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Dr. Cremers Reviews Tyrvaya Dry-Eye Nasal Spray – The Eye Show

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Dr. Cremers takes a look at the FDA approved dry-eye nasal spray, Tyrvaya. It works by producing tearing in the eye, which is believed to reduce the symptoms of dry-eye and work over the long-term to increase meibomian gland production.

Hi it’s dr sandy laura kramers thank you for joining us for the eye show this is podcast number 28. thank you for everybody for subscribing and i hope you will subscribe and pass us on to friends and family thank you all for those of you that have been emailing us and connecting with us around the globe we have now people and patients calling us and coming in

From as far away as fiji new zealand australia the netherlands germany italy we’ve been quite shocked by the feedback we’re getting from the podcast and of course from our website and so forth so please keep keep in touch with us and subscribe and pass this on to your friends and family so today we’re going to talk about one of the really new ways that have been

Fda approved to help with dry eyes and it’s called truvaya it looks like this comes in a little box like this and what this is is basically something called varenicline which has been used in champix or chantrix which is an anti smoking sensation drug and it is a nicotinic acetylcholine receptor agonists which basically for the pill when you’re taking a pill

To try to stop smoking this medication varenicline has been used to stimulate your reward center to increase your dopamine to help you try to find a way to not need the cigarette smoking you can just take the pill it decreases your smoking addiction so it is also helpful one of the side effects of it is it can cause a little bit of extra tearing in the eye

And there’s other side effects we’ll go through in a few minutes with the pill form but oscar oyster point which is the name of this company champix is under pfizer saw that this could be marketed as a nasal spray to help induce the lacrimal gland which is the gland under your bone to produce water and as well as they think it might help increase the meibomian

Gland production of oil now this is very still controversial i’m not 100 convinced on this but we’re going to go through a couple of things so verniclean has been around for many years it was first approved by the fda in 2006 as an anti-a smoking sensation drug there’s been some positives and negatives with varenicline it’s a 919 million dollar drug for pfizer

For the smoking sensation part and so they recently in 2021 pulled the the varenicline pill off the market because of the risk of cancer so there were some concerns of cancer causing components called nitrosamines in the pills and so they took it off so that happened after uh trevia came out so truvia we called the rep and said what’s going on what’s is there

Any risk of cancer with this they said no so as to my knowledge there’s no nitrosamines in this and actually the preservatives in this are relatively seem to be less uncomfortable for patients so the main ingredient in this is we’re in a clean point zero three milligrams and it has a bunch of preservatives sodium phosphate dibasca dibasic hepa hydride drite

Monovascus sodium phosphate anhydrous sodium chloride and a hypochloric acid so most of those are not the bak the bad ones associated with allergy so we’ve had now about 20 patients have been prescribed this we’ve had three patients that love it the rest of them have not really found it to be very helpful so it’s still early on we know with varenicline pill it

Helps about 20 percent of patients with smoking sensations so there may be something with different types of patients are going to react differently to medications and so we’re waiting to find out about whether this is going to be a game changer or not and so they have definitely marketed this to patients i i think i’ve even i’ve even seen i think an ad online

Uh the idea is the different way to have dry eye relief is your nose and so i have a lot of patients that you know kind of are don’t want to put things up their nose so the true tier which is going to be compared to of course uh which is that it was a fda approved instrument that you would stick up your nose and stimulate the nasal lacrimal nerve was approved

But patients wouldn’t use it nobody wanted to stick anything up their nose so will should this truvia succeed or not depends on how willing a dry eye patient is or how really uncomfortable they are with their dry eye to stimulate their nose to make them tear so if you stick a q-tip up your nose which i do not recommend but if you do that you will tear if you

If you tickle the the nose hairs in your nose you will probably sneeze and that generally will make you blink it’ll make you tear so the question i have for these companies is is it the actual chemical that’s helping this or is it the physical component of just touching the nose hairs and touching the nasolacrimal nerve that’s leading to tearing which it does

Naturally and does that which you know can cause sneezing does that cause the oil to come out because you’re blinking and squeezing and sneezing and so i think that’s what my concern is so i would love to see a study where you have truvaya on one hand uh and then you have patients that don’t do trivia but just stimulate their nose hairs and and or cause them

To sneeze by sticking a very thin q-tip up their nose i suspect you’re going to get the same result without the cost so travail of course is often not covered by insurances it’s of course having a very heavy promotion right now so it is um but it’s going to be probably about i think it’s around 80 a month or so so we’ll see how that turns out for patients

So if you look at the package insert which i highly recommend patients do from time to time because it is quite interesting um so a couple things you need to know so trevia is meant to be used twice a day we’re going to go through how you use in just a minute and it is not recommended for people under 18 years old hasn’t been checked in children has not been

Really available in pregnancy so it’s a category c because they haven’t done the studies yet so it’s not recommended in pregnant women yet and relative that let me just tell you what the side effects are that they reported they apparently report their carcinogenesis data on here which is the risk of cancer and the two-year outcome using it’s not clear if it

Was it was probably the varenicline but it was 20 milligrams per kilogram per day for two years they did not find any cancer risk in this but yet the variety clean was recently removed so that’s unclear what’s going on with that data and then the most common side effects of truvia let me tell you what my patients have told me and i’ll tell you what this says

Here so most of my patients did not notice an effect most a couple of my patients just couldn’t do it because of just it was too irritating to their nose and i said three patients really loved it one patient yesterday said they really felt the extra water coming down of the eye so they they loved it for sure but i haven’t had the wow yet for my patients okay

So here are the side effects that you can have uh five greater than five percent had cough throat irritation and irritation of the nose the cough was 16 throat irritation 13 percent and the nose irritation eight percent so that’s basically the the concern with this and let me just show you how this works you just basically take off the safety cap here you use

That this little knob there take off the blue top pump it up a few times it’ll come out eventually and then you stick it in your nose each nostril twice a day is what it’s recommended i suspect many patients will get similar relief by one nose once a day i think there is a component of the tears increasing from the lacrimal gland the oil component that’s what

I’m just not i don’t have any good studies to say that really that it’s going to help save the meibomian glands so i’m not negative against this i am prescribing this i’m just not clear on how it’s going to really help in terms of long-term health for the meibomian glands so that’s my take on that i hope this was helpful to you please pass us on and if you have

Any questions please continue to contact the office at visionary eye doctors thank you

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Dr. Cremers Reviews Tyrvaya Dry-Eye Nasal Spray – The Eye Show By VisionaryEyeDoctors