The FDA’s approval of varenicline nasal spray 0.03 mg (Tyrvaya, Oyster Point Pharma) for the treatment of the signs and symptoms of dry eye disease (DED) brings to the control of this common situation a new therapeutic modality this is novel for both its mechanism of action and mode of administration. The new medication is suggested for use two times daily, sprayed as soon as into each nostril.

As a pretty selective nicotinic acetylcholine receptor agonist, varenicline is designed to bind to cholinergic receptors in the nasal mucosa and activate the trigeminal parasympathetic pathway, ensuing in elevated manufacturing of basal tear film. Results from preclinical and scientific research display that varenicline nasal spray induces goblet cell degranulation and stimulates meibomian gland and lacrimal gland secretion. Unlike most prescription topical remedies for DED, varenicline nasal spray 0.03 mg pursuits to reestablish tear film stability/homeostasis, consistent with Marian Macsai, MD, chief medical officer of Oyster Point Pharma in Princeton, New Jersey.

“Tyrvaya brings innovation to patients…with DED,” Macsai explained. “It is the first and only nasal spray approved for the treatment of the signs and symptoms of DED, and it is the first and only pharmacological approach to cholinergic neuro-activation via the trigeminal parasympathetic pathway”.Macsai mentioned that as a new method to drug transport for DED, nasal spray management gives the advantage of avoiding the installation of medication onto an already irritated ocular surface. “Acting through a novel mechanism of action, Tyrvaya provides a clinically meaningful increase in basal tear film production to offer relief for [patients with DED] as early as 4 weeks after treatment initiation,” Macsai said. “The clinical trial data also showed benefit was achieved in a broad patient population of adults with mild, moderate, or severe DED.”

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