I’m not aware of quality control for medications outside the US, so I don’t feel comfortable going that route.

I use Systane nighttime ointment and during the day Systane Hydrating drops as needed. But these are only bandaids on the problem. My understanding is that some of the prescription meds actually work in other ways. Restasis works as an immunotherapy treatment and Miebo works to prevent tear evaporation. I couldn’t take Restasis due to burning and it didn’t seem to help either. I think I tried another one too that didn’t work. Punctual plugs have helped and I may try plasma serum drops, but they are expensive too.