Indication
Treatment of the signs and symptoms of dry eye disease.
LabelSpecialty Rx · Dry Eye
Tyrvaya Nasal Spray Varenicline for dry eye disease.
Tyrvaya treats dry eye through the nose, a fit for drop-averse patients, prescribed by optometrists and ophthalmologists within state scope.
0.03 mgvarenicline per spray
2 spraysone per nostril, twice daily
52% vs 14%Schirmer gain of 10 mm or more in ONSET-1
82%reported sneezing
Mechanism
A tear signal that starts in the nose
Varenicline binds nicotinic acetylcholine receptors in the nasal cavity, activating the trigeminal parasympathetic pathway and increasing production of basal tear film. The exact mechanism is not fully known.
ONSET-1
52% reached a Schirmer gain of 10 mm or more at day 28, versus 14% on vehicle.
LabelONSET-2
47% reached the same Schirmer threshold, versus 28% on vehicle.
LabelCompany
Oyster Point Pharma, a Viatris company, with the TEAMTyrvaya support program.
ViatrisStarting a patient
The routine is simple, but counsel on the sneeze.
- Prime before first use
- One spray each nostril, twice daily
- Expect sneezing at first
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Dosing
One spray in each nostril twice daily, about 12 hours apart.
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Priming
Prime with seven actuations before first use, and re-prime with one if unused for more than five days.
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Supply
A carton holds two bottles of 60 sprays, a 30-day supply.
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Side effects
Sneezing 82%; cough, throat irritation and nose irritation in 5% to 16%. No contraindications.
Treatment paths
Every path for dry eye
Dry eye care is layered and often combined. Vision Rescue does not rank these paths; the eye doctor and the patient choose.
At-home care
Lid hygiene, warm compresses and changes to screen habits and surroundings.
Advised by any treating OD or MDLubricating drops
Preservative-free tears, gels and ointments.
Recommended by optometrists and ophthalmologistsPrescription drops
Anti-inflammatory or immunomodulating eye drops.
Prescribed by ODs and MDs within state scopeNasal spray
Varenicline spray that increases natural tear production.
Prescribed by ODs and MDs within state scopeIn-office procedures
Punctal plugs and in-office gland treatments.
Optometrists and ophthalmologists, within state scopeWhere it fits
Choosing patients
Tyrvaya adds a route of delivery to the dry eye toolbox rather than replacing other therapy.
Drop-averse patients
Patients who find drops hard to instill or uncomfortable.
Aqueous deficiency
Patients with low tear production on Schirmer or tear volume testing.
Combination care
Alongside lid hygiene, heat therapy and preservative-free tears where indicated.
Label details
Product details
| Active ingredient | Varenicline solution |
|---|---|
| Strength | 0.03 mg per 0.05 mL spray |
| Route | Nasal |
| Pack | 2 bottles x 60 sprays, 30 days |
| Contraindications | None |
Adverse reactions
- Sneezing 82%
- Cough 16%
- Throat irritation 13%
- Instillation-site (nose) irritation 8%
Questions about Tyrvaya
How is Tyrvaya different from dry eye drops?
It is sprayed in the nose and stimulates natural tear production through a nerve pathway rather than adding fluid to the eye.
How often is it used?
One spray in each nostril twice daily, about 12 hours apart.
What is the most common side effect?
Sneezing, reported by 82% of patients in trials.
How long does a carton last?
Two 60-spray bottles provide 30 days of treatment.
Can it be combined with other dry eye care?
Yes. It is often used alongside lid hygiene and lubricating drops; follow the label and your clinical judgment.
Does Vision Rescue stock it?
No. It is a prescription filled by the pharmacy. Vision Rescue supplies the OTC dry eye products that complement it.
References
Give dry eye patients another route
Pair prescription therapy with the preservative-free tears and lid care patients use every day, in optometry and ophthalmology practices alike.
Stay current: Latest eye care industry news
Tyrvaya is a trademark of its owner. Written for licensed eye care professionals. Review the full Prescribing Information before prescribing. RescueLink: 15% participation credit on eligible OTC orders on VisionRescue.com via RescueLink; contact lenses and Rx excluded.