Could Your Medications Be Causing Dry Eye?

Dry eye disease affects millions of people and can make everyday activities like reading, driving,
or scrolling on your phone feel uncomfortable. While environmental factors like screen time,
allergies, and aging often get the blame, one common culprit is frequently overlooked: your
medications.

That’s right, some of the medications you take for completely unrelated health conditions may
be quietly contributing to your dry eye symptoms.

The good news? Once the cause is identified, there may be ways to improve your symptoms.
Let’s take a closer look at how certain medications can affect your tear production and what you
can do about it!

How Can Medications Cause Dry Eyes?

Your eyes rely on a healthy tear film to stay comfortable, clear, and protected. Some
medications can disrupt this delicate balance in a few different ways:

1. They can reduce tear production
   Certain medications interfere with the nerve signals that tell your lacrimal glands to make tears.
   Less tear production means the eyes dry out faster, leading to irritation, burning, and redness.
2. They can affect the oil glands in your eyelids
   The meibomian glands produce the oily layer of your tears, which helps prevent tears from
   evaporating too quickly. Some medications can disrupt these glands, causing tears to evaporate
   faster than normal.
3. They can irritate the ocular surface
   Some medications may trigger inflammation or toxicity on the surface of the eye, making the
   eyes feel dry, sensitive, and uncomfortable.
4. They can alter hormone balance
   Hormones play an important role in maintaining tear production. Medications that affect
   hormone levels can sometimes throw this system off balance, contributing to dryness.

Common Medications That May Cause Dry Eyes

Here are some common categories of medications that are known to contribute to dry eye
symptoms:

Cardiovascular Medications

Some blood pressure and heart medications may reduce tear production, including:

• Propranolol
• Furosemide (Lasix)

Antidepressants

Many antidepressants have drying side effects due to their effect on the nervous system:

• Amitriptyline (Elavil)
• Venlafaxine (Effexor)
• Duloxetine (Cymbalta)
• Bupropion (Wellbutrin)

Anti-Anxiety Medications

These medications may also contribute to ocular dryness:

• Escitalopram (Lexapro)
• Sertraline (Zoloft)
• Buspirone

Antihistamines

If you take allergy medications, they may dry out more than just your sinuses:

• Cetirizine (Zyrtec)
• Loratadine (Claritin)
• Fexofenadine (Allegra)
• Diphenhydramine (Benadryl)

Acne Medication

This medication is well known for reducing activity of oil glands around the body, including the oil
glands in your eyelids thus can lead to meibomian gland dysfunction

• Isotretinoin (Accutane)

Chemotherapy Agents

Several chemotherapy medications can affect tear production and cause toxicity to the ocular
surface, including:

• Paclitaxel (Taxol)
• Docetaxel (Taxotere)
• Methotrexate
• 5-fluorouracil
• Anastrozole (Arimidex)

Hormonal Medications

Hormonal changes can significantly impact tear production:

• Oral contraceptives
• Hormone replacement therapy
• Anti-androgen therapy

Why Older Adults May Be More at Risk

As we age, it becomes more common to take multiple medications for different health
conditions. This is known as polypharmacy, and it can increase the risk of medication-induced
dry eye.
Even if one medication causes only mild dryness, taking several medications with similar side
effects can have a cumulative effect making symptoms much more noticeable over time.

Is Medication-Induced Dry Eye Reversible?

In some cases, yes.
If a medication is contributing to dry eye symptoms, adjusting or switching that medication may
improve tear production and reduce inflammation. However, it’s important never to stop or
change a medication without first speaking to the prescribing doctor.
The key is recognizing the connection early so that your healthcare providers can work together
to find the best solution for both your overall health and your eye comfort.

What Should You Do If You Think Your Medication Is
Causing Dry Eyes?

If your eyes have been feeling dry, irritated, or gritty and you’re taking any of the medications
listed above, here are a few steps to take:

1. Talk to your healthcare provider about your symptoms
2. Review your medication list to identify possible contributors
3. Ask whether alternative medications are available
4. Schedule an eye exam if symptoms continue

An eye care professional can help determine whether your symptoms are medication-related
and recommend treatments to improve your comfort.

Final Thoughts

Dry eye disease can have many causes, but medications are an often-overlooked factor. Being
aware of which medications may contribute to dryness can lead to earlier intervention, better
symptom relief, and improved quality of life.
If you’ve been struggling with dry, irritated eyes, it may be worth taking a closer look at your
medication list. A simple conversation with your doctor or eye care provider could make a big
difference.

References

1. Dry Eye.The New England Journal of Medicine. 2018. Clayton JA.
2. Drug-Induced Periocular and Ocular Surface Disorders: An EAACI Position Paper. Allergy. 2025. Leonardi A, Bozkurt B, Silva D, et al.
3. Association Between Systemic Medication Use and Severity of Dry Eye Signs and Symptoms in the DRy Eye Assessment and Management (DREAM) Study. The Ocular Surface. 2024. Guo M, Diaz GM, YuY, et al.
4. A Review on Drug-Induced Dry Eye Disease.Indian Journal of Ophthalmology. 2023. Kam KW, Di Zazzo A, De Gregorio C, et al.

– Lucy Ton, OD