Tyrvaya (Varenicline) – Nasal: Uses, Side Effects, Dosages

What is Tyrvaya?

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

Medication Facts

Generic name: Varenicline

brand names): Tyrvaia

Availability of drugs: Arrangement

Therapeutic classification: Cholinergic agonist

Available generically: Nope

Controlled substance: N / A

Administrative route: intranasal

active ingredient: Varenicline

Dosage form(s): Nasal spray

What is Tyrvaya for?

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

How to use Tyrvaya

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

  • Before your first use, blow your nose to clear your nostrils if necessary.
  • Prime the pump by pressing it seven times, away from your face in the air. Don’t shake.
  • Tilt your head back without lying down.
  • Insert the applicator into your nostril with the tip pointing up towards your ear. Leave space between the applicator tip and the nasal wall.
  • Place your tongue on the roof of your mouth. Inhale gently while pressing the pump to release the spray. Spraying directly on your septum (the area between your nostrils) is not advised.
  • After each use, wipe the applicator with a clean cloth or tissue.
  • Replace the cap once you have finished 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).

To note: One month supply is two bottles. Do not open both vials at the same time. Finish using your first vial before opening the second.


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

Keep your medications out of reach of children and pets, preferably locked up.

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 health care provider.

What are the side effects of Tyrvaya?

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

Common side effects

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

  • Cough
  • To sneeze
  • Nose or throat irritation

Serious side effects

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

Serious side effects include signs of an allergic reaction such as:

  • Eruption
  • Itching
  • Wheezing
  • Unusual hoarseness
  • Cheating or choking
  • Swelling of the throat, lips, 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 medicine.

If you experience a serious side effect, you or your healthcare provider can report it to the FDA’s MedWatch adverse event reporting program or by phone (800-332-1088).

Dosage: How much Tyrvaya should I take?

Contents of the drug supplied and reviewed by

IBM Micromedex®

The dose of this drug will be different for different patients. Follow your doctor’s orders or label directions. 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.

The amount of medicine you take depends on the strength of the medicine. Also, the number of doses you take each day, the time between doses, and how long you take the medicine depends on the medical condition for which you are using the medicine.

  • For nasal dosage form (spray):

    • For the treatment of signs and symptoms of dry eye:

      • 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 should 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 maternal weight gain during pregnancy. We don’t know enough about the safety and effectiveness of Tyrvaya in pregnant women and their unborn fetuses. Talk to your health care provider if you are or plan to become pregnant, and 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 is not known whether Tyrvaya is present in breast milk in humans. If you plan to breastfeed, talk to your healthcare provider to weigh the benefits and risks of taking Tyrvaya while breastfeeding and the different ways available to feed your baby.

Adults over 65: There were no overall differences in safety or effectiveness between older and younger adults.

Children: There are no data on the safety and effectiveness of this medicine in children.

Missed dose

If you accidentally forget your dose of Tyrvaya, skip the missed dose and go back to your regular schedule. Do not double your dose or use additional sprays.

Try to find ways to remind yourself to take your medication regularly. If you miss too many doses, Tyvaya may be less effective in treating dry eyes.

Overdose: what happens if I use too much Tyrvaya?

There is limited information available on Tyrvaya overdose.

However, if you think you have an overdose or life-threatening symptoms, seek medical attention immediately.

What happens if I overdose on Tyrvaya?

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

If someone collapses or is not breathing after taking Tyrvaya, call 911 immediately.


Contents of the drug supplied and reviewed by

IBM Micromedex®

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

What are the reasons why I should not use Tyrvaya?

If you are allergic to Tyrvaya or any of its ingredients, avoid using it.

What other medicines interact with Tyrvaya?

There are no known significant interactions for Tyrvaya. However, talk to your health care provider before starting any new medication (including over-the-counter medications).

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

Which drugs are similar?

Other medicines similar to Tyrvaya used to treat dry eye include:

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

Frequently Asked Questions

  • What Tyrvaya is used to treat?

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

  • What are the common side effects of Tyrvaya?

    Some common side effects include:

    • Cough
    • To sneeze
    • Itchy nose

  • Where should I store Tyrvaya?

    Store Tyrvaya at room temperature, away from children and pets.

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

    Skip the missed dose. Resume your usual dosing schedule. Do not take extra doses or use extra 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:

  • Cigarette smoke
  • Hot and dry air
  • Air conditioner

Discuss the use of a humidifier in your room and the use of protective eyewear with your healthcare provider. And let your health care provider know if your medicine isn’t working well for you or if your dry eye gets worse.

Medical Disclaimer

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

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