Xdemvy (lotilaner 0.25% ophthalmic) is an anti-parasitic eye drop solution that may be used to treat Demodex blepharitis in adults 18 years of age and older.

Demodex blepharitis is a disease caused by an infestation of the eyelashes and eyelash follicles by Demodex mites, the most common ectoparasite found in humans. It is reasonably common, accounting for 45% of blepharitis cases overall, and 84% in people aged 60 and older. Symptoms of Demodex blepharitis include eyelid margin inflammation, redness, and ocular irritation, and it commonly occurs with rosacea or conditions such as diabetes.

Xdemvy works by inhibiting the gamma-aminobutyric acid (GABA)-gated chloride channels in the Demodex mites to cause paralysis in the mite and its death, and relief of eyelid redness and crusting. Lotilaner does not inhibit GABA-mediated chloride channels in humans at 1100 times the recommended human dose.

Xdemvy was FDA-approved on July 25, 2023.

There are no contraindications to the use of Xdemvy.

When instilling the eye drops, do not touch the tip with your fingers or allow the tip of the dispensing container to contact the eye, eyelids, face, or any other surface to minimize contamination of the solution. Serious damage to the eye and subsequent loss of vision may result from using contaminated eyedrop solutions.

Xdemvy is administered by instilling one drop in each eye twice daily (approximately 12 hours apart) for 6 weeks.

Xdemvy is administered by instilling one drop in each eye twice daily (approximately 12 hours apart) for 6 weeks.

Safety and effectiveness in children and young adults under the age of 18 has not been established.

There is no data regarding the use of Xdemvy in pregnant women, but systemic exposure to lotilaner from ocular administration is low and no malformations were reported in animal reproduction studies.

There is no data on the presence of lotilaner in human milk, the effects on the breastfed infant, or milk production; however, systemic exposure to lotilaner from ocular administration is low. Consider the benefits of breastfeeding along with the mother’s need for Xdemvy.

If you miss a dose, just continue treatment with the next dose. Do not double up on doses.