Tyrvaya (Varenicline) - Nasal

What Is Tyrvaya?

Tyrvaya (varenicline) is a prescription nasal spray used to treat the signs and symptoms of dry eye disease in adults. It belongs to the drug class called cholinergic agonists. Varenicline works by strongly binding to specific receptors that activate a pathway within the nose, resulting in increased tear production.

Drug Facts

Generic Name: Varenicline

Brand Name(s): Tyrvaya

Drug Availability: Prescription

Therapeutic Classification: Cholinergic agonist

Available Generically: No

Controlled Substance: N/A

Administration Route: Intranasal

Active Ingredient: Varenicline

Dosage Form(s): Nasal spray

What Is Tyrvaya Used For?

Tyrvaya (varenicline) is used to treat dry eye disease, a condition that affects millions of people worldwide. Varenicline helps tear production once sprayed in the nostril. This nasal spray is approved for use in adults only.

Tyrvaya (Varenicline) Drug Information

Verywell / Zoe Hansen

How to Use Tyrvaya

Spray Tyrvaya into your nostrils only twice daily, as directed by your healthcare provider. Separate your doses by about 12 hours apart. Do not spray Tyrvaya into your mouth or eyes.

  • Before your first use, blow your nose to clear your nostrils if needed. 
  • Prime the pump by pressing it down seven times, away from your face into the air. Do not shake.
  • Tilt your head back without lying down. 
  • Insert the applicator into your nostril, aiming the tip toward the top of your ear. Leave room between the applicator tip and the nasal wall. 
  • Place your tongue on the roof of your mouth. Softly breathe in while pressing the pump to release the spray. Spraying directly at your septum (the area that separates your nostrils) is not advised. 
  • After each usage, wipe the applicator with a clean cloth or tissue. 
  • Put the cap back on once you are done taking your dose.

If you don't use your pump for more than five days, reprime your pump by spraying one spray into the air (away from your face).

Note: A month's supply is two bottles. Do not open both bottles at the same time. Finish using your first bottle before opening the second.


Store nasal spray at room temperature (68 to 77 degrees F). Do not freeze. Use within 30 days of opening. Discard any part not used after 30 days. Ask your pharmacist about the best ways to discard any unused medicine.

Keep your medications away from children and pets, preferably locked.

How Long Does Tyrvaya Take to Work?

Tyrvaya takes less than two hours to peak in your system. However, this time may vary from person to person. Check with your healthcare provider.

What are the Side Effects of Tyrvaya?

This is not a complete list of side effects and others may occur. A healthcare provider can advise you on side effects. If you experience other effects, contact your pharmacist or a healthcare provider. You may report side effects to the Food and Drug Administration (FDA) at fda.gov/medwatch or 800-FDA-1088.

Common Side Effects

Common side effects of Tyrvaya include but are not limited to:

  • Cough
  • Sneezing
  • Nose or throat irritation

Severe Side Effects

Tyrvaya can cause severe side effects in some people. The reactions may be life-threatening. Call your healthcare provider right away if you have serious side effects. Call 911 if your symptoms feel life-threatening or think you have a medical emergency.

Severe side effects include signs of allergic reaction like:

  • Rash
  • Itching
  • Wheezing
  • Unusual hoarseness
  • Cheat or throat tightness
  • Swelling of your throat, lip, mouth, tongue, or face
  • Red, swollen, blistered, or peeling skin with or without fever

Report Side Effects

Tyrvaya may cause other side effects. Call your healthcare provider if you have any unusual problems while taking this medication.

If you experience a serious side effect, you or your healthcare provider may send a report to the FDA's MedWatch Adverse Event Reporting Program or by phone (800-332-1088).

Dosage: How Much Tyrvaya Should I Take?

Drug Content Provided and Reviewed by IBM Micromedex®

The dose of this medicine will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.

  • For nasal dosage form (spray):
    • For treatment of the signs and symptoms of dry eye disease:
      • Adults—1 spray in each nostril 2 times a day (at least 12 hours apart). Each spray contains 0.03 milligrams (mg) of varenicline.
      • Children—Use and dose must be determined by your doctor.


The following should be kept in mind when using Tyrvaya:

Pregnancy: In animal studies, varenicline caused low fetal weight and reduced the mother's weight gain during pregnancy. We don't know enough about the safety and effectiveness of Tyrvaya in pregnant people and on their unborn fetus. Discuss with your healthcare provider if you are or plan to become pregnant, and to weigh the benefits and risks of taking Tyrvaya during your pregnancy.

