Xdemvy Drug Information

Generic name: LOTILANER OPHTHALMIC SOLUTION

Ectoparasiticide [EPC]

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Uses of Xdemvy

is indicated for the treatment of Demodex blepharitis. XDEMVY is an ectoparasiticide (anti-parasitic) indicated for the treatment of Demodex blepharitis.

Dosage & Administration of Xdemvy

Instill one drop of XDEMVY in each eye twice daily (approximately 12 hours apart) for 6 weeks. If more than one topical ophthalmic drug is being used, the drugs should be administered at least five minutes apart. If one dose is missed, treatment should continue with the next scheduled dose.

Instill one drop of XDEMVY in each eye twice daily (approximately 12 hours apart) for 6 weeks.

Side Effects of Xdemvy

Clinical Trials Experience

Because clinical studies are conducted under widely varying conditions, adverse reaction rates observed in the clinical trials of a drug cannot be directly compared to rates in the clinical trials of another drug and may not reflect the rates observed in practice. XDEMVY was evaluated in 833 patients with Demodex blepharitis in two randomized, double-masked, vehicle-controlled studies (Saturn-1 and Saturn-2) with 42 days of treatment. The most common ocular adverse reaction observed in controlled clinical studies with XDEMVY was instillation site stinging and burning which was reported in 10% of patients.

Other ocular adverse reactions reported in less than 2% of patients were chalazion/hordeolum and punctate keratitis.

Warnings & Cautions for Xdemvy

Risk of Contamination Do not allow the tip of the dispensing container

to contact the eye, surrounding structures, fingers, or any other surface in order to minimize contamination of the solution. Serious damage to the eye and subsequent loss of vision may result from using contaminated solutions.

Use with Contact Lenses Contact lenses should be removed prior to instillation

of XDEMVY and may be reinserted 15 minutes following its administration.

Pregnancy Safety for Xdemvy

Pregnancy Risk Summary There are no available data on XDEMVY use in pregnant women to inform any drug associated risk; however, systemic exposure to lotilaner from ocular administration is low . In animal reproduction studies, lotilaner did not produce malformations at clinically relevant doses. Data Animal Data In an oral embryofetal developmental study in pregnant rats dosed during organogenesis from gestation days 6-19, increased post-implantation loss, reduced fetal pup weight, and incomplete skeletal ossification were observed at 50 mg/kg/day (approximately 1390 times the recommended human ophthalmic dose (RHOD) on a body surface area basis) in the presence of maternal toxicity (i.e., decreased body weight and food consumption). A rare malformation of situs inversus of the thoracic and abdominal viscera occurred in 1 fetus from a pregnant rat receiving 50 mg/kg/day; whether this finding was treatment-related could not be excluded. No maternal or embryofetal toxicity was observed at 18 mg/kg/day (approximately 501 times the RHOD on a body surface area basis). In an oral embryofetal development study in pregnant rabbits dosed during organogenesis from gestation days 7-19, no embryofetal toxicity or teratogenic findings were observed at 20 mg/kg/day (approximately 580-times the RHOD on an AUC basis), even in the presence of maternal toxicity (i.e., decreased food consumption and body weight). In an oral two-generation reproductive toxicity study, F0 male and female rats were administered lotilaner at doses up to 40 mg/kg/day for 10 weeks before pairing and during the 2-week pairing period (3 weeks for males). Dosing for F0 females continued through lactation day 22. F1 male and female rats were administered lotilaner at 1 and 5 mg/kg/day post-weaning from day 23 for 10 weeks before pairing and during the 2-week pairing period (3 weeks for males). Dosing for F1 parenteral females continued through lactation day 22. There were no clear adverse effects on the F1 generation, and a slightly lower mean body weight during lactation was noted for F2 pups at 5 mg/kg/day.

The no observed adverse effect level (NOAEL) was determined to be 5 mg/kg/day (approximately 139 times the RHOD on a body surface area basis).

Pediatric Use of Xdemvy

Pediatric Use Safety and effectiveness in pediatric patients below the age of 18 years have not been established.

Clinical Studies of Xdemvy

The safety and efficacy of XDEMVY for the treatment of Demodex blepharitis was evaluated in a total of 833 patients (415 of which received XDEMVY) in two 6-week, randomized, multicenter, double-masked, vehicle-controlled studies (Saturn-1 and Saturn-2). Patients with Demodex blepharitis were randomized to either XDEMVY or Vehicle at a 1:1 ratio dosed twice daily in each eye. Efficacy was demonstrated by improvement in lids (reduction of collarettes to no more than 2 collarettes per upper lid) in each study (Saturn-1 and Saturn-2) (see Figure 1 and Figure 2 ) by Day 43. Figure 1. Saturn-1: Proportion of patients with 2 or less collarettes for the upper eyelid *Day 43 Primary Endpoint; XDEMVY N=209, Vehicle N=204, p-value <0.01 Figure 2. Saturn-2: Proportion of patients with 2 or less collarettes for the upper eyelid *Day 43 Primary Endpoint; XDEMVY N=193, Vehicle N=200, p-value <0.01 The endpoints of mite eradication (mite density of 0 mites/lash) and erythema cure (Grade 0) of XDEMVY vs. Vehicle demonstrated statistically significant improvement at Day 43 across both Saturn-1 (Table 1) and Saturn-2 (Table 2) studies.

Table 1: Proportion of patients with eradication of Demodex mites and erythema cure in the analysis eye at Day 43 in Saturn-1 XDEMVY (N=212) Vehicle (N=209) p-value Mite Eradication 68% 17% < 0.01 Erythema Cure 19% 7% < 0.01 Table 2: Proportion of patients with eradication of Demodex mites and erythema cure in the analysis eye at Day 43 in Saturn-2 XDEMVY (N=203) Vehicle (N=209) p-value Mite Eradication 50% 14% < 0.01 Erythema Cure 30% 9% < 0.01 Figure 1 Figure 2

Drug information sourced from the FDA. This content is for informational purposes only and does not constitute medical advice. Consult a healthcare professional before making any medication decisions.

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