasis has a generic version, and Cequa does not.
How often do you use Cequa and Restasis?
The labeled dose for both is one drop in each eye twice a day, about 12 hours apart. Follow your eye doctor’s instructions.
Can I use artificial tears with Cequa or Restasis?
Both labels say they can be used with artificial tears, allowing 15 minutes between products. Ask your eye doctor which artificial tear to use.
Can I wear contact lenses with Cequa or Restasis?
Take your contact lenses out before using either drop. According to the labels, you can put them back in 15 minutes after the drops.
Is there a generic Cequa?
No. Cequa is brand only. Restasis has a generic version, cyclosporine ophthalmic emulsion 0.05%.
Can I switch from Restasis to Cequa?
Only your eye doctor can decide whether to switch prescription drops. Talk with them about your symptoms, other treatments you’ve tried and your insurance coverage.
A note from Peeq Pro: We’re not medical providers, but we believe patients should understand their treatment options. Always follow your eye doctor’s instructions for Cequa, Restasis and any other prescription.
For general education only and not medical advice. Always follow your eye doctor’s instructions and the product labeling. Cequa, Restasis, Xiidra and Miebo are trademarks of their respective owners; mentions are examples, not endorsements. Sources: Cequa (cyclosporine ophthalmic solution) 0.09% Prescribing Information; Restasis (cyclosporine ophthalmic emulsion) 0.05% Prescribing Information.