Lastacaft 0.25% Eye Drops
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Indications & Clinical Uses
- Lastacaft 0.25% eye drops contain alcaftadine, an antihistamine that blocks H1 receptors and also stabilises mast cells on the surface of the eye.
- In the United States Lastacaft is now sold over the counter as an eye allergy itch reliever that temporarily relieves itchy eyes due to pollen, ragweed, grass, animal hair and dander; the earlier prescription label describes the same product for the prevention of itching associated with allergic conjunctivitis.
- It is for adults and children aged 2 years and over, and a healthcare provider should be asked before using it in a younger child.
- One drop in each affected eye once daily gives cover for the whole day, and it works best when started before or at the beginning of the allergy season rather than only once the eye is already sore.
- The labeller is Allergan, an AbbVie company.
Side Effects
- Lastacaft is generally well tolerated and there is no boxed warning.
- The prescription label reported that the most common eye reactions each occurred in fewer than 4% of treated eyes: brief stinging or burning as the drop goes in, eye irritation, redness and itching.
- Some people notice a runny nose, a mild headache or an unpleasant taste at the back of the throat.
- Vision may blur for a moment, so wait until it clears before driving.
- Stop the drops and speak to a healthcare provider if you develop eye pain, any change in vision, increasing redness of the eye, or if the itching lasts more than 72 hours.
- Swelling of the eyelids, a rash or difficulty breathing suggests an allergic reaction and needs urgent attention.
- Never let the dropper tip touch your eye, eyelid or any surface, as this contaminates the bottle.
Precautions & Warnings
- Do not use Lastacaft to treat irritation caused by contact lenses.
- Remove contact lenses before putting the drop in, because the benzalkonium chloride preservative can be absorbed by soft lenses, and wait at least 10 minutes before putting the lenses back; do not wear lenses while the eye is red.
- If you use other eye medicines, leave at least 5 minutes between them.
- Lastacaft is for use in the eye only and must never be injected or swallowed.
- Safety and effectiveness below 2 years of age have not been established.
- Tell your healthcare provider if you are pregnant or breastfeeding, as data in pregnancy are limited.
- Replace the cap tightly after each use and keep the bottle out of the reach of children.
- The label directs storage at 15 to 25 degrees Celsius, which is cooler than the range given on the product sheet.
Avoid Interactions
- No significant systemic drug interactions are listed for alcaftadine, because very little of the drop is absorbed into the bloodstream from the surface of the eye.
- The practical issues are with other things put in the eye: if you use another eye drop or an eye ointment, leave at least 5 minutes between them so that neither washes the other out, and put ointments in last.
- Soft contact lenses must be out of the eye when the drop goes in and should stay out for at least 10 minutes, because the preservative is taken up by the lens material.
- Avoid prolonged use of redness-removing vasoconstrictor drops alongside Lastacaft, as these can cause rebound redness.
- Tell your healthcare provider about all the medicines you use, including other allergy treatments and any prescribed eye drops.
References
Frequently Asked Questions
Lastacaft (alcaftadine) 0.25% eye drops relieve itchy eyes caused by allergy to pollen, ragweed, grass, animal hair and dander. They are now sold over the counter in the United States for adults and children aged 2 and over, and work by blocking histamine in the eye.
Put one drop of Lastacaft (alcaftadine) in each affected eye once daily; a single dose lasts the whole day. Wash your hands first, tilt your head back, and do not touch the dropper tip to your eye. Leave at least 5 minutes between Lastacaft and any other eye drop.
Brief stinging or burning, eye irritation, redness and itching are the most common side effects of Lastacaft (alcaftadine), each reported in fewer than 4% of treated eyes. A runny nose or mild headache can occur. Stop and seek advice for eye pain, vision changes or worsening redness.
Remove contact lenses before using Lastacaft (alcaftadine) and wait at least 10 minutes before putting them back, because the benzalkonium chloride preservative is absorbed by soft lenses. Do not use Lastacaft for irritation caused by contact lenses, and do not wear lenses while your eye is red.
Store Lastacaft (alcaftadine) eye drops at 15°C to 25°C with the cap tightly closed, out of the reach of children. Keep the dropper tip from touching your eye or any surface, as this contaminates the solution. Do not use the drops after the expiry date on the bottle.
Children aged 2 years and over can use Lastacaft (alcaftadine) at the same dose as adults: one drop in each affected eye once daily. For children under 2, ask a healthcare provider first, because safety and effectiveness in that age group have not been established.

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