What Is Upneeq?

Upneeq (Oxymetazoline Hydrochloride Ophthalmic Solution, 0.1%) is a prescription eye drop approved by the FDA for the treatment of acquired blepharoptosis — commonly known as drooping upper eyelid — in adults. It is the first and only FDA-approved eye drop specifically designed to lift drooping eyelids without surgery.

Upneeq is manufactured by RVL Pharmaceuticals, Inc. and is used once daily. It is also commonly prescribed off-label for cosmetic eyelid lifting and for patients whose low-lying lids cause visual field obstruction.

How does Upneeq work?

Upneeq contains Oxymetazoline, a direct-acting alpha-adrenergic receptor agonist. When applied as an eye drop, it stimulates alpha-1 and alpha-2 receptors in Müller's muscle — the smooth muscle responsible for elevating the upper eyelid. By activating this muscle, Upneeq causes it to contract, physically lifting the drooping eyelid and creating a more open, alert appearance.

The effect typically begins within minutes and can last throughout the day. One drop is instilled into the affected eye(s) once daily. Contact lenses should be removed before application and can be reinserted after 15 minutes.

What doses are available for Upneeq?

• Oxymetazoline HCl 0.1% ophthalmic solution — supplied in single patient-use containers (0.3 mL each), packaged in cartons of 30 individual child-resistant foil pouches (one month supply)

There is only one strength available. No generic version of Upneeq exists as of 2026.

How hard is it to find Upneeq in stock?

Upneeq scores a 55 out of 100 on our findability scale, meaning it can be moderately difficult to locate. While there is no active FDA shortage, Upneeq is a specialty medication distributed primarily through select pharmacies, aesthetic clinics, and authorized telehealth providers rather than traditional retail pharmacies like CVS or Walgreens. This limited distribution model means your local pharmacy may not stock it or even be able to order it easily.

If you're having trouble finding Upneeq, try searching on Medfinder to check availability near you, or ask your prescriber about ordering directly through the Upneeq website or an authorized specialty pharmacy.

Who Can Prescribe Upneeq?

Upneeq is most commonly prescribed by:

• Ophthalmologists — eye specialists who diagnose and treat ptosis
• Optometrists — eye care providers who can prescribe eye medications
• Oculoplastic surgeons — specialists in eyelid and orbital surgery
• Dermatologists and aesthetic medicine providers — who may prescribe it for cosmetic eyelid enhancement
• Primary care physicians — less commonly, but can prescribe if comfortable with the indication

Upneeq is also available through telehealth providers, making it accessible without an in-person visit in many cases.

Is Upneeq a controlled substance?

No, Upneeq is not a controlled substance. It is not scheduled by the DEA and does not carry a risk of abuse or dependence. However, it is still a prescription medication and cannot be purchased over the counter.

Common Side Effects of Upneeq

• Punctate keratitis (1–5%)
• Conjunctival hyperemia / eye redness (1–5%)
• Dry eye (1–5%)
• Blurred vision (1–5%)
• Instillation site pain (1–5%)
• Eye irritation (1–5%)
• Headache (1–5%)

Serious but rare side effects include allergic reactions, ongoing or worsening eye redness, eye pain, changes in vision, fast or irregular heartbeats, sudden dizziness, and potential acute angle closure glaucoma. Seek medical attention immediately if you experience any of these.

Alternative Medications to Upneeq

• Phenylephrine ophthalmic drops — another alpha-adrenergic agonist sometimes used off-label for ptosis; available as a lower-cost OTC eye drop but not FDA-approved for blepharoptosis
• Brimonidine ophthalmic (Alphagan P) — an alpha-2 agonist eye drop used for glaucoma that has been used off-label for mild eyelid lift effects
• Surgical ptosis repair (blepharoplasty) — a more permanent but invasive solution, often covered by insurance when ptosis affects vision
• Eyelid crutches / ptosis crutches — mechanical devices attached to eyeglass frames that hold the eyelid open, a non-pharmacologic alternative

Drug Interactions with Upneeq

• Beta-blockers — may impact blood pressure when used with Upneeq
• Anti-hypertensives — additive blood pressure-lowering effects
• Cardiac glycosides (e.g., Digoxin) — potential cardiovascular interactions
• MAOIs (Monoamine oxidase inhibitors) — affect metabolism of circulating amines
• Alpha-adrenergic antagonists (e.g., Tamsulosin) — may reduce effectiveness
• Tricyclic antidepressants — moderate interaction potential
• Other ophthalmic vasoconstrictors — may have additive effects

Always inform your doctor about all medications you are taking, including over-the-counter and herbal products.

Final Thoughts on Upneeq

Upneeq is a groundbreaking treatment option for adults with acquired blepharoptosis, offering a non-surgical way to lift drooping eyelids with just one daily eye drop. While it can be challenging to find due to its specialty distribution model — scoring a 55 on our findability scale — it is not in shortage and can typically be obtained through specialty pharmacies, aesthetic clinics, or telehealth providers.

The biggest barrier for most patients is cost: at $225–$350 per month without insurance and limited coverage from many plans, the price can be significant. However, the manufacturer coupon from RVL Pharmaceuticals may bring the cost to $0 for eligible commercially insured patients. If you're struggling to find Upneeq in stock, Medfinder can help you locate it near you quickly.