Upneeq: the new eyedrop for droopy eyelids

While it may sound like science fiction, the FDA-approved eye lifting drop is real: UPNEEQ® is a prescription eye drop that temporarily improves droopy eyelids, or ptosis, with a single daily dose. While you won’t get the more dramatic results you can expect from eyelid lift surgery, patients see an average of about 1 mm of lift in their upper eyelid after the first use—just enough to make a noticeable difference. For cosmetic surgeons, this first-of-its-kind non-surgical treatment for eyelid ptosis creates an option that many patients will benefit from, including those not ready for eyelid surgery or who are suffering from low-lying eyelids due to BOTOX® injections. Below, we answer your top questions about Upneeq.

The medical name for droopy eyelids is blepharoptosis (blepharo = eyelid, ptosis = sagging). Eyelids that droop may lead you to appear tired, and your eyes may look smaller than they normally are. It can also interfere with the function of your eyes. Droopy eyelids have numerous possible causes, including aging, genetics, eye surgery, certain underlying medical conditions, or even Botox that inadvertently travels to the eyelid muscles after injection in the forehead.

Many patients seek eyelid lift surgery to treat cases of droopy eyelids, whether for cosmetic or medical reasons. Upneeq is a revolutionary second option: it is the first treatment specifically approved by the FDA to treat acquired droopy eyelids.

Upneeq (oxymetazoline hydrochloride ophthalmic solution), 0.1% is an eye drop that should be inserted once a day, one drop per eye. Upneeq contains oxymetazoline, an alpha adrenergic agonist that triggers the levator palpebrae muscle (Muller’s or Mueller’s muscle), causing the muscle to contract and raise the upper eyelid. Upneeq works by stimulating an involuntary eyelid muscle, the Muller’s muscle, to contract. In clinical studies, the average amount of upper eyelid lift was 1 mm. While this minor lift will not give you the dramatic results possible with surgery, this small lift can be cosmetically and/or medically beneficial to many patients.

Each dose (one drop daily) of Upneeq was shown to be effective for at least 6 hours in clinical studies.

Yes, Upneeq is FDA-approved to be both safe and effective for the treatment of acquired eyelid ptosis in adults. To gain FDA approval, Upneeq showed effectiveness in two 6-week trials that followed 304 patients with acquired blepharoptosis. A third study was also conducted to establish that the eye drop is safe. The main ingredient in Upneeq, oxymetazoline hydrochloride, is the same primary ingredient in decongestant nasal spray, such as Afrin®. In nasal spray, the ingredient works by stimulating the blood vessels to contract, while in Upneeq, this ingredient works to stimulate eyelid muscle contraction.

In clinical trials, a range of side effects were observed in 1-5% of patients and included eye inflammation or irritation, redness, dry eye, blurred vision, headache, redness in the lining inside and at the front of the eye (conjunctival hyperemia), and inflammation of the cornea (punctate keratitis). Eye pain is also possible around the time that Upneeq drops are used.

Upneeq should only be used as prescribed: one dose, once daily. Work with your doctor to decide how long it is appropriate for you to use Upneeq, and follow their recommendations.

Yes, you can likely use Upneeq with other eye drops. After using Upneeq, wait 15 minutes before using any other eye drops (or inserting contact lenses). Be sure to talk to your doctor about all of the prescription and over the counter medications and eye drops you use in your consultation to ensure that they are safe to use with Upneeq.

If you have mild, moderate, or severe eyelid ptosis (upper eyelid sagging), and you are not taking any medications that will interfere with Upneeq, then you may be a good candidate for the eye-lifting drop. Disclose all of your medications and supplements, as well as your medical history, with your board certified cosmetic surgeon or ophthalmologist in order to determine if you are a good candidate. Upneeq may affect blood pressure and amine metabolism, and therefore may interfere with certain prescription medications, including:

Upneeq helps those with acquired droopy eyelids that develop over time, and is ideal for temporary use—but it can only achieve mild improvement of ptosis. As such, Upneeq is not a substitute for eyelid lift surgery (blepharoplasty), which offers results that are lasting and can treat both genetic and acquired droopy eyelids. Upneeq can be considered a helpful but temporary alternative to surgery for those who are not prepared to have a surgical eyelid lift.

Upneeq costs $105 for a 30-day supply.