Breastfeeding: In animal studies, rats given varenicline had varenicline in their milk. However, it's not known if Tyrvaya is present in breastmilk in humans. If you plan to breastfeed, talk with your healthcare provider to weigh the benefits and risks of taking Tyrvaya while nursing and the different ways available to feed your baby.

Adults over the age of 65 years: There were no general differences in safety or effectiveness between older and younger adults.

Children: There is no data on the safety and effectiveness of this drug in children.

Missed Dose

If you accidentally forgot your Tyrvaya dose, skip the missed dose and return to your regular time. Do not double your dose or use extra sprays.

Try to find ways to help yourself remember to routinely take your medication. If you miss too many doses, Tyvaya might be less effective in treating dry eyes.

Overdose: What Happens If I Use Too Much Tyrvaya?

There is limited information available about Tyrvaya overdose.

However, if you think that you're experiencing an overdose or life-threatening symptoms, seek immediate medical attention.

What Happens If I Overdose on Tyrvaya?

If you think you or someone else may have overdosed on Tyrvaya, call a healthcare provider or the Poison Control Center (800-222-1222).

If someone collapses or isn't breathing after taking Tyrvaya, call 911 immediately.


Drug Content Provided and Reviewed by IBM Micromedex®

It is very important that your eye doctor (ophthalmologist) check your progress at regular visits to make sure the medicine is working properly and to check for unwanted effects.

What Are Reasons I Shouldn’t Use Tyrvaya?

If you're allergic to Tyrvaya or any of ingredients, avoid using it.

What Other Medications Interact With Tyrvaya?

There are no known, significant interactions for Tyrvaya. However, speak to your healthcare provider before starting any new drugs (including over-the-counter medicines).

For more detailed information about medication interactions with Tyrvaya, talk with your pharmacist or healthcare provider.

What Medications Are Similar?

Other drugs similar to Tyrvaya used to treat dry eyes include:

This is a list of medications that are also used to treat dry eyes. It is NOT a list of medicines that should be taken with Tyrvaya. You should not take these medications together unless your healthcare provider instructs you to do so. If you have any questions, talk with your pharmacist or a healthcare provider.

Frequently Asked Questions

  • What is Tyrvaya used to treat?

    Tyrvaya is used to treat symptoms of dry eyes in adults.

  • What are the common side effects of Tyrvaya?

    Some common side effects include:

    • Cough
    • Sneezing
    • Nose irritation
  • Where should I store Tyrvaya?

    Store Tyrvaya at room temperature away from children and pets.

  • What should I do if I miss my dose of Tyrvaya?

    Skip the missed dose. Return to your usual dosing schedule. Do not take extra doses or use additional sprays.

How Can I Stay Healthy While Taking Tyrvaya?

Dry eye can be a chronic, lifelong condition. Avoid the following aggravating factors to help you stay healthy while living with dry eye disease:

  • Cigarette smoke
  • Dry, hot air
  • Air conditioning

Discuss using a humidifier in your bedroom and using protective eyewear with your healthcare provider. And do let your healthcare provider know if your medicine isn't working well for you, or if your dry eye gets worse.

Medical Disclaimer

Verywell Health's drug information is meant for educational purposes only and is not intended to replace medical advice, diagnosis, or treatment from a healthcare provider. Consult your healthcare provider before taking any new medication(s). IBM Watson Micromedex provides some of the drug content, as indicated on the page.

4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Food and Drug Administration. Tyrvaya label.

  2. Seen S, Tong L. Dry eye disease and oxidative stressActa Ophthalmol. 2018;96(4):e412-e420. doi:10.1111/aos.13526

  3. Quiroz-Mercado H, Hernandez-Quintela E, Chiu KH, Henry E, Nau JA. A phase II randomized trial to evaluate the long-term (12-week) efficacy and safety of OC-01 (varenicline solution) nasal spray for dry eye disease: The MYSTIC studyOcul Surf. 2021;24:15-21. doi:10.1016/j.jtos.2021.12.007

  4. Wirta D, Vollmer P, Paauw J, et al. Efficacy and safety of OC-01 (varenicline solution) nasal spray on signs and symptoms of dry eye disease: the ONSET-2 phase 3 randomized trialOphthalmology. 2022;129(4):379-387. doi:10.1016/j.ophtha.2021.11.004

By Queen Buyalos, PharmD
Queen Buyalos is a pharmacist and freelance medical writer. She takes pride in advocating for cancer prevention, overall health, and mental health education. Queen enjoys counseling and educating patients about drug therapy and translating complex ideas into simple language.