Xdemvy (Lotilaner) is the first FDA-approved eye drop for Demodex blepharitis. Learn about its uses, dosage, cost, and everything patients need to know in 2026.
Xdemvy (Lotilaner ophthalmic solution 0.25%) is a prescription eye drop and the first — and currently only — FDA-approved treatment specifically designed to treat Demodex blepharitis, a common eyelid condition caused by Demodex mites.
If your eye doctor has mentioned Xdemvy, or you've been searching for answers about your itchy, crusty eyelids, this guide covers everything you need to know: what the medication is, how it's used, what it costs, and how to access it in 2026.
Here are the key facts:
Xdemvy comes as an ophthalmic solution (eye drops) in 5 mL and 10 mL bottles. It works by killing Demodex mites that infest the eyelid area — the root cause of Demodex blepharitis.
Xdemvy is approved for treating Demodex blepharitis. This is a form of eyelid inflammation caused by an overgrowth of tiny Demodex mites (primarily Demodex folliculorum) that live in and around the hair follicles of your eyelashes.
Symptoms of Demodex blepharitis include:
Demodex blepharitis is more common than many people realize — it's estimated to affect millions of Americans, though it's often underdiagnosed or misdiagnosed as general blepharitis or dry eye.
Some eye care providers may also use Xdemvy off-label for meibomian gland dysfunction (MGD) associated with Demodex lid infestation, sometimes called Demodex-induced meibomianitis. This is when the mites cause blockage or dysfunction of the oil glands in your eyelids.
The dosing instructions for Xdemvy are straightforward:
According to the prescribing information, Xdemvy has no listed contraindications — meaning there are no specific conditions that completely prevent someone from using it. However, you should always discuss your full medical history with your eye doctor before starting treatment.
Cost is one of the biggest concerns patients have about Xdemvy. Here's what you need to know:
Insurance coverage for Xdemvy has improved significantly:
For a complete breakdown of all savings options, see our guide on how to save money on Xdemvy.
Xdemvy is a limited distribution drug, so you won't find it at your regular retail pharmacy. It's dispensed through select specialty pharmacies, including CVS Specialty and Walgreens Specialty, often with home delivery.
Your eye doctor's office will typically help coordinate sending your prescription to the appropriate specialty pharmacy. For help finding Xdemvy, visit Medfinder or check out our guide on how to check if a pharmacy has Xdemvy in stock.
Xdemvy represents a major breakthrough for people suffering from Demodex blepharitis. Before its approval, patients had to rely on off-label remedies like tea tree oil scrubs or oral Ivermectin — treatments that were often inconvenient, less effective, or not specifically designed for the condition.
If you've been dealing with persistent, crusty, itchy eyelids that don't respond to standard treatments, talk to your eye doctor about whether Demodex blepharitis could be the cause and whether Xdemvy is right for you.
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